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
The apical pulse, also known as the point of maximal impulse (PMI), is located at the fifth intercostal space at the left midclavicular line. This is the location where the heartbeat is strongest and is the standard location for assessing the apical heart rate.
Choice B rationale
Placing the stethoscope directly over the heart on the sternum is not the standard method for assessing the apical heart rate. While the sternum is close to the heart, it is not the location where the heartbeat is strongest or most easily heard.
Choice C rationale
The right side at the midclavicular line, fourth intercostal space, is not the standard location for assessing the apical heart rate. The heart is located more towards the left side of the chest, and the apical pulse is typically not as easily heard on the right side.
Choice D rationale
The midaxillary line on the left side is not the standard location for assessing the apical heart rate. While this location is on the left side of the chest, it is not where the heartbeat is strongest or most easily heard.

A. Adenosine (Adenocard). B. Emergency cardioversion. C. Anticoagulant therapy. D. Permanent pacemakers.

Correct Answer is C

Explanation

Choice A rationale
Adenosine (Adenocard) is a medication that can be used to treat supraventricular tachycardia, a type of abnormal heart rhythm. However, it is not typically used for atrial fibrillation.
Choice B rationale
Emergency cardioversion, where an electric shock is used to restore the heart’s normal rhythm, can be used in some cases of atrial fibrillation. However, if the atrial fibrillation has been present for more than 48 hours, there is a risk of blood clots, and anticoagulation for several weeks before the procedure may be needed.
Choice C rationale
Anticoagulant therapy is often used in patients with atrial fibrillation to reduce the risk of stroke. Atrial fibrillation can lead to blood pooling in the atria, increasing the risk of clot formation. These clots can then travel to the brain, causing a stroke.
Choice D rationale
Permanent pacemakers are sometimes used in atrial fibrillation to help regulate the heart’s rhythm. However, they are typically used when other treatments have failed or are contraindicated.

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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

In the context of interprofessional care of the client and family, where should a nurse position the stethoscope on the chest to assess a client’s apical heart rate?

Correct Answer is A

Explanation

A patient with dilated cardiomyopathy has recently developed atrial fibrillation that has been unresponsive to drug therapy for several days. What topic should the nurse plan to include in patient teaching?

Correct Answer is C

Explanation

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