The nurse is caring for a client diagnosed with a myocardial infarction (MI) who is reporting severe chest pain.Which interventions should the nurse implement? (Select all that apply.)
Place the client in the supine position.
Administer morphine intramuscularly.
Administer nitroglycerin subcutaneously.
Administer aspirin 325 orally.
Apply oxygen via nasal cannula.
Correct Answer : D,E
Choice D rationale
Administering aspirin 325 orally is important for clients with a myocardial infarction (MI). Aspirin helps to inhibit platelet aggregation, reducing the risk of further clot formation and improving blood flow to the heart. This can significantly decrease mortality and complications associated with MI.
Choice E rationale
Applying oxygen via nasal cannula helps to increase oxygen delivery to the heart and other vital organs during an MI. Ensuring adequate oxygenation can help reduce the extent of myocardial injury and support overall cardiac function during a critical period.
Choice A rationale
Placing the client in a supine position is not appropriate during an MI, as it can increase discomfort and the workload on the heart. Instead, the client should be positioned in a semi-Fowler’s or comfortable position to improve breathing and comfort.
Choice B rationale
Administering morphine intramuscularly is not recommended during an MI. Morphine can be used for pain relief but should be given intravenously to ensure rapid onset and better control over dosing. Intramuscular administration is less effective and can delay pain relief.
Choice C rationale
Administering nitroglycerin subcutaneously is not appropriate. Nitroglycerin is typically given sublingually or intravenously during an MI to provide rapid vasodilation and pain relief. Subcutaneous administration is not effective in this context. .
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A rationale
Stress and anxiety can contribute to gastrointestinal issues, but they are not the most likely cause of a duodenal ulcer.
Choice B rationale
Nonsteroidal anti-inflammatory drugs (NSAIDs) can cause gastrointestinal irritation and ulcers, but Helicobacter pylori infection is a more common cause.
Choice C rationale
Excessive alcohol consumption can irritate the stomach lining and contribute to ulcer formation, but Helicobacter pylori infection is more likely to be the primary cause.
Choice D rationale
Helicobacter pylori infection is the most common cause of duodenal ulcers. The bacteria damage the protective lining of the stomach and duodenum, leading to ulcer formation. .
Correct Answer is ["B","C","D"]
Explanation
Choice A rationale
Lying down after meals can increase the risk of acid reflux in individuals with a hiatal hernia. Patients are often advised to remain upright after eating to minimize symptoms.
Choice B rationale
Elevating the head of the bed helps prevent gastric contents from refluxing into the esophagus, reducing symptoms of hiatal hernia and promoting better sleep.
Choice C rationale
Reducing caffeine and spicy foods can help manage symptoms, as these substances can irritate the stomach lining and exacerbate reflux in hiatal hernia patients.
Choice D rationale
Maintaining a healthy weight is important because excess weight can increase abdominal pressure and contribute to the worsening of hiatal hernia symptoms.
Choice E rationale
Drinking less fluid is not typically a recommendation for hiatal hernia. Adequate hydration is important for overall health, and reducing fluid intake may not have a significant impact on symptoms.
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