Which of the following medication orders should the nurse question for the patient in question 1- reperfusion question-patient having an MI? (A) metoprolol (Lopressor) (B) aspirin (C) propranolol (Inderal) (D) heparin - ANSWER-(C) Rationale. The patient in the scenario is having an acute anterior wall MI. A beta blocker is beneficial for an acute MI as these agents decrease the work of the heart and increase the threshold for ventricular fibrillation. Propranolol, although a betaandrenergic blocker like metoprolol, is NOT a cardioselective beta blocker. It affects beta receptors in heart muscle AND lung tissue. Therefore, it is more likely to cause bronchoconstriction than a cardioselective beta blocker. The other 3- cardioselective beta blocker, antiplatelet, and anticoagulation-are indicated in an acute MI. If heart block develops while caring for the patient in question 1 (pt with an MI who went through reperfusion from PCI or fibrinolytic therapy), which of the following would it most likely be? (A) sinoatrial block (B) second degree, Type I (C) second degree, Type II (D) third degree, complete - ANSWER-(C) Rationale. The patient is having an acute anterior MI, which is generally due to LAD occlusion. The LAD supplies the HIS bundle, which could result in a seconddegree, type II heart block. The other 3 types are due to SA node or AV node ischemia, which generally occur with an RCA occlusion — interior wall MI. Appropriate drug therapy for dilated cardiomyopathy is aimed toward: (A) decreasing contractility and decreasing preload and afterload (B) decreasing contractility and increasing preload and afterload (C) increasing contractility and increasing both preload and afterload D) increasing contractility and decreasing both preload and afterload - ANSWER-(D) Rationale. (Dilated cardiomyopathy is likely to result in systolic dysfunction, which decreases contractility, causes compensatory arterial constriction , and results in a