The patient has hypertension and just experienced an MI. Which type of medication would be expected to be added to decrease the workload on his heart?

Correct Answer: B

Rationale: In this scenario, the correct answer is B) β-adrenergic blocker. When a patient with hypertension experiences a myocardial infarction (MI), it is crucial to decrease the workload on the heart to prevent further damage and improve outcomes. β-adrenergic blockers, also known as beta-blockers, are indicated in this situation because they reduce the heart rate and myocardial contractility, thus decreasing the workload on the heart and oxygen demand. Option A) ACE inhibitor is primarily used in hypertension to lower blood pressure by inhibiting the angiotensin-converting enzyme. While it is beneficial in managing hypertension, it does not directly reduce the workload on the heart after an MI. Option C) Calcium channel blockers are used in various cardiovascular conditions, including hypertension, but they do not specifically target reducing the workload on the heart after an MI. Option D) Angiotensin II receptor blockers (ARBs) are also commonly used in hypertension management but may not directly reduce the workload on the heart post-MI. Educationally, understanding the rationale behind selecting the appropriate medication post-MI in a patient with hypertension is crucial for nursing and medical students. This knowledge helps in making informed decisions based on the pathophysiology and pharmacological actions of different drug classes. It also highlights the importance of individualized patient care and the impact of medication choices on clinical outcomes.

Correct Answer: C

Rationale: Cardiac markers and enzymes are crucial indicators used in diagnosing and monitoring various heart conditions. In this context, the correct answer is option C, which includes both Troponin and CK-MB as cardiac markers. Troponin is a highly specific marker for cardiac muscle injury and is considered the gold standard in diagnosing myocardial infarction. Elevated levels of Troponin in the blood indicate damage to the heart muscle, providing essential information for timely intervention and treatment. CK-MB, on the other hand, is an enzyme found predominantly in the heart muscle. An increase in CK-MB levels is also indicative of myocardial damage, particularly within the first 24 hours of a heart attack. It is often used in conjunction with Troponin for a comprehensive assessment of cardiac health. Option A (Troponin) alone is not sufficient as CK-MB adds complementary information. Option B (CK-MB) alone could be misleading without considering Troponin levels, as both markers together offer a more accurate picture of cardiac health. Understanding the significance of these cardiac markers and enzymes is essential for healthcare professionals, especially those working in cardiology, emergency medicine, or critical care settings. Mastery of these concepts ensures accurate diagnosis, appropriate treatment, and improved patient outcomes in cardiovascular care.

Correct Answer: B

Rationale: In the dietary management of essential hypertension, reducing caloric and sodium intake, as mentioned in option B, is crucial. High sodium intake can lead to fluid retention and increased blood pressure. Caloric reduction helps in weight management, which is important as obesity is a risk factor for hypertension. Moreover, a diet rich in fruits, vegetables, whole grains, and lean proteins can also positively impact blood pressure levels. Option A, increasing carbohydrate intake, is incorrect as high carbohydrate diets can lead to weight gain and insulin resistance, which can worsen hypertension. Option C, increasing protein intake, is not specifically recommended for managing hypertension unless there is a separate medical indication. Option D, reducing fluid intake, can be harmful as it may lead to dehydration and worsen blood pressure control. In an educational context, it is important for healthcare professionals to understand the impact of dietary choices on hypertension management. Teaching patients about the importance of a balanced diet, low in sodium and calories, can empower them to take control of their health. By explaining the rationale behind dietary recommendations, educators can help individuals make informed choices to support their cardiovascular health.

Correct Answer: D

Rationale: In this scenario, the correct answer is D) low cardiac output. Mrs. Payer's weakness after an acute myocardial infarction (MI) is primarily due to her heart's inability to pump effectively, leading to reduced cardiac output. This results in inadequate delivery of oxygen and nutrients to tissues, causing weakness and fatigue. Option A) emotional exhaustion is incorrect because although emotional stress can exacerbate heart conditions, weakness in this context is more directly related to cardiac function. Option B) not eating is incorrect as the weakness experienced by Mrs. Payer is not solely due to lack of food intake but rather a physiological consequence of her heart's compromised ability to pump blood effectively. Option C) elevated CO2 level is incorrect as weakness in acute MI is primarily related to decreased oxygen delivery rather than elevated CO2 levels. Educationally, understanding the relationship between cardiac output and symptoms like weakness in acute MI is crucial for healthcare professionals to provide appropriate care and interventions for patients. Recognizing the signs and symptoms of reduced cardiac output can help in prompt identification and management of complications post-MI.

Correct Answer: A

Rationale: In the context of resuming sexual activity after a myocardial infarction (MI), the correct answer is A) extent of the client's recovery. This is because the decision to resume sexual activity should be based on the individual's overall physical recovery, cardiac function, and any potential complications post-MI. Option B) length of time after the myocardial infarction is not the primary determinant for resuming sexual activity as it is more crucial to assess the client's recovery status and cardiac health. Option C) previous history of sexual difficulty may be a consideration, but the immediate focus should be on the current recovery status post-MI. Option D) client's age alone should not dictate the resumption of sexual activity; rather, it should be based on the individual's physical condition and recovery progress. Educationally, this question highlights the importance of considering a holistic approach to post-MI care, including addressing lifestyle factors like sexual activity. It underscores the need for healthcare providers to assess individual recovery and cardiac health status before making recommendations regarding resuming sexual activity, emphasizing patient-centered care and individualized decision-making.