A client is admitted to the emergency department with chest pain and shortness of breath. The client states that the chest pain has been happening intermittently all day, lasts about 15 minutes at a time, and has been happening without any physical exertion or emotional stress. STAT lab results reveal troponin levels of 0.01 ng/mL, and a 12-lead electrocardiogram (ECG) shows sinus tachycardia with a T-wave inversion. Which diagnosis would the nurse expect for this client?
NSTEMI
Stable angina
STEMI
Unstable angina
The Correct Answer is D
A. NSTEMI would present with elevated troponin levels indicating myocardial injury, which is not the case here.
B. Stable angina occurs predictably with exertion and is relieved by rest or nitroglycerin.
C. STEMI is characterized by ST-elevation on the ECG and elevated troponin levels, indicating significant myocardial injury.
D. Unstable angina presents with chest pain that occurs at rest or with minimal exertion and is not predictable. The presence of T-wave inversion and normal troponin levels is consistent with this diagnosis.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. Transporting the patient to the cardiac catheterization lab for percutaneous coronary intervention (PCI) is the priority intervention for a patient with an ST-elevation myocardial infarction (STEMI). PCI is the preferred treatment to restore blood flow to the affected coronary artery.
B. Aggressive diuresis and digoxin are not appropriate for the acute management of a STEMI. Diuresis may be used in cases of heart failure but is not the immediate priority.
C. Synchronized cardioversion and radiofrequency catheter ablation are treatments for certain arrhythmias but are not indicated for the acute management of STEMI.
D. Administering gemfibrozil, a lipid-lowering agent, and preparing for a stress test are not appropriate interventions in the acute setting of a STEMI. Immediate reperfusion therapy is necessary.
Correct Answer is B
Explanation
A. While soft stools after taking docusate sodium is noteworthy, it is not immediately life-threatening and does not require urgent intervention.
B. Oliguria (low urine output) in a client with TTP is concerning because it may indicate acute kidney injury or worsening of the condition, requiring immediate assessment and intervention.
C. An elevated blood pressure in a client with PACs is important but not as critical as potential kidney dysfunction in the TTP patient.
D. A weight loss of 0.5 kg in a client with heart failure on furosemide may be expected and does not require immediate intervention.
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