A patient is admitted to the emergency department with clinical indications of an ST elevated myocardial infarction. The facility does not have the capability for percutaneous coronary intervention. Given this scenario, what is the priority intervention in the treatment and nursing management of this patient?

Administer thrombolytic therapy unless contraindicated

Keep oxygen saturation levels to at least 88%

Maintain heart rate above 100 beats/min

Administer diuretics aggressively and monitor daily weight

Answer and Explanation

The Correct Answer is A

A. Thrombolytic therapy is the priority in managing an ST-elevated myocardial infarction (STEMI) when percutaneous coronary intervention (PCI) is not available. It helps dissolve the blood clot causing the blockage in the coronary artery.

B. Maintaining oxygen saturation is important, but the priority is to restore coronary blood flow.

C. The focus should be on stabilizing the heart rhythm, not specifically maintaining a high heart rate.

D. Diuretics are important in managing heart failure but are not the priority in acute STEMI management.

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Correct Answer is A

Explanation

A. Sudden weight gain can indicate fluid retention, a common early sign of heart failure exacerbation. Prompt reporting allows for early intervention.

B. Nitroglycerin is used to treat chest pain, not specifically to prevent heart failure exacerbations.

C. Assessment of the apical pulse is important, but monitoring weight is more directly related to managing heart failure.

D. Compliance with diuretic therapy is important, but recognizing early signs of fluid retention, such as rapid weight gain, is crucial for preventing exacerbations.

A. "Perhaps you should discuss this with your physician." B. "I recommend you exercise daily and avoid smoking to decrease your risk." C. "Tell me more about these fears of dying from a heart attack." D. "Of course you aren't going to die, at least not in the immediate future."

Correct Answer is C

Explanation

A. Referring the patient to the physician without addressing the concern may make the patient feel dismissed.

B. While lifestyle changes are important, this response does not address the patient’s emotional concern directly.

C. Encouraging the patient to express their fears allows the nurse to provide emotional support and address any misconceptions or anxieties, which is crucial for holistic care.

D. This response could be seen as dismissive and may not address the patient’s underlying concerns or fears.

View Question and Answer

A nurse is caring for a client in the emergency department (ED).

<div id="exhibits">Exhibits</div>

The nurse is planning care for the client. For each potential prescription, indicate whether it is an anticipated (high priority), nonessential (low priority), contraindicated(unrelated).

Select one or more in each option.

View Question and Answer

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Naxlex Comprehensive Predictor Exams

An essential aspect of teaching that may prevent recurrence of heart failure exacerbations is

Correct Answer is A

Explanation

A client who has coronary artery disease tells the nurse he is afraid of dying from a heart attack. Which of the following responses should the nurse make?

Correct Answer is C

Explanation

A patient is having a cardiac evaluation to assess for possible heart failure and valvular disease. Which study best identifies heart function and measures the size of the cardiac chambers?

A patient is being treated for hypertensive emergency. When treating this patient, the nurse recognizes the initial goal is to lower the mean blood pressure (BP) by 20-25% because

The patient is admitted with a suspected acute myocardial infarction (AMI). In assessing the 12-lead electrocardiogram (ECG) changes, which findings would indicate to the nurse that the patient is in the process of a myocardial infarction (MI)?

While close family members are visiting, a patient has a respiratory arrest, and resuscitation is started. Which action by the nurse is best?

The nurse is caring for a patient with a left subclavian central venous catheter (CVC) and a left radial arterial line. Which assessment finding by the nurse requires immediate action?

A nurse is performing cardiopulmonary resuscitation (CPR) for an adult client who is unresponsive. The nurse should evaluate the client's circulation by palpating which of the following pulses?

The patient presents to the ED with severe chest discomfort. A cardiac catheterization and angiography shows an 90% occlusion of the left main coronary artery. Which procedure will be most likely performed on this patient?