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.
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A. The patient pain reflects the target heart rate has been set too high and needs to be lowered to finish the test.
This option suggests that the chest pain is related to the target heart rate being set too high. However, chest pain during an exercise stress test is more commonly associated with myocardial ischemia rather than an inappropriate target heart rate. Lowering the target heart rate may not address the underlying issue of ischemia.
B. The patient’s pain reflects pericarditis and the test should be stopped.
Chest pain during an exercise stress test is more commonly associated with myocardial ischemia rather than pericarditis. Pericarditis is inflammation of the pericardium, and its symptoms may include chest pain that is often sharp and pleuritic. However, during an exercise stress test, the focus is on detecting cardiovascular abnormalities, and chest pain is more concerning for ischemia.
C. The patient’s pain reflects ischemia to the myocardium and the test should be stopped.
This is the most appropriate interpretation. Chest pain during an exercise stress test may indicate insufficient oxygen supply to the myocardium (ischemia). Stopping the test allows for further evaluation and appropriate intervention.
D. The patient’s pain reflects that supplemental oxygen is needed to finish the test.
Chest pain during an exercise stress test is not typically addressed by providing supplemental oxygen. Stopping the test and evaluating the cause of the chest pain is a more appropriate action.
Correct Answer is ["A","B","C","D"]
Explanation
A. Normal sinus rhythm that becomes sinus tachycardia
Sinus tachycardia can be an indication of increased sympathetic activity in response to decreased cardiac output. It may suggest the heart's compensatory response to maintain adequate perfusion.
B. Onset of a cough with pink, frothy sputum
Pink, frothy sputum is a classic sign of pulmonary edema, which can occur in the setting of worsening heart failure. It indicates the presence of blood-tinged fluid in the alveoli.
C. Presence of dyspnea at rest
Dyspnea at rest suggests that the client is experiencing difficulty breathing even without physical exertion. This can be indicative of more severe heart failure.
D. Falls asleep when not disturbed
Falling asleep when not disturbed may indicate fatigue or exhaustion, which is common in individuals with heart failure. However, it is not a direct indicator of worsening heart failure and can be influenced by various factors.
E. Urine drainage is increased in amount
Increased urine output can be a sign of diuretic therapy or an attempt by the body to compensate for fluid overload. However, it is essential to consider other factors such as renal function and medication effects.
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