A patient who has chest pain is admitted to the emergency department (ED), and all of the following are ordered. Which one should the nurse arrange to be completed first?

Troponin level

Electrocardiogram (ECG)

Insertion of a peripheral IV

Chest X-ray

Answer and Explanation

The Correct Answer is B

A. A troponin level will confirm myocardial injury but should be done after an ECG, as the ECG provides immediate information on the condition.

B. The first action in a chest pain situation is to obtain an ECG to assess for myocardial infarction or other cardiac abnormalities. The ECG provides immediate information about the heart's electrical activity and can help identify whether the chest pain is related to a cardiac event.

C. Insertion of a peripheral IV is important for administering medications and fluids, but it is not as urgent as obtaining an ECG to evaluate the patient's heart.

D. A chest X-ray is useful for other potential diagnoses (e.g., pulmonary embolism or pneumothorax) but is not the first step in diagnosing a myocardial event.

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Correct Answer is D

Explanation

A. Antihistamines can raise blood pressure, but this is less likely to be the primary cause compared to medication non-adherence.

B. Acetaminophen is generally safe for use in hypertensive patients and is unlikely to contribute to the high blood pressure in this scenario.

C. Stress can contribute to elevated blood pressure, but non-adherence to medications is a more likely cause of the severe BP elevation in this case.

D. Poor medication adherence is a common cause of elevated blood pressure despite treatment. If the client has not been consistently taking their antihypertensive medications, this could explain the elevated BP and symptoms (headache, blurred vision).

A. Venous insufficiency B. Intermittent claudication C. Neuropathy D. Deep vein thrombosis

Correct Answer is B

Explanation

A. Venous insufficiency results in symptoms such as swelling, aching, or heaviness, especially in the lower legs, but does not typically cause pain with exertion that is relieved by rest.

B. Intermittent claudication refers to pain and cramping in the legs that occurs during physical activity (like walking) due to reduced blood flow, which is relieved by rest. This is a hallmark symptom of peripheral arterial disease (PAD).

C. Neuropathy refers to nerve damage, often seen in conditions like diabetes, and is usually characterized by tingling, numbness, or burning sensations, not cramping or pain relieved by rest.

D. Deep vein thrombosis (DVT) presents with swelling, redness, warmth, and possible pain in the affected leg due to blood clot formation, not cramping with exertion.

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A patient who has chest pain is admitted to the emergency department (ED), and all of the following are ordered. Which one should the nurse arrange to be completed first?

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Correct Answer is D

Explanation

The nurse is assessing a client diagnosed with peripheral arterial disease. The client reports leg pain and cramping after walking 3 blocks, which is relieved when the client stops and rests. The nurse documents that the client is experiencing which clinical manifestation?

Correct Answer is B

Explanation

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