A client is admitted to the emergency department with chest pain and shortness of breath. The client states that the chest pain has been happening intermittently all day, lasts about 15 minutes at a time, and has been happening without any physical exertion or emotional stress. STAT lab results reveal troponin levels of 0.01 ng/mL, and a 12-lead electrocardiogram (ECG) shows sinus tachycardia with a T-wave inversion. Which diagnosis would the nurse expect for this client?
NSTEMI
Stable angina
STEMI
Unstable angina
The Correct Answer is D
A. NSTEMI would present with elevated troponin levels indicating myocardial injury, which is not the case here.
B. Stable angina occurs predictably with exertion and is relieved by rest or nitroglycerin.
C. STEMI is characterized by ST-elevation on the ECG and elevated troponin levels, indicating significant myocardial injury.
D. Unstable angina presents with chest pain that occurs at rest or with minimal exertion and is not predictable. The presence of T-wave inversion and normal troponin levels is consistent with this diagnosis.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["B","D"]
Explanation
A. Digoxin improves cardiac output by increasing the force of cardiac contractions, not by increasing the heart rate. In fact, it may slow the heart rate.
B. Holding the dose and calling the doctor if the heart rate is less than 60 beats per minute is correct, as digoxin can cause bradycardia.
C. Doubling the dose is incorrect and dangerous. Missed doses should be handled according to physician instructions, typically by skipping the missed dose and taking the next scheduled dose.
D. Loss of appetite and nausea can be signs of digoxin toxicity and should be reported to the healthcare provider.
E. Frequent urination is not an expected side effect of digoxin; it is more commonly associated with diuretics.
Correct Answer is D
Explanation
A. While a platelet transfusion can temporarily increase platelet counts, it does not reduce the destruction of platelets in ITP and is generally not effective as a long-term solution.
B. Replacement of ADAMTS-13 is relevant in thrombotic thrombocytopenic purpura (TTP), not ITP. It is not used for reducing platelet destruction in ITP.
C. Protamine sulfate is an antidote for heparin overdose and does not address the platelet destruction in ITP.
D. A laparoscopic splenectomy is often considered for clients with ITP who do not respond to medication therapy. The spleen is a primary site for platelet destruction, and its removal can reduce the destruction of platelets, leading to increased platelet counts.
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