A patient who smokes reports chest pain while at rest.
Which condition would the nurse suspect the patient is experiencing?

Choice A rationale:

Silent ischemia refers to a lack of oxygen to the heart that doesn't cause symptoms like chest pain. It is often diagnosed during an electrocardiogram (ECG) done for other reasons. The patient in this scenario is experiencing chest pain, so silent ischemia is not the correct choice.

Choice B rationale:

Angina decubitus refers to chest pain that occurs while lying down and is relieved by standing or sitting. The patient in this scenario is experiencing chest pain at rest, which is not characteristic of angina decubitus.

Choice D rationale:

Chronic stable angina is chest pain or discomfort that typically occurs with activity or stress and is relieved by rest or nitroglycerin. The patient in this scenario is experiencing chest pain at rest, which is not characteristic of chronic stable angina.

Choice A rationale:

Hypertensive crisis is characterized by severely elevated blood pressure, usually above 180/120 mm Hg. The given differences in blood pressure (a decrease of 20 mm Hg in systolic BP) do not indicate hypertensive crisis.

Choice B rationale:

An auscultatory gap refers to a temporary disappearance of sounds normally heard over the brachial artery during blood pressure measurement. This phenomenon can lead to inaccurate readings and might cause a delay in recognizing the true blood pressure values. In this case, the decrease in systolic BP when changing positions indicates the presence of an auscultatory gap, requiring the nurse to be vigilant during blood pressure measurements.

Choice C rationale:

Resistant hypertension is a term used when blood pressure remains above goal despite concurrent use of three antihypertensive agents of different classes. The given scenario does not indicate resistant hypertension but rather suggests a technical issue during blood pressure measurement due to the auscultatory gap.