A nurse in an emergency department is assessing a client who is having a suspected acute myocardial infarction (MI). Which of the following manifestations should the nurse expect to find for a client experiencing an acute MI? (Select all that apply.)
Orthopnea
Diaphoresis
Nausea
Headache
Tachycardia
Correct Answer : B,C,E
A. Orthopnea is difficulty breathing while lying flat, and it is typically associated with heart failure or pulmonary conditions, not an acute MI.
B. Diaphoresis (excessive sweating) is a common symptom of an acute MI due to the body's stress response to the myocardial injury.
C. Nausea can occur during an acute MI, particularly in women, as a result of the stress response or ischemia affecting the gastrointestinal system.
D. Headache is not a typical symptom of an acute MI. While it can occur due to stress or other factors, it is not a hallmark of myocardial infarction.
E. Tachycardia (increased heart rate) is a common response to an acute MI as the body attempts to compensate for reduced cardiac output and oxygenation.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. Right hemiparesis, or weakness on the right side of the body, is typically associated with a stroke involving the left hemisphere of the brain, as the left side of the brain controls motor function on the right side of the body.
B. Inability to recognize family members, or prosopagnosia, is a common result of right hemisphere strokes. The right hemisphere is responsible for spatial awareness and recognition of faces, so damage to this area can impair the ability to recognize familiar people.
C. Aphasia is a language disorder commonly associated with strokes affecting the left hemisphere, particularly the areas responsible for speech production and comprehension, such as Broca's area and Wernicke's area.
D. Difficulty reading, or alexia, is more commonly associated with damage to the left hemisphere, specifically the areas related to language processing, rather than the right hemisphere.
Correct Answer is B
Explanation
A. A cone-shaped dressing is a common and appropriate finding following an amputation. The dressing is typically shaped this way to help with the formation of a residual limb that is appropriately shaped for a prosthetic.
B. Pitting edema around the stump dressing is a complication. This could indicate poor circulation, infection, or fluid retention, which requires prompt assessment and intervention to prevent further complications.
C. Looseness of the stump dressing could be problematic, but it is not necessarily an immediate complication. It may lead to issues like infection or improper healing if not addressed, but it is not the most concerning finding in this scenario.
D. Figure-eight wrapping is a standard technique used to secure the dressing and promote proper shaping of the stump. It is an appropriate practice for amputation care.
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