A 51-year-old male has come to the health clinic for his annual physical exam. After exerting himself by walking from his car to the clinic, he experienced substernal pain, discomfort in his left shoulder, and his jaw.
These symptoms lasted for 2-3 minutes and then subsided with rest.
He mentions that this has been a frequent occurrence over the past few months with similar levels of exertion.
What is the nurse likely to suspect he is experiencing?
Stable angina.
Prinzmetal angina.
Myocardial infarction (MI).
Unstable angina.
The Correct Answer is A
Choice A rationale
Stable angina typically occurs with exertion and goes away with rest. The symptoms described, including substernal pain, discomfort in the left shoulder and jaw, which subside with rest, are characteristic of stable angina.
Choice B rationale
Prinzmetal angina, also known as variant angina, is a type of angina (chest pain) caused by spasms in the coronary arteries. These spasms occur most often in coronary arteries that have not become hardened due to plaque buildup. However, they can also occur in hardened arteries. The symptoms can be similar to those of stable angina, but the typical triggers for the episodes are different.
Choice C rationale
A myocardial infarction (MI), or heart attack, occurs when one of the coronary arteries becomes blocked, often by a blood clot, causing part of the heart muscle to be damaged or die. The symptoms are usually more severe than what is described and do not typically subside with rest.
Choice D rationale
Unstable angina is a condition in which the angina symptoms become more severe, occur more frequently, or occur at rest. This is a medical emergency as it can often lead to a heart attack.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A rationale
Intermittent claudication and pallor are not typically symptoms of a myocardial infarction. Intermittent claudication, or pain in the legs with exercise, is more commonly associated with peripheral artery disease. Pallor, or paleness, can occur with various conditions but is not a specific sign of myocardial infarction3.
Choice B rationale
Jugular vein distention and dependent edema are not typically symptoms of a myocardial infarction. These signs are more commonly associated with heart failure3.
Choice C rationale
Mid-epigastric pain and heartburn can sometimes be symptoms of a myocardial infarction, particularly in women. However, these symptoms can also occur with many other conditions, including gastrointestinal disorders3.
Choice D rationale
Sweating and cool, clammy skin are common symptoms of a myocardial infarction. These symptoms occur due to the body’s stress response to the decreased blood flow to the heart muscle3.
Correct Answer is A
Explanation
Choice A rationale
Propranolol (Inderal) is a beta-adrenergic receptor blocker, also known as a beta-blocker. Beta-blockers can increase airway reactivity and may interfere with the activity of beta-agonists. They should be used with great caution or not at all in patients with chronic asthma.
However, beta blockers are safe for use in most patients with COPD, but less so in patients with asthma. Therefore, Propranolol (Inderal) is not recommended for patients with chronic obstructive pulmonary disease (COPD) and asthma.
Choice B rationale
Captopril (Capoten) is an ACE inhibitor, which is among the most widely used antihypertensive drugs. They are not contraindicated in asthma or COPD, but they can induce a bothersome cough that, although not damaging to the lungs, can be confused with cough due to underlying pulmonary diseases such as asthma and COPD1.
Choice C rationale
Diltiazem (Cardizem) is a calcium antagonist. There is no specific contraindication for using calcium antagonists in patients with COPD or asthma. These medications work by relaxing the muscles of your heart and blood vessels, but they do not have a direct effect on airway reactivity or lung function.
Choice D rationale
Hydrochlorothiazide (HydroDIURIL) is a diuretic. Diuretics help your body get rid of excess salt and water, primarily by stimulating your kidneys. They do not have a direct effect on airway reactivity or lung function, and there is no specific contraindication for using them in patients with COPD or asthma.
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