A patient with angina pectoris is experiencing chest pain at rest and needs to take three nitroglycerin (NTG) pills to relieve the pain. What should the nurse consider this as a major symptom of?

Stable angina

Full-blown acute myocardial infarction (MI)

Unstable angina

Pulmonary embolus .

Answer and Explanation

The Correct Answer is C

Choice A rationale
Stable angina is characterized by chest pain that occurs with exertion and is relieved by rest. If a patient with angina pectoris is experiencing chest pain at rest and needs to take three nitroglycerin pills to relieve the pain, this is not typical of stable angina.
Choice B rationale
A full-blown acute myocardial infarction (MI), or heart attack, typically presents with severe chest pain, shortness of breath, and other symptoms. While chest pain at rest could be a symptom of an MI, other symptoms would likely be present.
Choice C rationale
Unstable angina is characterized by chest pain that occurs at rest, is severe and prolonged, and is not relieved by nitroglycerin. Therefore, a patient with angina pectoris who is experiencing chest pain at rest and needs to take three nitroglycerin pills to relieve the pain could be experiencing unstable angina.
Choice D rationale
Pulmonary embolus, a blockage in one of the pulmonary arteries in the lungs, typically presents with sudden-onset shortness of breath, chest pain that may become worse upon deep breathing or coughing, and other symptoms. Chest pain at rest could be a symptom of a pulmonary embolus, but other symptoms would likely be present.

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Correct Answer is A

Explanation

Choice A rationale
Stable angina typically occurs with exertion and goes away with rest. The symptoms described, including substernal pain, discomfort in the left shoulder and jaw, which subside with rest, are characteristic of stable angina.
Choice B rationale
Prinzmetal angina, also known as variant angina, is a type of angina (chest pain) caused by spasms in the coronary arteries. These spasms occur most often in coronary arteries that have not become hardened due to plaque buildup. However, they can also occur in hardened arteries. The symptoms can be similar to those of stable angina, but the typical triggers for the episodes are different.
Choice C rationale
A myocardial infarction (MI), or heart attack, occurs when one of the coronary arteries becomes blocked, often by a blood clot, causing part of the heart muscle to be damaged or die. The symptoms are usually more severe than what is described and do not typically subside with rest.
Choice D rationale
Unstable angina is a condition in which the angina symptoms become more severe, occur more frequently, or occur at rest. This is a medical emergency as it can often lead to a heart attack.

A. Redness on both sides of the sternal incision. B. Fine crackles heard at both lung bases. C. Complaints of incisional chest pain. D. Pallor and weakness of the right hand.

Correct Answer is D

Explanation

Choice A rationale
Redness on both sides of the sternal incision could indicate a normal inflammatory response post-surgery or could be a sign of infection. However, it is not the most crucial observation to report in the context of a patient who has undergone coronary artery bypass grafting using a right radial artery graft.
Choice B rationale
Fine crackles heard at both lung bases could indicate fluid accumulation in the lungs, possibly due to heart failure or pneumonia. While this is a significant finding that requires further investigation, it is not the most crucial observation in this specific context.
Choice C rationale
Complaints of incisional chest pain are common after coronary artery bypass grafting. Pain management is an important part of post-operative care, but this symptom is not the most crucial to report in this context.
Choice D rationale
Pallor and weakness of the right hand could indicate compromised blood flow to the hand, which is a serious complication considering the right radial artery was used for the graft. This could lead to ischemia and tissue damage in the hand, thus it is the most crucial observation to report to the healthcare provider.

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A patient with angina pectoris is experiencing chest pain at rest and needs to take three nitroglycerin (NTG) pills to relieve the pain. What should the nurse consider this as a major symptom of?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Correct Answer is A

Explanation

In the context of a patient who has undergone coronary artery bypass grafting using a right radial artery graft, which observation is most crucial for the nurse to report to the healthcare provider?

Correct Answer is D

Explanation

A patient who has been experiencing chest pain for several hours is admitted with a diagnosis of rule out acute myocardial infarction (AMI). Which laboratory test is most specific for the nurse to monitor in determining whether the patient has had an AMI?

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In the context of a 65-year-old male patient diagnosed with chronic pulmonary disease and elevated pulmonary vascular resistance, which type of heart failure should the nurse assess for in this patient?