A patient reports episodic chest pain lasting a few minutes that is provoked by exertion and relieved within 10 minutes upon resting.
Which cause of the patient's symptoms would the nurse suspect?
Spasm of a major coronary artery.
Exposure of the thrombogenic surface to plaque.
Myocardial ischemia due to coronary artery disease.
Myocardial ischemia secondary to microvascular disease.
The Correct Answer is C
Choice A rationale:
Spasm of a major coronary artery, also known as variant (Prinzmetal's) angina, typically occurs at rest and is not necessarily provoked by exertion. The patient's chest pain is exacerbated by exertion, making this choice less likely.
Choice B rationale:
Exposure of the thrombogenic surface to plaque refers to acute coronary syndromes like unstable angina or myocardial infarction. While plaque rupture and thrombosis can cause myocardial ischemia, the characteristic feature of these conditions is chest pain that may not be relieved by rest, unlike the patient described here.
Choice D rationale:
Myocardial ischemia secondary to microvascular disease, also known as cardiac syndrome X, is a condition where chest pain occurs without significant coronary artery stenosis. However, this condition usually affects women, and the pain is often unrelated to exertion. In the given case, the pain is provoked by exertion, making this choice less likely.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A rationale:
Metabolic acidosis is characterized by a low pH (<7.35) and a low bicarbonate level (<22 mEq/L) The given arterial blood gas (ABG) values indicate a pH of 7.48 (which is alkalotic), a PaCO2 of 38 (within the normal range of 35-45 mm Hg), and an HCO3- of 30 (which is elevated) These values indicate metabolic alkalosis, not metabolic acidosis.
Choice B rationale:
Metabolic alkalosis is characterized by a high pH (>7.45) and an elevated bicarbonate level (>26 mEq/L) The given ABG values indicate a pH of 7.48 (which is alkalotic) and an elevated HCO3- of 30, indicating metabolic alkalosis. This condition can result from excessive loss of acids (e.g., vomiting) or excessive intake of bicarbonate or alkali substances.
Choice C rationale:
Respiratory acidosis is characterized by a low pH (<7.35) and a high PaCO2 (>45 mm Hg) The given ABG values indicate a normal pH of 7.48 and a PaCO2 of 38 (within the normal range), ruling out respiratory acidosis.
Choice D rationale:
Respiratory alkalosis is characterized by a high pH (>7.45) and a low PaCO2 (<35 mm Hg) The given ABG values indicate a pH of 7.48 (which is alkalotic) and a PaCO2 of 38 (within the normal range), ruling out respiratory alkalosis.
Correct Answer is A
Explanation
Choice B rationale:
A decrease in plasma renin levels is not a known cause of primary hypertension. Primary hypertension often has no identifiable cause, and it is a diagnosis of exclusion.
Choice C rationale:
Too much plaque in the blood vessels describes atherosclerosis, which is a risk factor for hypertension but not the direct cause of primary hypertension. Plaque buildup narrows arteries and increases resistance, contributing to elevated blood pressure.
Choice D rationale:
Kidney disease can cause secondary hypertension but is not the most common cause of primary hypertension. Primary hypertension, also known as essential hypertension, is the most common form, and its exact cause remains unknown in many cases.
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