A patient is being admitted to the emergency department with intermittent chest pain. They provide a list of daily medications.

Which medication from the list has the most immediate implications for the patient’s care?

Calcium channel blocker

Phosphodiesterase 5 enzyme inhibitor

Anticoagulant

Loop diuretics

Answer and Explanation

The Correct Answer is B

Choice A rationale
Calcium channel blockers are primarily used to treat hypertension, angina, and certain heart arrhythmias. They work by relaxing the muscles of your heart and blood vessels. While they can affect heart rate and blood pressure, they would not typically have immediate implications for a patient presenting with intermittent chest pain.
Choice B rationale
Phosphodiesterase 5 enzyme inhibitors, such as sildenafil (Viagra), are used to treat erectile dysfunction and pulmonary arterial hypertension. These medications can interact with nitroglycerin, a common medication used to treat chest pain, to cause a severe and life-threatening drop in blood pressure. Therefore, it’s crucial to know if a patient is taking this type of medication when they present with chest pain.
Choice C rationale
Anticoagulants are used to prevent blood clots. If a patient is taking an anticoagulant, it could affect their clotting times and could be important if the patient needs surgery or if the cause of their chest pain is a clot. However, this would not typically have immediate implications for the treatment of chest pain.
Choice D rationale
Loop diuretics are strong diuretics that are used to treat edema and hypertension. They work by preventing your body from absorbing too much salt, allowing the salt to instead be passed in your urine. While important to know for overall patient care, they would not typically have immediate implications for a patient presenting with chest pain.

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Correct Answer is C

Explanation

Choice A rationale
Anxiety is a common response to the stress of hospitalization and illness, especially in the context of a serious condition like ST-segment-elevation myocardial infarction (STEMI).
However, while anxiety can exacerbate physical symptoms and should be addressed, it is not the primary problem in this scenario.
Choice B rationale
Acute pain is a common symptom of STEMI, as the heart muscle is deprived of oxygen. However, the patient’s blood pressure and heart rate readings suggest a more immediate concern related to the cardiovascular system.
Choice C rationale
Decreased cardiac output is likely the priority problem for this patient. The patient’s low blood pressure (86/40 mm Hg) and high heart rate (132 beats/min) suggest that the heart is not pumping enough blood to meet the body’s needs, which is a direct consequence of the STEMI1. This can lead to organ failure and other serious complications if not addressed promptly.
Choice D rationale
Stress management is an important aspect of long-term care for patients with heart disease, as chronic stress can contribute to further heart damage. However, in the acute phase of a STEMI, the focus is on stabilizing the patient’s condition and preventing complications.

A. Assess the need for smoking cessation. B. Apply TED hose to bilateral legs. C. Consult physical therapy. D. Obtain Ankle-Brachial Index (ABI) with a hand-held Doppler.

Correct Answer is B

Explanation

Choice A rationale
Assessing the need for smoking cessation is a standard part of nursing care, especially for patients with circulatory issues. Smoking can exacerbate circulatory problems and delay wound healing.
Choice B rationale
Applying TED hose to bilateral legs might not be appropriate for this patient. TED hose are compression stockings designed to prevent deep vein thrombosis and promote circulation.
However, in a patient with weak pedal pulses and a full-thickness wound on the leg, the compression from the stockings could potentially worsen circulation to the area and impede wound healing.
Choice C rationale
Consulting physical therapy could be beneficial for this patient. Physical therapists can provide exercises and interventions to improve circulation and mobility, which could help with the patient’s circulatory issues and wound healing.
Choice D rationale
Obtaining an Ankle-Brachial Index (ABI) with a hand-held Doppler could be useful in this situation. The ABI is a simple, non-invasive test that can help diagnose peripheral artery disease (PAD), a condition that could be causing the patient’s weak pedal pulses and wound healing issues.

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A patient is being admitted to the emergency department with intermittent chest pain. They provide a list of daily medications. Which medication from the list has the most immediate implications for the patient’s care?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A patient has been admitted to the coronary care unit (CCU) with an ST-segment-elevation myocardial infarction (STEMI). The patient is restless, anxious, has a blood pressure of 86/40 mm Hg, and a heart rate of 132 beats/min. What is the priority problem for this patient?

Correct Answer is C

Explanation

The nurse is caring for a client with weak pedal pulses, absent hair on bilateral legs, and a full-thickness wound on the right lateral malleolus with defined margins, including a minimal amount of serous exudate. Which of the following interventions is contraindicated?

Correct Answer is B

Explanation

A patient with dilated cardiomyopathy has recently developed atrial fibrillation that has been unresponsive to drug therapy for several days. What topic should the nurse plan to include in patient teaching?

Most cases of combined systolic and diastolic hypertension have no known cause and are documented on the chart as what type of hypertension?

When preparing a patient for a cardiac catheterization and coronary angiogram, which piece of information about the patient is crucial for the nurse to relay to the healthcare provider prior to the procedure?

As a nurse in a community-based setting, you are educating clients on strategies to prevent cardiovascular disease. Which interventions should you include? (Select all that apply)

While conducting an admission assessment, the nurse observes clubbing of the patient’s fingers. Based on this finding, the nurse should he patient about which disease process?

In the context of a patient who has undergone coronary artery bypass grafting using a right radial artery graft, which observation is most crucial for the nurse to report to the healthcare provider?

A patient who has been experiencing chest pain for several hours is admitted with a diagnosis of rule out acute myocardial infarction (AMI). Which laboratory test is most specific for the nurse to monitor in determining whether the patient has had an AMI?

Diltiazem (Cardizem) has been prescribed for a patient newly diagnosed with Prinzmetal’s (variant) angina. What accurate action of diltiazem should the nurse include in the teaching plan?

A patient is being admitted to the emergency department with intermittent chest pain. They provide a list of daily medications.

Which medication from the list has the most immediate implications for the patient’s care?