The client usually has central chest pressure when mowing the lawn that is relieved with rest and nitroglycerin. Today while sitting and reading the paper, he got pain that is now left sided, radiating down his arm, rated “4”. He took 3 nitroglycerin 5 minutes apart without relief. What is the understanding of this situation?

The client now has developed a myocardial infarction

The client has developed Prinzimetal’s angina.

The client now has stable angina.

The client now has unstable angina.

Answer and Explanation

The Correct Answer is D

A. The client now has developed a myocardial infarction:

A myocardial infarction (heart attack) is characterized by prolonged ischemia leading to damage or death of heart muscle cells. While the symptoms described could be concerning for a heart attack, the term "myocardial infarction" would typically imply a more sustained and severe ischemic event.

B. The client has developed Prinzmetal's angina:

Prinzmetal's angina, also known as variant angina, is characterized by chest pain that usually occurs at rest and is caused by vasospasm of the coronary arteries. The given scenario does not specifically describe the typical characteristics of Prinzmetal's angina.

C. The client now has stable angina:

Stable angina typically follows a predictable pattern and is relieved with rest and/or nitroglycerin. However, the scenario describes a change in the usual pattern of chest pain.

D. The client now has unstable angina:

Unstable angina is characterized by a change in the usual pattern of stable angina, often occurring at rest or with minimal exertion and not relieved by usual measures. This option seems to align with the information provided.

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Correct Answer is ["A","B","C","D"]

Explanation

Withhold food and oral fluids before the procedure

Withholding food and oral fluids before the procedure is essential to prevent complications during the cardiac catheterization. The client is typically NPO (nothing by mouth) for a specified period before the procedure.

B. Review medications the client has taken in the last 24 hours

Reviewing the client's medications is crucial to ensure that any medications affecting coagulation or blood vessels are appropriately managed before the cardiac catheterization.

C. Verify that written consent has been obtained

Verifying the presence of written consent is a critical step to confirm that the client has been adequately informed about the procedure, its risks, and benefits, and has given consent for the cardiac catheterization.

D. Check for iodine sensitivity

Checking for iodine sensitivity is important because iodinated contrast dye is commonly used during cardiac catheterization. Allergies or sensitivities to iodine contrast must be identified to prevent adverse reactions.

E. Administer all ordered oral medications

Administration of oral medications before the procedure depends on the specific medications and the healthcare provider's instructions. Some medications may be held, while others may be continued as prescribed.

A. International normalized ratio (INR) B. Brain natriuric peptide (BNP) C. Troponin D. Creatinine

Correct Answer is B

Explanation

A. International normalized ratio (INR):

INR is a test used to monitor the effectiveness of anticoagulant therapy, particularly drugs like warfarin. It measures the time it takes for blood to clot. It's not directly related to assessing heart failure but is more associated with monitoring anticoagulation status.

B. Brain natriuretic peptide (BNP):

BNP is a peptide released by the heart in response to increased pressure and volume in the heart, often seen in heart failure. Elevated BNP levels can indicate the presence of heart failure. It's a useful diagnostic marker for heart failure.

C. Troponin:

Troponin is a protein released into the blood when there is damage to the heart muscle, usually during a heart attack. It is not specific to heart failure but is commonly used to diagnose myocardial infarction (heart attack).

D. Creatinine:

Creatinine is a waste product that comes from the normal wear and tear on muscles. While elevated creatinine levels can be seen in conditions affecting kidney function, it's not a direct marker for assessing heart failure. However, kidney function is often evaluated in conjunction with heart failure assessments.

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Naxlex Comprehensive Predictor Exams

A client is scheduled for a cardiac catheterization. The nurse should do which of the following pre-procedure tasks? (SELECT ALL THAT APPLY)

Correct Answer is ["A","B","C","D"]

Explanation

The nurse is caring for a client who has signs and symptoms of heart failure. Which of the following diagnostic tests is appropriate to assess the patient’s heart failure?

Correct Answer is B

Explanation

A critical-care nurse is caring for a client diagnosed with pneumonia as a surgical complication. The nurse’s assessment reveals that the client has an increased work of breathing due to copious tracheobronchial secretions. What should the nurse encourage the patient to do?

What is the best indication if the client with congestive heart failure is holding excess fluid?

A community health nurse teaches a group of seniors at an assisted living facility about modifiable risk factors that contribute to the development of peripheral arterial disease (PAD). The nurse knows that the teaching was effective based on which of the following statements?

A client with severe nausea has a one time order for ondansetron (Zofran) 8 mg IVPB to be administered over 15 minutes. The medication is diluted in 50 mL of D5W. The tubing drop factor is 15 gtt/mL. How many drops per minute should be given?

The nurse is taking the history of a client with occupational lung disease (silicosis). The nurse should assess whether the client wears which item during periods of exposure to silica particles?

The nurse is planning the care of a client with heart failure. The nurse should identify what overall goals for the client’s care? (SELECT ALL THAT APPLY)

An admitting nurse is assessing a client with COPD. The nurse auscultates diminished breath sounds. These findings indicated the nurse to monitor the client for what?

The nurse is providing care for a client recently diagnosed with peripheral arterial occlusive disease (PAD). What assessment finding is most consistent with this diagnosis?