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:
0.459% saline is a hypotonic solution with a lower concentration of salt than the normal physiological range (0.9% NaCl) Hypotonic solutions can cause red blood cells to swell and potentially burst due to the osmotic imbalance, making it inappropriate for hypovolemic shock.
Choice B rationale:
0.9% NaCl, also known as normal saline, is an isotonic solution with a salt concentration similar to the body's own fluids. Isotonic solutions are ideal for hypovolemic shock as they help to expand the intravascular volume without causing significant shifts of fluid and electrolytes within the body compartments.
Choice C rationale:
5% dextrose in 0.45% saline is a hypotonic solution with a low salt concentration. While it provides some fluid replacement, it doesn't address the electrolyte imbalance adequately, which is crucial in hypovolemic shock.
Choice D rationale:
Dextran is a plasma volume expander but is not the first-line choice for hypovolemic shock. It might be used in certain situations, but isotonic crystalloids like 0.9% NaCl are preferred for rapid volume expansion and stabilization of the patient.
Correct Answer is A
Explanation
Choice A rationale:
Maximizing cardiac output is a primary goal for patients with chronic heart failure (HF) because it helps improve tissue perfusion and oxygen delivery to meet the body's demands. It is a crucial aspect of managing heart failure and preventing further complications.
Choice B rationale:
Maintaining ideal body weight is important for overall health but is not a primary goal specific to chronic heart failure management.
Choice C rationale:
While exercise is beneficial for heart failure patients, it needs to be tailored to the patient's condition. Performing aerobic exercises daily might not be suitable for all heart failure patients and is not a primary goal.
Choice D rationale:
Maintaining a steady pulse oximetry reading is important, but it is a measure of oxygen saturation in the blood and not a primary goal for managing chronic heart failure.
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