A 29-year-old women presents to the ER with chest pain that started this evening. She has experienced episodes like this before which typically occur in the evening and resolve by the next morning. The client has a medical history of migraines and Raynaud's disease.

Temp: 98 F

BP: 119/72 mm/Hg

HR: 99 bpm

RR: 16 bpm

Sp02: 96% RA

An EKG is completed and indicates no evidence of a myocardial infarction but supports the diagnosis of Prinzmetal Angina. The nurse finds the client crying stating, "I'm so young, how can my heart arteries be clogged? I eat healthy and the doctor said my cholesterol was normal." What is the nurses best response?

"This condition is caused by the coronary arteries spasming, not by cholesterol."

"Just because you're young and eat right doesn't mean you can't have plaque buildup."

"I understand it can be upsetting to have coronary artery disease at your age."

"I am sure everything will be alright."

Answer and Explanation

The Correct Answer is A

A. The best response is to educate the client about the cause of Prinzmetal angina. It occurs due to spasm in the coronary arteries, which is different from the plaque buildup seen in traditional coronary artery disease. This response addresses the client's concern in an accurate and reassuring manner.

B. While healthy eating is important, Prinzmetal angina is not typically caused by cholesterol or plaque buildup. This response could increase the client's anxiety.

C. While acknowledging the client's emotions is important, this response does not address the underlying concern or provide an accurate explanation of Prinzmetal angina.

D. Offering reassurance without providing accurate information about the condition does not help the client understand the cause of their symptoms and could leave them confused or anxious.

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Correct Answer is D

Explanation

A. Amiodarone is an antiarrhythmic used to treat ventricular arrhythmias like monomorphic VT, but it is not the first-line treatment for a pulseless patient. Defibrillation should be performed immediately, and amiodarone can be administered after defibrillation if the rhythm persists.

B. CPR is essential for maintaining circulation in a pulseless patient, but defibrillation should be the first priority for monomorphic VT. CPR should be continued if defibrillation is not immediately available, but the most effective intervention is defibrillation to attempt to restore normal rhythm.

C. Cardioversion is used for stable, regular arrhythmias, but for a pulseless client in monomorphic VT, defibrillation is the appropriate first intervention. Cardioversion is typically used when the patient is conscious or stable and is not a priority for pulseless VT.

D. For a pulseless client with monomorphic ventricular tachycardia, defibrillation is the priority intervention. Defibrillation delivers an electric shock to the heart, which may terminate the abnormal rhythm and allow the heart to return to normal sinus rhythm. This is the most effective and immediate treatment for a pulseless client in ventricular tachycardia.

A. "I will make sure that my partner takes all the prescribed medication." B. "I will have my partner take the antibiotics if any STI symptoms occur." C. "I will have my partner use a condom until I finish the antibiotics." D. "I will tell my partner that it is important to be examined at the clinic."

Correct Answer is A

Explanation

A. "I will make sure that my partner takes all the prescribed medication.": This is the correct answer. Expedited partner therapy involves treating the partner(s) without an initial clinical visit, so ensuring they take all prescribed medications is essential to prevent reinfection.

B. "I will have my partner take the antibiotics if any STI symptoms occur.": This is incorrect because the partner should take the antibiotics regardless of symptoms to effectively treat the infection.

C. "I will have my partner use a condom until I finish the antibiotics.": While condom use is important, it does not replace the need for the partner to receive treatment.

D. "I will tell my partner that it is important to be examined at the clinic.": Although important, expedited partner therapy aims to provide treatment without a clinic visit.

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Naxlex Comprehensive Predictor Exams

What would be the priority intervention for the care of the client who is pulseless and has the following rhythm on the monitor?

Correct Answer is D

Explanation

After the nurse has taught the client with a newly diagnosed sexually transmitted infection about expedited partner therapy, which client statement indicates that teaching has been effective?

Correct Answer is A

Explanation

After teaching a client who has an implantable cardioverter- defibrillator (ICD), a nurse assesses the client's understanding. Which statement by the client indicates correct understanding of the teaching?

A 20-year-old has a mandatory electrocardiogram (ECG) before participating on a college soccer team and is found to have sinus bradycardia, rate 52. The students blood pressure is 119/76 and denies any health issues. Which action by the nurse is most appropriate?

Physician orders Cardizem to infuse at 10 mg/hr. Available is Cardizem 125 mg in 100 ml D5W. What is the rate in ml/hr?

Which lab value would be most likely to cause the following dysrhythmia?

The nurse taking a focused health history for a client with possible testicular cancer will ask the client about a history of

A client with genital herpes has painful blisters on her vulva. After teaching the client self-care measures, which statement indicates the need for further education?

A client has peripheral arterial disease (PAD). What statement by the client indicates misunderstanding about self-management activities?