To explain cardiogenic shock to Mr. Payer, the most appropriate response would be

Correct Answer: C

Rationale: In this scenario, the most appropriate response to explain cardiogenic shock to Mr. Payer is option C: "Her heart right now is unable to pump enough blood and oxygen to her body tissues." This response is correct because it directly addresses the physiological aspect of cardiogenic shock, which is the heart's inability to effectively pump blood to meet the body's needs. By providing this explanation, Mr. Payer can better understand the root cause of the condition and its implications for his wife's health. Option A is incorrect because it lacks clarity and does not provide any information about the medical condition. Option B is incorrect as it is vague and does not specifically mention the insufficient pumping of blood by the heart. Option D is also incorrect as it is not relevant to the situation at hand and does not address Mr. Payer's need for information about cardiogenic shock. Educationally, this question serves to assess the learner's understanding of cardiogenic shock and their ability to communicate complex medical concepts in a clear and empathetic manner. By selecting the correct response, learners demonstrate their knowledge of cardiovascular physiology and their capacity to effectively communicate medical information to patients and their families.

Correct Answer: C

Rationale: In this scenario, option C is the correct choice because a pulse rate of 108 that is irregular upon awakening in the night could indicate a potential arrhythmia or other cardiac issue following mitral valve replacement. This warrants immediate medical attention to assess and manage any complications that may be arising post-surgery. Option A (60 while watching television) is within a normal range for resting heart rate, especially during a sedentary activity like watching television. Option B (84 after eating breakfast) is also within a normal range for postprandial heart rate elevation due to the digestive process. Option D (96 after taking a walk) is a reasonable heart rate response to physical activity and does not necessarily indicate a concerning issue. Educationally, this question reinforces the importance of patient education post-cardiac surgery, specifically in monitoring vital signs like pulse rate for early detection of complications. It highlights the need for patients to be vigilant about changes in their health status and to seek medical advice promptly when needed. Monitoring pulse rate can provide valuable insights into cardiovascular health and recovery progress.

Correct Answer: B

Rationale: The correct answer is B - Give Digibind as an antidote. This is the priority action because Digibind is the specific antidote for digoxin toxicity, effectively binding to digoxin and reversing its toxic effects. Checking a potassium level (A) may be important, but addressing the toxicity is the priority. Changing dosing (C) or giving potassium supplement (D) do not directly address the toxicity and may delay appropriate treatment.

Correct Answer: B

Rationale: The correct answer is B because non-cardio-selective beta blockers can inhibit glycogenolysis in the liver, leading to decreased production of glucose from glycogen. This can result in a drop in blood sugar levels. Choice A is incorrect because beta blockers do not increase breakdown of glycogen. Choice C is incorrect as beta blockers do impact blood sugar levels. Choice D is incorrect because beta blockers do not increase cellular uptake of glucose.

Correct Answer: D

Rationale: The correct answer is D: Class IV. Calcium channel blockers, such as verapamil and diltiazem, belong to Class IV anti-arrhythmic agents. These drugs work by blocking calcium channels in cardiac cells, leading to decreased conduction through the AV node and slowing of the heart rate. This is particularly effective in treating arrhythmias such as atrial fibrillation or supraventricular tachycardia. Choices A, B, and C are incorrect: A: Class IA agents (e.g., quinidine, procainamide) block sodium channels and have effects on potassium channels, not calcium channels. B: Class II agents (e.g., beta blockers) work by blocking beta-adrenergic receptors, not calcium channels. C: Class III agents (e.g., amiodarone, sotalol) primarily block potassium channels, not calcium channels, to prolong repolarization.