Cardiovascular Nursing

Why A is the answer

Quadrigeminy does not mean four premature beats in a row.

The gemin- prefixes count the repeating group on the strip, not the ectopic beats inside it. A group of two is bigeminy: one ordinary complex, then one premature beat. A group of three is trigeminy, and a group of four is quadrigeminy. Each group holds exactly one premature beat, and the number names how far apart those beats fall.

Why the other options are not the answer

• B — "Bigeminy names a premature beat that follows a single standard complex": This is stated accurately, with one ordinary complex and then one premature beat, repeating.
• C — "Trigeminy names a premature beat that follows two normal complexes": This is correct as written, but the number in the prefix counts the repeating group, not the premature beats.
• D — "Fixed coupling names a steady interval between a premature beat and the normal beat before it": Accurate, and it names the beats by that measured interval rather than by the group they sit in.

Why B is correct

New difficulty naming familiar objects is reported first: in thrombocytopenia, a new focal neurologic change is the sentinel sign of intracranial hemorrhage. That is the one bleed that kills quickly and can be neither seen nor compressed. Under a circulation and life-threat reading of priority, this focal cortical deficit outranks every visible bleed listed.

Why the other options are wrong

• A — Gum bleeding noted during oral care: expected in immune thrombocytopenia and handled with pressure and gentle oral care, so it is documented and reported routinely rather than urgently.
• C — Fresh petechiae across the anterior chest: petechiae track the platelet count and are the classic surface marker of the disease, so their appearance confirms what is already known about the client.
• D — A firm bruise over the left hip and thigh: a deep hematoma is worrying and can conceal a large blood volume, but it earns measurement and close observation, not the first report. It remains a visible, compressible, monitorable bleed, whereas a deficit inside a closed skull is none of those things.

Why C is the answer

C needs correcting: variant angina usually strikes at rest, between midnight and early morning, not during hard exercise in the day. Variant (Prinzmetal) angina is chest pain from a spasm, a sudden tightening of a heart artery.

Why the other options are not the answer

• A — "His attacks come from a sudden tightening that narrows a heart artery for a short time": This is accurate; the spasm can cut blood flow even when no plaque has built up.
• B — "His attacks are more likely in extreme cold if he smokes": This is accurate. Extreme cold is a valid trigger, but it sets off a spasm, often at rest, rather than pain tied to effort.
• D — "His attacks can also be brought on by drinking alcohol": This is accurate; alcohol is a trigger he should limit.

Why D is the answer

The brown color is not a bruise. Red cells are pushed out of the overloaded vein and break down in the tissue. The iron they leave behind stains the skin, often permanently. The principle: the staining is leaked blood, not an injury from outside.

Why the other options are not the answer

• A — "Red cells have leaked out of the overloaded vein into the surrounding tissue": This statement is accurate. This is where the staining begins.
• B — "The iron those cells leave behind is what stains the skin brown": This statement is accurate. The brown pigment is iron left in the skin.
• C — "The pressure inside her leg veins stays high as blood flows backward": This statement is accurate. High vein pressure is part of the picture, though backward flow is one cause of it and a blocked vein is another.

Why A is correct

The aortic area is the second intercostal space, right sternal border.

A valve is heard where its sound carries, and aortic flow carries up and to the right.

Why the other options are wrong

• B — "Third intercostal space at the left sternal border": One space lower, and on the wrong side.
• C — "Second intercostal space at the left sternal border": The space is right and this is a valid listening point, but sound reaching the left border is pulmonic.
• D — "Left lower sternal border at the fourth intercostal space": Right-sided heart sounds project here instead.