Which finding is associated with a blue tinge around the lips and conjunctiva?

Correct Answer: B

Rationale: In this question, the correct answer is B) Central cyanosis. Central cyanosis is characterized by a bluish discoloration of the lips and conjunctiva due to decreased oxygen saturation in the arterial blood. This finding is indicative of systemic hypoxemia and is often seen in conditions affecting the heart and lungs. Option A) Finger clubbing is associated with chronic hypoxia but does not directly cause a blue tinge around the lips and conjunctiva. Option C) Peripheral cyanosis is due to decreased blood flow or vasoconstriction in the extremities, not centrally around the lips and conjunctiva. Option D) Delayed capillary filling time is a sign of poor circulation but does not specifically present as a blue tinge around the lips and conjunctiva. Educationally, understanding the clinical manifestations of central cyanosis is crucial for healthcare professionals, especially those specializing in cardiovascular care. Recognizing this sign can prompt timely intervention and management of underlying cardiovascular or respiratory issues to improve patient outcomes. It also underscores the importance of thorough assessment skills in identifying critical findings that require immediate attention.

Correct Answer: D

Rationale: The correct answer is D) impairs perfusion of the coronary arteries. In the context of tachycardia caused by sympathetic response to ischemic pain, an increased heart rate leads to higher oxygen demand by the myocardium. This increased demand for oxygen is detrimental in cases of ischemia because it can exacerbate the imbalance between oxygen supply and demand, further compromising the perfusion of the coronary arteries. Impaired perfusion of the coronary arteries can worsen the ischemic condition, potentially leading to myocardial infarction or other serious cardiac events. Option A) increases cardiac output is incorrect because while tachycardia does increase heart rate, it does not necessarily improve cardiac output efficiency, especially in the context of ischemia where oxygen demand is already high. Option B) causes reflex hypotension is incorrect because tachycardia, by itself, is more likely to cause hypertension rather than hypotension due to increased sympathetic activity and vasoconstriction. Option C) may lead to atrial dysrhythmias is incorrect because while tachycardia can predispose individuals to various arrhythmias, the primary concern in the context of ischemic pain is the increased oxygen demand and impaired coronary perfusion. Understanding the relationship between sympathetic response, tachycardia, oxygen demand, and coronary perfusion is crucial in managing patients with cardiac conditions, especially in scenarios involving ischemia. By grasping these concepts, healthcare providers can better assess and intervene in cases of acute coronary syndromes to prevent serious complications like myocardial infarction.

Correct Answer: C

Rationale: In explaining to the patient that the internal mammary artery will be detached from the chest wall and attached to a coronary artery distal to the stenosis during CABG surgery (Option C), the nurse is providing accurate information about the procedure. This is the correct answer because using the internal mammary artery as a graft has shown better long-term patency rates compared to synthetic grafts or saphenous veins. Option A is incorrect because a synthetic graft is typically used to bypass the obstruction, not as a tube for blood flow. Option B is incorrect as resecting the coronary artery is not a standard practice in CABG surgery. Option D is incorrect because reversed segments of a saphenous artery are typically used as grafts, but not from the aorta. For educational context, it is important for nurses to understand the rationale behind using specific grafts in CABG surgery to provide accurate and clear information to patients. This knowledge helps in patient education, informed consent, and post-operative care management. Understanding the advantages and disadvantages of different graft options is crucial for optimal patient outcomes.

Correct Answer: A

Rationale: Unstable angina is a type of chest pain that occurs at rest due to reduced blood flow to the heart. The correct answer is A) Chest pain at rest. This is because unstable angina is characterized by chest pain that is unpredictable, occurs at rest, and can be a sign of an impending heart attack. Option B) Chest pain during exertion typically describes stable angina, where chest pain is triggered by physical activity or stress, but it is relieved by rest. Option C) Chest pain relieved by nitroglycerin is more indicative of stable angina, where nitroglycerin can alleviate chest pain associated with coronary artery disease. It is crucial for healthcare professionals, especially those specializing in cardiovascular care, to understand the differences between stable and unstable angina as the management and urgency of treatment differ significantly. Recognizing the symptoms of unstable angina promptly is vital for providing appropriate care and preventing adverse cardiac events.

Correct Answer: C

Rationale: The correct answer is C) Both A and B. Explanation: A Mantoux test, also known as a tuberculin skin test, involves the intradermal injection of purified protein derivative (PPD) tuberculin into the forearm. This injection is administered just beneath the skin's surface, which is why it is considered an intradermal injection. After the injection, healthcare providers measure the diameter of any induration, or raised, hardened area of skin at the injection site. The size of the induration is crucial in interpreting the results of the Mantoux test. Why the other options are wrong: A) Intradermal injection alone does not encompass the full process of the Mantoux test. The test involves both the intradermal injection and the subsequent measurement of any resulting induration. B) Induration measurement alone is not sufficient to describe the Mantoux test. The process involves both the injection and the measurement of induration to assess the body's immune response to the PPD tuberculin. Educational context: Understanding the Mantoux test is vital for healthcare professionals, especially those working in settings where tuberculosis screening is necessary. By knowing how the test is conducted and interpreted, healthcare providers can accurately assess individuals for potential exposure to tuberculosis and determine the need for further testing or treatment. This knowledge is crucial for ensuring the health and safety of both patients and healthcare workers.