The nurse is attempting to determine the ventricular rate and rhythm of a patient's telemetry strip. What should the nurse examine to determine this part of the analysis?

A. "The decreased HDL level will increase the amount of cholesterol moved away from the artery walls":

This statement is incorrect. High-density lipoprotein (HDL) is often referred to as "good" cholesterol because it helps remove excess cholesterol from the bloodstream and transport it to the liver for processing. A decreased HDL level is associated with an increased risk of cardiovascular disease, not with moving cholesterol away from artery walls.

B. "Increased LDL and decreased HDL increase my risk of coronary artery disease":

This statement is correct. Low-density lipoprotein (LDL) is often referred to as "bad" cholesterol because elevated LDL levels contribute to the buildup of plaque in the arteries, increasing the risk of coronary artery disease (CAD). Conversely, decreased HDL levels are associated with reduced cholesterol removal from the bloodstream, further increasing the risk of CAD.

C. "Increased LDL has the potential to decrease my risk of heart disease":

This statement is incorrect. Elevated LDL levels are a major risk factor for heart disease and are associated with an increased risk of atherosclerosis and cardiovascular events.

D. "The increased LDL will decrease the amount of cholesterol deposited on the artery walls":

This statement is incorrect. Increased LDL levels contribute to the deposition of cholesterol on artery walls, leading to the formation of plaque and narrowing of the arteries, which is detrimental to heart health.

A. The symptoms indicate an acute coronary episode and should be treated as such:

The client's symptoms, including sudden midsternal chest pain unrelieved with rest and a history of coronary artery disease (CAD), strongly suggest an acute coronary event, such as a myocardial infarction (heart attack). Pale, cool skin can also be indicative of decreased perfusion due to cardiac compromise. Given these critical signs and symptoms, the nurse should interpret this as a potential cardiac emergency and initiate immediate interventions aimed at managing and stabilizing the client's condition.

B. The symptoms indicate angina and should be treated as such:

While angina can present with symptoms such as chest pain, it is typically relieved with rest or nitroglycerin. In contrast, the client in this scenario has midsternal chest pain that is not relieved with rest, which is more indicative of an acute coronary event like a myocardial infarction. Therefore, interpreting the symptoms as angina and treating them as such may not be appropriate given the severity and persistence of the chest pain.

C. Treatment should be determined pending the results of an exercise stress test:

Waiting for the results of an exercise stress test is not appropriate in this scenario, as the client's presentation suggests an acute cardiac event that requires immediate intervention. Exercise stress tests are typically used for diagnostic purposes to assess cardiovascular function under controlled conditions but are not suitable for managing acute coronary episodes or emergencies.

D. The symptoms indicate a pulmonary etiology rather than a cardiac etiology:

While some symptoms, such as shortness of breath or chest pain, can overlap between cardiac and pulmonary conditions, the client's presentation with sudden midsternal chest pain unrelieved with rest, pale cool skin, and a history of CAD strongly suggests a cardiac etiology, specifically an acute coronary event. It is essential to prioritize cardiac assessment and intervention based on the client's symptoms and medical history.