A nurse is assessing a patient who has a history of atherosclerosis. Which assessment finding suggests myocardial ischemia?

Chest pain that radiates to the jaw

Sudden and severe abdominal pain

Blurred vision

Dry cough

Answer and Explanation

The Correct Answer is A

A. Chest pain that radiates to the jaw:
This finding suggests myocardial ischemia, as chest pain (angina) that radiates to the jaw is a classic symptom of cardiac origin. It is known as referred pain and occurs because the nerves that innervate the heart and jaw have a similar sensory pathway. The pain may be described as pressure, squeezing, or tightness in the chest, and it often spreads to the neck, shoulders, arms, or jaw. This pattern of pain radiation is typical in myocardial ischemia or heart attack due to inadequate blood supply to the heart muscle.

B. Sudden and severe abdominal pain:
While abdominal pain can be associated with various conditions, sudden and severe abdominal pain is not a typical symptom of myocardial ischemia. Instead, it may indicate other abdominal issues such as gastrointestinal problems, pancreatitis, or intra-abdominal vascular events. Myocardial ischemia typically presents with chest pain or discomfort, rather than abdominal pain.

C. Blurred vision:
Blurred vision is not a typical symptom of myocardial ischemia. It may suggest ocular issues such as refractive errors, dry eyes, or conditions affecting the retina or optic nerve. Myocardial ischemia primarily manifests with symptoms related to the heart, such as chest pain, shortness of breath, or other signs of cardiovascular compromise.

D. Dry cough:
A dry cough is not a typical symptom of myocardial ischemia. It may be associated with various respiratory conditions such as allergies, asthma, or respiratory infections. Myocardial ischemia primarily presents with symptoms related to the heart and cardiovascular system, such as chest pain, palpitations, or dyspnea.

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Correct Answer is C

Explanation

A. Sedentary lifestyle: While a sedentary lifestyle can contribute to the development and progression of peripheral arterial disease (PAD), it is not the highest risk factor compared to other options listed. Regular physical activity is important for cardiovascular health and can help reduce the risk of PAD, but other risk factors may have a greater impact on disease development.

B. Diabetes: Diabetes is a significant risk factor for PAD, especially when poorly controlled. High blood sugar levels can damage blood vessels and nerves, leading to atherosclerosis and reduced blood flow to the limbs. However, compared to cigarette smoking, diabetes may not be considered the highest risk factor for PAD.

C. Cigarette smoking: Cigarette smoking is the highest risk factor for peripheral arterial disease (PAD). Tobacco smoke contains numerous harmful chemicals that damage blood vessels and promote atherosclerosis, narrowing the arteries and reducing blood flow to the limbs. Smoking not only increases the risk of developing PAD but also accelerates its progression and worsens symptoms. Quitting smoking is one of the most important interventions for preventing and managing PAD.

D. Hyperlipidemia: Elevated levels of cholesterol and triglycerides (hyperlipidemia) contribute to the development of atherosclerosis, which is a key mechanism underlying peripheral arterial disease (PAD). However, while hyperlipidemia is a significant risk factor, it may not be considered the highest risk factor compared to cigarette smoking. Controlling cholesterol levels through lifestyle changes and medications is essential for managing PAD and reducing cardiovascular risk.

A. Dry skin B. Burning sensation C. Diarrhea D. Irregular heart rate

Correct Answer is D

Explanation

A. Dry skin:
Dry skin is not a commonly reported side effect of diltiazem, a calcium channel blocker used for blood pressure management. While dry skin can occur due to various reasons, it is less likely to be directly associated with diltiazem use. Therefore, it is not the side effect that the nurse should prioritize instructing the patient to report to the provider.

B. Burning sensation:
Although burning sensation is not a common side effect of diltiazem, it can occasionally occur as a skin reaction or hypersensitivity reaction to the medication. While this symptom may warrant attention, it is generally less concerning compared to other potential side effects of diltiazem. Therefore, while it is important for the patient to report any unusual sensations or discomfort, burning sensation alone may not be the most critical side effect to report.

C. Diarrhea:
Diarrhea is a potential side effect of diltiazem use. Calcium channel blockers like diltiazem can affect gastrointestinal motility and lead to gastrointestinal disturbances, including diarrhea. While diarrhea can be bothersome and may indicate intolerance to the medication, it is generally considered a common side effect rather than a severe adverse reaction. Therefore, while the nurse should educate the patient about the possibility of diarrhea and encourage reporting any persistent or severe cases, it may not be the most critical side effect to report to the provider.

D. Irregular heart rate:
Irregular heart rate, including bradycardia or tachycardia, is a significant and potentially serious side effect of diltiazem. As a calcium channel blocker, diltiazem can affect cardiac conduction, leading to alterations in heart rate and rhythm. Irregular heart rate can indicate a significant cardiovascular complication and may require prompt medical attention. Therefore, the nurse should prioritize instructing the patient to report any changes in heart rate, including palpitations, rapid heartbeat, or irregular pulse, to the provider immediately.

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A nurse is assessing a patient who has a history of atherosclerosis. Which assessment finding suggests myocardial ischemia?

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Naxlex Comprehensive Predictor Exams

A nurse is caring for a patient with peripheral arterial disease. Which factor will the nurse identify as the highest risk?

Correct Answer is C

Explanation

The nurse is caring for a patient taking diltiazem for blood pressure management. The nurse instructs the patient to report which side effect to the provider?

Correct Answer is D

Explanation

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