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. A blood pressure of 90/50 mm Hg is concerning, but it is less urgent than severe respiratory depression. The nurse should still assess this client promptly.

B. A temperature of 96° F (35.6° C) is mildly low and should be addressed, but it is not as critical as a severely low respiratory rate.

C. A pulse of 118 beats/min is elevated and may require monitoring, but it does not pose as immediate a threat as respiratory depression.

D. A respiratory rate of 6 breaths/min is critically low, which may indicate respiratory depression, particularly after anesthesia. Immediate assessment and intervention are needed to ensure adequate oxygenation and ventilation.

A. Ca 12 B. Mag 3.1 C. K+ 2.6 D. Mag 1.1

Correct Answer is D

Explanation

A. Hypercalcemia (Calcium > 10.5 mg/dL) can lead to shortened QT intervals, not prolonged ones, and is unlikely to cause Torsades de Pointes.

B. A magnesium level of 3.1 mEq/L is slightly elevated and would not contribute to QT prolongation or Torsades de Pointes. In fact, magnesium supplementation is a treatment for this condition.

C. Hypokalemia (Potassium < 3.5 mEq/L) can prolong the QT interval and contribute to dysrhythmias, but it is less commonly a direct cause of Torsades de Pointes compared to hypomagnesemia. A potassium level of 2.6 mEq/L is low but would not typically result in Torsades without coexisting hypomagnesemia.

D. Hypomagnesemia (Magnesium < 1.5 mEq/L) disrupts the heart's electrical activity, prolonging the QT interval and increasing the risk of polymorphic ventricular tachycardia, like Torsades de Pointes. Magnesium is critical for stabilizing myocardial electrical conduction, and a value of 1.1 mEq/L indicates significant deficiency, consistent with this dysrhythmia.

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Naxlex Comprehensive Predictor Exams

The post anesthesia care unit (PACU) charge nurse notes vital signs on four postoperative clients. Which client would the nurse assess first?

Correct Answer is D

Explanation

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

Correct Answer is D

Explanation

A nurse reviews a client's laboratory results. Which findings would alert the nurse to the possibility of atherosclerosis? (Select all that apply.)

The nurse is caring for a client who has frequent gastric pain and dyspepsia. Which procedure would the nurse expect the health care provider to order to make an accurate diagnosis?

The new graduate nurse is assessing a client with an unrepaired abdominal aortic aneurysm. What assessment technique requires further education by the supervising nurse?

The health care provider orders: Epinephrine 0.25 mg IV stat Pharmacy provides: Epinephrine 0.1 mg/mL. How many mL will the nurse prepare to administer? (Round to one decimal place.)

The nurse is preparing to administer adenosine (Adenocard) to a client experiencing supraventricular tachycardia. When giving this medication, what is important to remember?

A client with chronic obstructive pulmonary disease (COPD) has poor gas exchange. Which action by the nurse would support the client's ventilation?

A client who has been receiving diuretic therapy is admitted to the emergency department with a serum potassium level of 3.0 mEq/L. The nurse should alert the health care provider immediately that the client is on which medication?