A 29-year-old women presents to the ER with chest pain that started this evening. She has experienced episodes like this before which typically occur in the evening and resolve by the next morning. The client has a medical history of migraines and Raynaud's disease.

Temp: 98 F

BP: 119/72 mm/Hg

HR: 99 bpm

RR: 16 bpm

Sp02: 96% RA

An EKG is completed and indicates no evidence of a myocardial infarction but supports the diagnosis of Prinzmetal Angina. The nurse finds the client crying stating, "I'm so young, how can my heart arteries be clogged? I eat healthy and the doctor said my cholesterol was normal." What is the nurses best response?

"This condition is caused by the coronary arteries spasming, not by cholesterol."

"Just because you're young and eat right doesn't mean you can't have plaque buildup."

"I understand it can be upsetting to have coronary artery disease at your age."

"I am sure everything will be alright."

Answer and Explanation

The Correct Answer is A

A. The best response is to educate the client about the cause of Prinzmetal angina. It occurs due to spasm in the coronary arteries, which is different from the plaque buildup seen in traditional coronary artery disease. This response addresses the client's concern in an accurate and reassuring manner.

B. While healthy eating is important, Prinzmetal angina is not typically caused by cholesterol or plaque buildup. This response could increase the client's anxiety.

C. While acknowledging the client's emotions is important, this response does not address the underlying concern or provide an accurate explanation of Prinzmetal angina.

D. Offering reassurance without providing accurate information about the condition does not help the client understand the cause of their symptoms and could leave them confused or anxious.

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Correct Answer is C

Explanation

A. Serum insulin levels reflects short-term insulin secretion but does not indicate long-term glucose control.

B. Hemoglobin levels relate to anemia, not glucose control.

C. Hemoglobin A1C level reflects the average blood glucose over the past 2-3 months, providing an excellent measure of long-term control.

D. Fingerstick fasting blood glucose level reflects glucose levels at the moment of testing, not long-term control.

A. Encourage the client to sit up at the bedside in a chair and lean forward. B. Have the client rest in bed with the head elevated 15 to 20 degrees. C. Place the client in the Trendelenburg position with pillows behind the head. D. Ask the client to rest in bed in a high- Fowlers position with the knees flexed.

Correct Answer is A

Explanation

A. Sitting up and leaning forward helps improve lung expansion and ventilation, which is beneficial for clients with COPD.

B. Elevating the head is helpful but not as effective as sitting upright for COPD clients who need to improve their ventilation.

C. The Trendelenburg position is not appropriate for improving ventilation in COPD patients.

D. While high-Fowler's may help in some situations, having the knees flexed can restrict the diaphragm and limit breathing capacity.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

After starting the treatment for type 2 diabetes mellitus 6 months earlier, a client is in the office for a follow-up examination. The nurse will monitor which laboratory test to evaluate the clients adherence to the antidiabetic therapy over the past few months?

Correct Answer is C

Explanation

A client with chronic obstructive pulmonary disease (COPD) has poor gas exchange. Which action by the nurse would support the client's ventilation?

Correct Answer is A

Explanation

Which information about continuous bladder irrigation will the nurse teach to a client who is being admitted for a transurethral resection of the prostate (TURP)?

A client is being discharged home after a large myocardial infarction and subsequent coronary artery bypass grafting surgery. The client's sternal wound has not yet healed. What statement by the client most indicates a higher risk of developing sepsis after discharge?

After receiving change-of-shift report about the following four clients, which client should the nurse assess first?

During the administration of finasteride (Proscar), the nurse must remember which important precaution?

A client who has acute glomerulonephritis is hospitalized with hyperkalemia. Which information will the nurse monitor to evaluate the effectiveness of the prescribed calcium gluconate IV?

A client who has been anticoagulated with warfarin (Coumadin) has been admitted for gastrointestinal bleeding. The history and physical examination indicates that the client may have been taken too much warfarin. The nurse anticipates that client will receive which antidote?