Which of the following conditions may persist in an asymptomatic patient?

Correct Answer: D

Rationale: The correct answer is D) Aortic aneurysm, as it is a condition that can persist in an asymptomatic patient. Aortic aneurysms can often be asymptomatic until they reach a critical size or rupture, making them potentially dangerous if left undetected. Option A) Angina is incorrect because angina typically presents with chest pain or discomfort due to reduced blood flow to the heart muscle, which is a symptomatic condition. Option B) Cardiogenic shock is incorrect as it is a life-threatening condition characterized by a sudden drop in blood pressure and inadequate blood flow to the body's organs, leading to symptoms such as rapid breathing, confusion, and cold extremities. Option C) Ventricular tachycardia is incorrect because it is an abnormal heart rhythm that can cause symptoms such as palpitations, dizziness, chest discomfort, and fainting, making it a symptomatic condition. Educationally, understanding the distinction between asymptomatic and symptomatic cardiovascular conditions is crucial for healthcare providers in assessing and managing patients effectively. Recognizing that some conditions can be silent but still pose serious risks underscores the importance of regular screenings and diagnostic tests to identify potential issues before they become symptomatic and potentially life-threatening.

Correct Answer: B

Rationale: The correct answer is B) Holter monitoring. Holter monitoring is used to evaluate ECG responses to normal activity over an extended period, usually 1 or 2 days. This method allows for continuous monitoring of the heart's electrical activity during daily activities, providing a more comprehensive assessment compared to a single ECG. Option A) Serial ECGs involve taking multiple ECG readings at different time points but do not provide continuous monitoring over an extended period like Holter monitoring. Option C) The 6-minute walk test is a measure of exercise capacity and functional status, not a method for continuous ECG monitoring. Option D) Event monitors or loop recorders are used for intermittent monitoring to capture specific cardiac events or symptoms, not for continuous monitoring over 1 or 2 days like Holter monitoring. In an educational context, understanding the different methods of cardiac monitoring is crucial for healthcare professionals, especially those working in cardiology or primary care settings. Knowing when to use each method based on the patient's symptoms and clinical presentation is essential for accurate diagnosis and appropriate management of cardiovascular conditions. Holter monitoring plays a specific role in assessing cardiac rhythm disturbances that may occur during daily activities, providing valuable information for diagnosis and treatment planning.

Correct Answer: D

Rationale: In the treatment of hypertensive crises, the most commonly used drugs are fenoldopam (Corlopam) and sodium nitroprusside (Nipride) as indicated by option D. Fenoldopam is a selective dopamine receptor agonist that promotes vasodilation, helping to reduce blood pressure quickly. Sodium nitroprusside is a potent vasodilator that acts on both arteries and veins, rapidly lowering blood pressure in emergency situations. Option A, Esmolol and captopril, are not typically used in hypertensive crises. Esmolol is a beta-blocker that acts more for long-term blood pressure control, while captopril is an ACE inhibitor that may take longer to show its full effect. Option B, Enalaprilat and minoxidil, are also not the first-line agents for hypertensive crises. Enalaprilat is an ACE inhibitor, similar to captopril, and minoxidil is a potent vasodilator that is more commonly used for chronic hypertension. Option C, Labetalol and bumetanide, are used in hypertensive emergencies, but they are not the most commonly used drugs for this purpose. Labetalol is a combined alpha and beta-blocker, and bumetanide is a loop diuretic, which are not the primary choices for immediate blood pressure reduction. It is crucial for healthcare professionals to be well-versed in the appropriate medications for hypertensive crises to ensure prompt and effective management of potentially life-threatening situations. Understanding the mechanisms of action and indications of each drug is essential for providing optimal patient care in emergency situations.

Correct Answer: A

Rationale: The correct answer is A) To lie or sit and place one tablet under the tongue when chest pain occurs. This is the correct instruction for taking sublingual nitroglycerin tablets because sublingual administration allows for rapid absorption of the medication into the bloodstream, providing quick relief for angina symptoms. Placing the tablet under the tongue helps facilitate this rapid absorption. Option B is incorrect because taking the tablet with a large amount of water would not allow for sublingual absorption and would delay the onset of action. Option C is incorrect because if the chest pain persists after taking one tablet, the patient should take a second tablet after 5 minutes and seek emergency medical assistance if the pain is still not relieved, rather than waiting 15 minutes to go to the hospital. Option D is incorrect because dizziness and headache are common side effects of nitroglycerin and do not necessarily indicate a need to stop the medication; the patient should be advised to sit or lie down and wait for the symptoms to subside. In an educational context, it is important for nurses to provide clear and accurate instructions to patients regarding the administration of sublingual nitroglycerin to ensure optimal effectiveness in relieving angina symptoms. Educating patients on the correct administration technique can help improve outcomes and patient safety in managing cardiovascular conditions.

Correct Answer: A

Rationale: In the context of thrombolytic therapy for myocardial infarction (MI), it is crucial for the nurse to recognize signs indicating treatment failure. The correct answer, option A, "Continues to have chest pain," signifies unsuccessful thrombolysis. Chest pain persistence suggests ongoing myocardial ischemia due to inadequate clot dissolution, necessitating further interventions like rescue angioplasty. This outcome highlights the importance of prompt recognition and action in managing MI. Option B, "Has a marked increase in CK enzyme levels within 3 hours of therapy," is incorrect as elevated CK levels are expected after MI and thrombolysis due to myocardial damage, not necessarily indicating treatment failure. Option C, "Develops major GI or GU bleeding during treatment," is also incorrect as bleeding is a known side effect of thrombolytic therapy but does not inherently denote treatment failure. Option D, "Develops premature ventricular contractions and ventricular tachycardia during treatment," is incorrect as these arrhythmias can occur post-MI and are not specific indicators of thrombolytic therapy failure. Educationally, understanding the nuances of post-MI care, including thrombolytic therapy outcomes, is crucial for nurses caring for cardiac patients. This rationale emphasizes the importance of clinical vigilance, prompt assessment, and appropriate response to patient responses to therapy to optimize outcomes and prevent complications.