A 65-year-old woman with no history of pulmonary or cardiovascular issues presents to the emergency department with nausea, fatigue, and fullness and pain of the abdomen. The nurse knows the assessment tests that will be ordered first will include:
Abdominal ultrasound and chest X-ray.
Test of the acidity of the gastric contents and assessment of the throat.
Electrocardiogram (EKG) and serum troponin levels.
Abdominal X-ray and colonoscopy.
The Correct Answer is C
Choice A reason:
Abdominal ultrasound and chest X-ray are not the first-line tests for a patient presenting with these symptoms. While they can be useful in assessing certain conditions, the priority in this case is to rule out cardiac causes, especially given the symptoms that could indicate a cardiac event.
Choice B reason:
Testing the acidity of gastric contents and assessing the throat is not relevant for the initial evaluation of these symptoms. While gastrointestinal issues can present with similar symptoms, the first step should be to rule out more serious cardiac causes.
Choice C reason:
Electrocardiogram (EKG) and serum troponin levels are the correct answer. These tests are critical in assessing cardiac function and identifying potential myocardial infarction or other cardiac issues. Given the patient's symptoms, which can be indicative of a cardiac event, these tests are prioritized to rule out any immediate cardiac threats.
Choice D reason:
Abdominal X-ray and colonoscopy are not appropriate first-line tests in this scenario. While they may be necessary later to investigate gastrointestinal issues, the primary concern given the patient's symptoms is to rule out cardiac events with an EKG and serum troponin levels.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A reason:
Aspirin is an antiplatelet medication used to prevent blood clots in the arteries but is not the primary treatment for deep vein thrombosis (DVT), which is likely in this scenario. The patient's symptoms suggest a possible DVT, which requires anticoagulation therapy.
Choice B reason:
Clopidogrel (Plavix) is another antiplatelet medication, similar to aspirin, and is not the primary treatment for DVT. It is more commonly used to prevent clotting in arterial diseases such as coronary artery disease but not for venous thromboembolism.
Choice C reason:
Enoxaparin (Lovenox) is a low molecular weight heparin used for the initial treatment of DVT. It is an anticoagulant that helps prevent further clot formation and allows the body to break down the existing clot. Given the patient's symptoms, enoxaparin is the appropriate medication to anticipate for managing DVT.
Choice D reason:
Warfarin (Coumadin) is an oral anticoagulant used for long-term prevention of thromboembolism but is not typically used for initial DVT treatment due to its slow onset of action. Enoxaparin or other forms of heparin are preferred for immediate anticoagulation.
Correct Answer is C
Explanation
Choice A reason:
Hypotension is not the likely cause of chest pain that does not improve after sublingual Nitroglycerin in a patient with a history of atherosclerosis. While hypotension can cause symptoms, the description of chest pain at rest that does not respond to Nitroglycerin suggests a more severe cardiac issue.
Choice B reason:
Stable angina typically occurs with exertion and is relieved by rest or Nitroglycerin. Chest pain consistent at rest that does not improve with Nitroglycerin suggests unstable angina, which is a more serious condition and requires immediate medical attention.
Choice C reason:
Unstable angina is the correct answer. It occurs when chest pain happens at rest and is not relieved by Nitroglycerin, indicating that the blood flow to the heart is severely restricted. This condition is a medical emergency as it can lead to a myocardial infarction.
Choice D reason:
Coronary vasodilation would typically relieve chest pain by increasing blood flow to the heart. The pain described is more consistent with unstable angina, where there is a significant reduction in blood flow to the heart that does not respond to vasodilation.
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