The nurse knows which of the following types of angina is most closely related with an impending myocardial infarction (MI)?
Unstable
Variant
Chronic stable
Nocturnal
The Correct Answer is A
A) Unstable:
Unstable angina is the type of angina most closely related to an impending myocardial infarction (MI). It is characterized by unpredictable chest pain that occurs at rest or with minimal exertion, or that increases in severity or frequency. Unstable angina represents a medical emergency and can progress to an MI if not promptly treated. It occurs when there is increased myocardial oxygen demand and a partially occluded coronary artery, often due to a ruptured atherosclerotic plaque.
B) Variant (Prinzmetal's) angina:
Variant angina, also known as Prinzmetal's angina, is caused by a spasm of the coronary artery, which temporarily narrows or obstructs blood flow. Although it can be severe and may occur at rest, it is typically transient and is not directly related to the development of an MI. Variant angina usually responds to medications such as nitrates or calcium channel blockers, and while it can be dangerous, it is not the most likely type of angina associated with a myocardial infarction.
C) Chronic stable angina:
Chronic stable angina occurs with predictable patterns, typically with exertion or stress, and resolves with rest or nitroglycerin. It does not usually indicate an impending MI, as it is a chronic condition caused by atherosclerosis that limits the heart's blood supply under stress. While chronic stable angina increases the risk of MI over time, it is not directly associated with an imminent heart attack.
D) Nocturnal angina:
Nocturnal angina refers to chest pain that occurs during the night or early morning hours, often during sleep. It may be associated with sleep apnea, GERD, or increased sympathetic tone during sleep. This type of angina is less commonly linked to an impending MI compared to unstable angina, although it should still be evaluated for any underlying cardiovascular issues.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A) Respiratory acidosis:
Respiratory acidosis occurs when there is an accumulation of carbon dioxide (CO2) in the blood, leading to a decrease in pH. In the given blood gas values, the PaCO2 is 28 mmHg, which is lower than the normal range (35-45 mmHg), indicating that CO2 is being exhaled more than usual, not accumulating.
B) Metabolic acidosis:
Metabolic acidosis results from a decrease in bicarbonate (HCO3-) or an increase in acid in the body. However, in the provided values, the bicarbonate (HCO3-) is normal at 24 mEq/L, and the pH is elevated at 7.51, indicating alkalosis rather than acidosis
C) Metabolic alkalosis:
Metabolic alkalosis occurs when there is an increase in bicarbonate levels or excessive loss of acids, often associated with vomiting or diuretic use. However, in this case, the bicarbonate level (HCO3-) is normal, and the pH is more consistent with alkalosis due to respiratory factors, not metabolic causes.
D) Respiratory alkalosis:
Respiratory alkalosis occurs when there is excessive exhalation of CO2, leading to a rise in blood pH (alkalosis). The pH is 7.51, which is above the normal range (7.35-7.45), indicating alkalosis. Additionally, the PaCO2 is low at 28 mmHg, which suggests that the client is hyperventilating and exhaling too much CO2, confirming respiratory alkalosis as the correct interpretation.
Correct Answer is D
Explanation
A) “I will be able to recall events from childhood after completing rehabilitation”:
This demonstrates an unrealistic expectation. While rehabilitation can significantly improve cognitive functions, a serious brain injury may affect memory and recall to a degree that may not be fully reversible. Complete recovery of specific memories, such as childhood events, is not guaranteed.
B) "I will display all of my pre-injury traits and characteristics.":
This also reflects an unrealistic goal. Brain injuries can result in permanent changes to cognitive, emotional, and physical functioning. While rehabilitation can help a patient regain many abilities, it is unlikely that they will fully return to their pre-injury state, particularly in terms of personality traits and behaviors.
C) “I will regain complete motor and sensory functions after rehabilitation”:
This is also unrealistic. While rehabilitation aims to help patients regain as much motor and sensory function as possible, it is often not possible to fully restore complete function after a significant brain injury. Recovery may be partial, and some deficits may remain, depending on the extent of the injury.
D) “I should actively participate in the rehabilitation process as appropriate”:
This reflects a realistic and positive approach to recovery. Active participation in rehabilitation is essential for maximizing recovery after a brain injury. The process involves setting attainable goals based on the patient’s current abilities and gradually working toward improving those functions.
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