A patient reports episodic chest pain lasting a few minutes that is provoked by exertion and relieved within 10 minutes upon resting.
Which cause of the patient's symptoms would the nurse suspect?
Spasm of a major coronary artery.
Exposure of the thrombogenic surface to plaque.
Myocardial ischemia due to coronary artery disease.
Myocardial ischemia secondary to microvascular disease.
The Correct Answer is C
Choice A rationale:
Spasm of a major coronary artery, also known as variant (Prinzmetal's) angina, typically occurs at rest and is not necessarily provoked by exertion. The patient's chest pain is exacerbated by exertion, making this choice less likely.
Choice B rationale:
Exposure of the thrombogenic surface to plaque refers to acute coronary syndromes like unstable angina or myocardial infarction. While plaque rupture and thrombosis can cause myocardial ischemia, the characteristic feature of these conditions is chest pain that may not be relieved by rest, unlike the patient described here.
Choice D rationale:
Myocardial ischemia secondary to microvascular disease, also known as cardiac syndrome X, is a condition where chest pain occurs without significant coronary artery stenosis. However, this condition usually affects women, and the pain is often unrelated to exertion. In the given case, the pain is provoked by exertion, making this choice less likely.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A rationale:
Dizziness with a blood pressure of 150/92 mm Hg indicates hypertension, but it is not an immediate life-threatening condition requiring urgent assessment compared to a severe headache and vomiting.
Choice B rationale:
A severe headache and vomiting could be indicative of a serious neurological condition such as a stroke, intracranial bleeding, or increased intracranial pressure. This patient needs urgent assessment and intervention to prevent potential complications.
Choice C rationale:
A hip fracture with a pain level of 2 on a 1-to-10 scale suggests pain but is not immediately life-threatening compared to symptoms like severe headache and vomiting.
Choice D rationale:
Fatigue after receiving an ACE inhibitor is a common side effect and, while important to monitor, does not pose an immediate threat compared to the symptoms of severe headache and vomiting.
Correct Answer is C
Explanation
Choice A rationale:
Serotonin is a neurotransmitter that plays a role in mood regulation, sleep, and other functions in the body. It is not a component that forms an adhesive bridge between platelets and vascular subendothelial structures in the clotting process.
Choice B rationale:
Platelet factor III is not a component that forms an adhesive bridge between platelets and vascular subendothelial structures in the clotting process. Platelet factor III is not widely recognized in the context of clotting; it is more commonly referred to as tissue factor and is involved in the extrinsic pathway of coagulation.
Choice C rationale:
Von Willebrand factor (VWF) is a protein that plays a crucial role in hemostasis. It forms an adhesive bridge between platelets and vascular subendothelial structures, particularly at sites of vascular injury. VWF helps platelets adhere to the injured vessel wall, leading to the formation of a stable blood clot. This process is essential for preventing excessive bleeding. A deficiency or dysfunction in VWF can lead to von Willebrand disease, a bleeding disorder characterized by prolonged bleeding times.
Choice D rationale:
Adenosine diphosphate (ADP) is a molecule released by platelets when they are activated. ADP helps in the aggregation of platelets, but it does not directly form an adhesive bridge between platelets and vascular subendothelial structures.
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