A client with a history of angina is being admitted to the emergency department with a suspected myocardial infarction (MI). Which of the following findings will help the nurse distinguish stable angina from an MI?

MI only occurs with exertion.

Stable angina can occur for longer than 30 minutes.

Stable angina can be relieved with rest and nitroglycerin.

The pain of an MI lasts less than 15 minutes.

Answer and Explanation

The Correct Answer is C

Choice A reason: Myocardial infarction (MI) is not limited to occurrences with exertion. While stable angina typically occurs during physical activity or emotional stress, MI can happen at any time, even at rest. The underlying cause of an MI is the complete blockage of blood supply to a part of the heart muscle, usually due to a blood clot in a coronary artery. This blockage can lead to the death of heart muscle tissue, a condition that requires immediate medical attention.

Choice B reason: Stable angina does not typically last for more than 30 minutes. It is characterized by chest pain or discomfort that occurs predictably with exertion or emotional stress and is relieved within minutes by rest or nitroglycerin. In contrast, the pain from an MI is more prolonged and severe, and it is not relieved by rest or nitroglycerin. If chest discomfort lasts longer than 15 minutes and is not alleviated by rest or nitroglycerin, it is a warning sign that the individual may be experiencing an MI.

Choice C reason: This is the distinguishing feature between stable angina and an MI. Stable angina is usually relieved within 3-5 minutes by rest or nitroglycerin, which helps to dilate the coronary arteries and improve blood flow to the heart muscle. Nitroglycerin is ineffective in relieving the symptoms of an MI because the problem is not just reduced blood flow but a complete blockage that nitroglycerin cannot overcome.

Choice D reason: The pain associated with an MI typically lasts for more than 15 minutes and can be quite severe. Unlike stable angina, the pain of an MI is not relieved by rest or nitroglycerin. The duration and severity of the pain, along with other symptoms such as shortness of breath, sweating, nausea, or lightheadedness, help differentiate an MI from stable angina.

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Correct Answer is A

Explanation

Choice A reason:Taping the connections on the client's chest tube is essential to maintain a closed system and prevent air leaks, which could lead to a pneumothorax.

Choice B reason:Positioning the client in a supine position is not recommended as it may not facilitate optimal drainage from the pleural space.

Choice C reason:Stripping the chest tube, which involves applying pressure and sliding the fingers down the tube to remove clots, is not routinely recommended as it can generate high negative pressures and damage lung tissue.

Choice D reason: The chest tube drainage system should be placed below the level of the client's heart to allow for gravity drainage of pleural fluid and air.

A. Bubbling of the water in the water seal chamber with exhalation B. Crepitus in the area above and surrounding the insertion site C. Movement of the trachea toward the unaffected side D. Eyelets are not visible

Correct Answer is B

Explanation

Choice A reason:Bubbling in the water seal chamber with exhalation can be normal, indicating that air is being evacuated from the pleural space.

Choice B reason:Crepitus, or subcutaneous emphysema, can indicate that air is leaking into the tissue around the chest tube site, which is a serious complication that requires immediate attention.

Choice C reason:

Movement of the trachea toward the unaffected side can indicate tension pneumothorax, a life-threatening condition that also requires immediate attention.

Choice D reason:If the eyelets of the chest tube are not visible, it may simply mean that the tube is inserted fully, which is not an immediate cause for concern unless other symptoms are present.

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A client with a history of angina is being admitted to the emergency department with a suspected myocardial infarction (MI). Which of the following findings will help the nurse distinguish stable angina from an MI?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who has a chest tube. Which of the following actions should the nurse take?

Correct Answer is A

Explanation

A nurse is assessing a client who has a pneumothorax with a chest tube in place. For which of the following findings should the nurse notify the provider immediately?

Correct Answer is B

Explanation

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