What advice about sexual activity should the nurse give to a male patient who has had an MI?

Correct Answer: C

Rationale: In advising a male patient who has had a myocardial infarction (MI) about sexual activity, the nurse should recommend option C) Prophylactic nitroglycerin may be used if angina occurs. This is the correct answer because nitroglycerin is a vasodilator that helps to relax and widen blood vessels, increasing blood flow to the heart muscle. If the patient experiences angina, which can be triggered by physical exertion like sexual activity, nitroglycerin can help relieve chest pain by improving blood supply to the heart. Option A) The patient should use the superior position is incorrect because there is no evidence to support the superiority of this position in reducing the risk of complications during sexual activity after an MI. Option B) Foreplay may cause too great an increase in heart rate is incorrect as moderate physical activity, including foreplay, is generally considered safe for most patients with stable cardiovascular conditions. Option D) Performance can be enhanced with the use of sildenafil (Viagra) is also incorrect. While sildenafil is a medication commonly used to treat erectile dysfunction, it is not recommended for patients with recent myocardial infarction or those who are taking nitrates like nitroglycerin due to the risk of a dangerous drop in blood pressure. Educational context: It is crucial for healthcare providers to address sexual activity concerns with patients who have had a myocardial infarction. Providing accurate information and guidance can help alleviate anxiety and ensure the patient's safety. Educating patients about using nitroglycerin prophylactically if angina occurs during sexual activity empowers them to manage their condition effectively and engage in a healthy and satisfying sex life while prioritizing their cardiovascular health.

Correct Answer: D

Rationale: Rationale: The correct answer is D) improvement of symptoms. When evaluating a patient's response to anticoagulant therapy for arterial occlusion, the primary goal is to assess whether the treatment is effectively improving the patient's symptoms. Improvement of symptoms indicates that the therapy is successfully restoring blood flow to the affected area, reducing the risk of further complications such as tissue damage or ischemia. Option A) increased claudication is incorrect because it suggests a worsening of symptoms, which would indicate that the anticoagulant therapy is not effective. Claudication refers to pain and discomfort in the legs due to reduced blood flow, so an increase in claudication would be a negative outcome. Option B) decreased blood pressure is also incorrect as it is not directly related to evaluating the response to anticoagulant therapy for arterial occlusion. Blood pressure management is important in cardiovascular health, but in this context, improvement in symptoms is a more specific indicator of treatment effectiveness. Option C) compliance to skin care is irrelevant to the evaluation of anticoagulant therapy for arterial occlusion. Skin care may be important for wound healing or prevention of skin breakdown in patients with circulation issues, but it is not a primary consideration when assessing the response to anticoagulant therapy for arterial occlusion. Educational context: Understanding how to evaluate the response to anticoagulant therapy in patients with arterial occlusion is crucial for healthcare professionals managing cardiovascular conditions. By focusing on the improvement of symptoms, clinicians can determine the efficacy of treatment and make informed decisions to optimize patient care and outcomes. This rationale highlights the importance of clinical assessment and outcome monitoring in cardiovascular healthcare.

Correct Answer: B

Rationale: In this scenario, the correct answer is B) should be instructed in preventing hypotensive reactions. When a patient with essential hypertension complains of dizziness upon changing position, it could indicate orthostatic hypotension, a common side effect of antihypertensive medications. Providing education on preventing hypotensive reactions, such as rising slowly from sitting or lying down, increasing fluid intake, and monitoring blood pressure regularly, can help manage this issue. Option A) is probably not taking his medications properly is incorrect because assuming non-adherence without evidence can lead to incorrect conclusions and potentially harm the patient's trust in healthcare providers. Option C) is responding as expected to the prescribed medications is incorrect because dizziness upon changing position is not an expected response to antihypertensive medications and warrants further evaluation. Option D) should be totally reevaluated is too drastic a response at this stage without first addressing potential medication-related side effects. In an educational context, understanding the relationship between essential hypertension, antihypertensive medications, and potential side effects like orthostatic hypotension is crucial for healthcare professionals. Recognizing and managing these side effects through patient education is essential in providing safe and effective care for individuals with hypertension.

Correct Answer: A

Rationale: In cases of ventricular fibrillation or ventricular tachycardia, defibrillation is used to immediately restore normal heart rhythm. The correct answer is A) completely depolarize all myocardial cells simultaneously. This is because during ventricular fibrillation or tachycardia, the heart's electrical system is chaotic, leading to ineffective contractions. Defibrillation works by delivering a controlled electric shock to the heart, which depolarizes all myocardial cells at once, essentially resetting the heart's electrical activity and allowing the natural pacemaker to regain control, hopefully restoring a normal rhythm. Option B) decrease ventricular irritability is incorrect because defibrillation does not aim to decrease irritability but rather to synchronize the heart's electrical activity. Option C) increase ventricular irritability is incorrect as increasing irritability would worsen the chaotic electrical activity in the ventricles. Option D) increase amplitude of the QRS complexes is incorrect because defibrillation does not directly affect the amplitude of QRS complexes but rather aims to restore the heart's normal rhythm. Educationally, understanding the purpose of defibrillation in cases of ventricular fibrillation or tachycardia is crucial for healthcare professionals, especially those working in emergency situations. It is essential to know the mechanism of action of defibrillation to provide timely and effective care to patients experiencing life-threatening cardiac arrhythmias.

Correct Answer: B

Rationale: In evaluating a client's compensation in chronic congestive heart failure, the most useful measure would be option B) Daily weight assessment. This is because in congestive heart failure, fluid retention is a common issue due to the heart's inability to effectively pump blood. Monitoring daily weight can provide valuable information on fluid status. Option A) Weekly digoxin blood level assessment is not the most useful measure for evaluating compensation in chronic congestive heart failure because while digoxin is commonly used in heart failure management, monitoring its blood levels does not directly assess the client's compensation status. Option C) Hourly urinary output is not the most useful measure as it may not accurately reflect the overall fluid balance and compensation status of the client with chronic congestive heart failure. Option D) Monthly activity level assessment is not the most useful measure as it does not provide real-time information on the client's fluid status and compensation in chronic congestive heart failure. Educationally, understanding the rationale behind selecting the appropriate measure for evaluating a client's compensation in chronic congestive heart failure is crucial for healthcare providers to make informed clinical decisions and provide optimal care for their patients. Monitoring daily weight can help in early identification of fluid retention and decompensation, leading to timely interventions and improved outcomes for individuals with congestive heart failure.