The nurse is caring for a client who is undergoing an exercise stress test. Prior to reaching the target heart rate, the client develops chest pain. What is the nurse’s most appropriate interpretation of the chest pain?

The patient pain reflects the target heart rate has been set too high and needs to be lowered to finish the test.

The patient’s pain reflects pericarditis and the test should be stopped.

The patient’s pain reflects ischemia to the myocardium and the test should be stopped.

The patient’s pain reflects that supplemental oxygen is needed to finish the test.

Answer and Explanation

The Correct Answer is C

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.

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Correct Answer is C

Explanation

A. Obtain a sputum sample:

This option is more relevant when the client is experiencing cough with sputum production, which might suggest respiratory issues. However, in the context of coughing after eating or drinking, the primary concern is likely related to the swallowing process rather than respiratory conditions.

B. Inspect the client’s tongue and mouth:

While inspecting the tongue and mouth is a good practice for assessing oral health, it may not directly address the issue of coughing after eating or drinking, which is more indicative of potential swallowing difficulties.

C. Perform a swallowing assessment:

This is the most appropriate option for the given scenario. A swallowing assessment helps identify any abnormalities or difficulties in the swallowing process, which could contribute to the client's coughing after eating or drinking.

D. Assess the client’s nutritional status:

While assessing nutritional status is important for overall health, it may not directly address the immediate concern of coughing after eating or drinking. Nutritional status assessment is a broader aspect of care.

A. “I will need to stop smoking because the nicotine causes less blood to flow to my hands and feet.” B. “The older I get the higher my risk for peripheral arterial disease gets.” C. “Since my family is from Italy, I have a higher risk of developing peripheral arterial disease.” D. “I will need to increase the amount of green leafy vegetables I eat to lower my cholesterol levels.”

Correct Answer is A

Explanation

A. “I will need to stop smoking because the nicotine causes less blood to flow to my hands and feet.”

Explanation: This statement reflects an understanding of the association between smoking and reduced blood flow, particularly due to nicotine's vasoconstrictive effects.

B. “The older I get the higher my risk for peripheral arterial disease gets.”

Explanation: While age is a non-modifiable risk factor for PAD, it is not a statement indicating a change in behavior to address risk factors. It is correct information but doesn't involve a proactive approach to risk reduction.

C. “Since my family is from Italy, I have a higher risk of developing peripheral arterial disease.”

Explanation: Family history is a non-modifiable risk factor, and the statement correctly identifies this risk factor. However, it doesn't address modifiable factors or actions to reduce risk.

D. “I will need to increase the amount of green leafy vegetables I eat to lower my cholesterol levels.”

Explanation: This statement demonstrates an understanding of a dietary modification to lower cholesterol levels, which is a positive step toward reducing a modifiable risk factor for PAD.

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The nurse is caring for a client who is undergoing an exercise stress test. Prior to reaching the target heart rate, the client develops chest pain. What is the nurse’s most appropriate interpretation of the chest pain?

Nursing Test Bank

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