Walkthrough: Physiological Adaptation Q18 – NCLEX-RN®

00:00 The nurse educates a client who survived a left anterior descending artery myocardial infarction and states "Why is this the most dangerous type of heart attack?" Which statement by the nurse is best? Okay, we need a little more than 2 sentences here, but it's just 3 so let's break it down. So who am I? The nurse. What am I doing? I'm educating a client. Now, what's particular about this client? Well, they survived a left anterior descending artery blockage. So sometimes you hear that called the LAD. Now, they had a myocardial infarction because this artery was blocked. So, they're asking why is this a dangerous heart attack? In fact, this one is often called a widow maker. So, which statement by the nurse is best? Does that mean that there could be 4 possibly correct answers? Yeah, there could be but we're asking for the best answer. So, what I want you to do is prepare yourself.

01:04 There may be more than 1 correct answer, but when you see the word like best, first, most, those are priority words so you know that, don't you get upset.

01:15 If you think there's more than 1 correct answer, there could be. You're looking for the best. It's all relative to the other answers. So we'll show you how to walk through that but first you try it solo, do it on your own, write down the numbers; number 1, number 2, number 3, number 4 on your scratch paper or your write on wipe off board if you're really rocking it today then as you're working your way through the question "Is this the best statement about an LAD MI?" Is this the best statement about an LAD MI? So, look at those one at a time, make your decision, yes or no, in or out but be sure to always make yourself say why you're eliminating an answer or keeping it in. Don't panic. If you're not sure about a question, move on to the next answer choice. Right? Keep moving and you're eliminating, you'll be able to keep track of where you are and don't allow yourself to kind of spiral down that you don't know the answer. It's always a process to answer a test question so just stay committed to the process, eyes on the price and I promise you're going to improve your test taking strategies. Okay, pause the video then come back when you're ready after you had the opportunity to work through the process finding your best answer. Welcome back. So remember the topic of this question. I'm looking for which statement by the nurse is best. So I'm looking for something that either best describes or is the safest for an LAD MI, so a left anterior descending artery MI. So if the nurse says because it causes all of your heart valves to close at the same time. Okay, you're looking at that thing. Is that even a good destructor? Trust me. When you are stressed, you can talk yourself in to anything. If you're just kind of trying to scheme down and pick the answer of your choice so think about that. Is the cause of an MI to all the heart valves close the same time? No. That's not what happens. An MI is because a blood supply was blocked to heart tissue. It's not going to cause all the valves to close at one time, but I promise you you may think now like "That's an easy answer" but when you're stressed you're not thinking as clearly unless you practiced, use a system. So number 1, you're out of there. We're going to cross that one off. Number 2, because it blocks blood flow from the lungs, so does the left anterior descending coronary artery block blood flow from the lungs? Well, that's all connected, manic, have a hard time remembering my coronary artery. Those are things I have heard students say. So, let's leave 2 in there. Number 3, is this the best statement for an LAD MI because it supplies the most blood to a large part of the heart that pushes blood out to the body. Okay, that's a long answer. Remember like 2, I'm like eehh sketchy on, but 3 I'm saying that it's considered the most dangerous because it supplies the most blood to a large part of the heart. Okay, I'm not clear where that is yet but it says that pushes blood out to the body. Well then I'm just going to picture in my mind the heart. Right. Right atrium, right ventricle, pulmonary artery, through the lungs back to the left atrium, left ventricle, then out to the body. So, does the LAD supply the left ventricle because that is the part of the heart that's most responsible for pushing the blood out to the rest of the body. Yeah, it does. So I'm keeping 3 in because that all makes sense, that is a good statement and it is better than number 2. Alright, so now I wasn't sure about number 2 but that's how you can get rid of it.

05:15 Now, number 4, because the LAD artery is the main artery connecting the right chambers of your heart, yeah, no. That's why it's called the left, right, anterior descending. So, you know that that answer is another one that's fairly easy to knock off if you slow down, if you're thinking about it. If you're picturing the anatomy in your mind, you should be able to even if you're not an expert, in remembering all the coronary arteries. See how you can find the right answer if you just slow down and keep comparing them to each other. I promise you can get this. So, an MI, well, the LAD that's called the widow maker because it supplies the left ventricle.

05:59 Why is that a bad thing? Well, you know that infarcted tissue is stiff tissue, dead tissue doesn't contract and expand like we need a heart to. So if you have a stiff area, a dead area of your left ventricle, it's going to give you all kinds of problems that's why they called the widow maker, patients often don't survive this. So, that's not really a high note to end the question on. Is it? Talking about the widow maker and how many people don't survive it, but keep in mind slowing down, thinking through it, each one of those answer choices means is going to be your best strategy in raising your exam scores and getting better at taking exams.