A client comes into the emergency room with complaints of persistent, crushing chest pain. Along with the chief complaint, what other symptoms would make the nurse suspect that the client is experiencing a myocardial infarction (MI)?
Intermittent claudication with pallor
Jugular vein distention and dependent edema
Mid-epigastric pain and heartburn
Diaphoresis and cool clammy skin
The Correct Answer is D
A. Intermittent claudication with pallor is typically associated with peripheral artery disease (PAD) rather than myocardial infarction.
B. Jugular vein distention and dependent edema are signs of right-sided heart failure, which may develop after an MI but are not classic acute MI symptoms.
C. Mid-epigastric pain and heartburn can sometimes be confused with MI symptoms, but heartburn alone is not diagnostic of an MI.
D. Diaphoresis and cool clammy skin are correct. These symptoms occur due to sympathetic nervous system activation in response to cardiac ischemia, leading to vasoconstriction, sweating, and signs of impending shock.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. Weight gain is more commonly associated with right-sided heart failure due to fluid retention and peripheral edema, not left-sided heart failure.
B. Shortness of breath (dyspnea) is correct. Left-sided heart failure causes pulmonary congestion, leading to dyspnea, orthopnea, and pulmonary edema as blood backs up into the lungs.
C. Pulmonary embolism is not a direct manifestation of left-sided heart failure. While heart failure increases the risk of clot formation, a pulmonary embolism is a separate condition.
D. Anorexia is more common in right-sided heart failure, as systemic venous congestion can lead to gastrointestinal edema and poor appetite.
Correct Answer is A
Explanation
A. Adequate hydration helps thin mucus secretions, making them easier to expectorate. Drinking 2 to 3 L of water daily is recommended unless contraindicated by another condition.
B. Semi-Fowler's position can help with breathing but does not directly aid in thinning secretions.
C. Oxygen therapy helps with oxygenation but does not address thick mucus.
D. A low-salt diet may be beneficial for overall health but does not directly impact mucus consistency.
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