A 71-year-old man is slated for pacemaker insertion for treatment ...

[big1devin]

A 71-year-old man is slated for pacemaker insertion for treatment of a third-degree AV block.
 
  The man's nurse has been educating him about his diagnosis and treatment and answering the numerous questions he has about his health problem. Which of the following teaching points should the nurse include in this patient teaching?
  A)
  This is almost certainly a condition that you were actually born with, but that is just now becoming a serious problem.
  B)
  Because the normal electrical communication in lacking, the bottom parts of your heart are beating especially fast to compensate for inefficiency.
  C)
  The root problem is that the top chambers of your heart and the bottom chambers of your heart aren't coordinating to pump blood efficiently.
  D)
  If left untreated, this would have put you at great risk of stroke or heart attack.

Question 2

Around 3 weeks after razing an old chicken house, a 71-year-old retired farmer has developed a fever, nausea, and vomiting. After ruling out more common health problems, his care provider eventually made a diagnosis of histoplasmosis.
 
  Which of the following processes is most likely taking place?
  A)
  Toxin production by Histoplasma capsulatum is triggering an immune response.
  B)
  Antibody production against the offending fungi is delayed by the patient's age and the virulence of the organism.
  C)
  Spore inhalation initiates an autoimmune response that produces the associated symptoms.
  D)
  Macrophages are able to remove the offending fungi from the bloodstream but can't destroy them.

[ghepp]

Answer to Question 1

Ans:
C

Feedback:

A third-degree AV block is characterized by independent, and thus uncoordinated, pacemaker action for the atria and for the ventricles. It can be either congenital or acquired, and ventricular contraction tends to be slow, not fast. Manifestations tend to be those associated with decreased cardiac output, and a third-degree AV block is not necessarily associated with a large increase in stroke or MI risk.

Answer to Question 2

Ans:
D

Feedback:

Disseminated histoplasmosis results from the inability of macrophages of the reticuloendothelial system to destroy the fungi. Fungi do not produce toxins, and antibody production and autoimmune responses are not involved in the pathophysiology of this fungal infection.

[big1devin]

Gracias!

[kthug]

Excellent