Exhibits

Click to indicate if the listed symptoms are consistent with angina, myocardial infarction, or both. Each column must have at least one response option selected.

Occurring without cause

Feelings of fear

Pain relieved by nitroglycerin

Pain only relieved by opioids

Epigastric distress

Chest pain radiating down arm

Answer and Explanation

The Correct Answer is {"A":{"answers":"A"},"B":{"answers":"A,B"},"C":{"answers":"B"},"D":{"answers":"A"},"E":{"answers":"A"},"F":{"answers":"A,B"}}

Myocardial Infarction (MI):

Occurring without cause
Feelings of fear
Pain only relieved by opioids
Epigastric distress
Chest pain radiating down arm

Angina:

Feelings of fear
Pain relieved by nitroglycerin
Chest pain radiating down arm

Rationale:

Occurring without cause: MI pain often develops spontaneously without obvious exertional triggers. It may strike during rest or sleep due to complete blockage of a coronary artery, which differentiates it from angina that is typically exertion-induced.
Feelings of fear: Both MI and angina can provoke intense feelings of fear or a sense of impending doom. The body's sympathetic response to chest pain and hypoxia can trigger anxiety and a heightened emotional reaction in both conditions.
Pain relieved by nitroglycerin: Stable angina pain usually responds well to nitroglycerin because it reduces myocardial oxygen demand by dilating coronary vessels. Relief after nitroglycerin suggests the pain is related to transient ischemia rather than infarction.
Pain only relieved by opioids: In MI, the ischemic injury is severe and prolonged, causing chest pain that is often refractory to nitroglycerin. Opioids like morphine are typically needed to manage the intense, persistent discomfort caused by myocardial tissue death.
Epigastric distress: Epigastric pain or discomfort may occur especially with inferior wall MIs, mimicking indigestion or gastrointestinal upset. This atypical presentation can delay diagnosis, particularly in older adults and women.
Chest pain radiating down arm: Radiation of chest pain to the left arm, jaw, neck, or back is common in both MI and angina. It occurs because the same spinal segments supply sensory nerves to the heart and these other areas, causing referred pain.

Nursing Test Bank

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Correct Answer is D

Explanation

A. Computerized tomography (CT) scan: A CT scan may be done before a lumbar puncture if there is concern for increased intracranial pressure or brain herniation, especially in patients with altered mental status or focal neurological signs. However, it does not confirm the presence of meningitis or identify the causative organism.

B. Skull radiography: Skull X-rays are primarily used to identify skull fractures or bony abnormalities. They are not helpful in diagnosing meningitis. They may show fractures or sinus involvement but do not provide information about cerebrospinal fluid (CSF) or inflammation in the meninges.

C. Magnetic resonance imaging (MRI): MRI offers detailed images of the brain and spinal cord and may help detect complications of meningitis, such as abscesses or cerebral edema. However, it is not the first-line diagnostic tool to confirm meningitis and is more useful in complex or unclear cases.

D. Lumbar puncture: A lumbar puncture allows for direct sampling of cerebrospinal fluid, which is essential for diagnosing bacterial meningitis. CSF analysis provides information on glucose, protein, white blood cell count, and the presence of organisms, making it the definitive diagnostic test in suspected cases.

A. Limit calories on days unable to exercise. B. Regular exercise with medical approval. C. Monitor blood glucose levels daily. D. Monthly appointments with the dietician.

Correct Answer is B

Explanation

A. Limit calories on days unable to exercise: While adjusting caloric intake is a useful strategy in managing blood glucose, inconsistent caloric restriction without a structured plan can lead to hypoglycemia or poor nutritional intake. This approach alone is insufficient for improving HDL levels, which are influenced more significantly by physical activity.

B. Regular exercise with medical approval: Engaging in consistent aerobic exercise enhances insulin sensitivity, helping to lower blood glucose levels. Physical activity also promotes cardiovascular health by raising HDL cholesterol, which offers protective benefits against atherosclerosis—an important concern in diabetic clients.

C. Monitor blood glucose levels daily: Daily glucose monitoring is essential for adjusting treatment and preventing complications, but it does not directly increase HDL levels. Monitoring provides data, but behavior changes like diet and exercise are what actively influence these health markers.

D. Monthly appointments with the dietician: Regular consultation with a dietitian supports nutritional management, but monthly visits may not have a timely or sufficient impact on HDL and glucose control. Lifestyle modifications, particularly regular exercise, offer more immediate and measurable effects in both areas.

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Exhibits Click to indicate if the listed symptoms are consistent with angina, myocardial infarction, or both. Each column must have at least one response option selected.

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is caring for a client admitted to the hospital with a tentative diagnosis of bacterial meningitis. Which diagnostic procedure should the nurse prepare the client for?

Correct Answer is D

Explanation

The nurse is developing a plan of care for a client with type 2 diabetes mellitus (DM). When providing teaching on lowering blood glucose levels and increasing serum high-density lipoprotein (HDL) levels, which instruction should the nurse include?

Correct Answer is B

Explanation

A client with a history of asthma reports having episodes of bronchoconstriction and increased mucus production while exercising. Which action should the nurse implement?

A client with pernicious anemia takes supplemental folate and self-administers monthly vitamin B12 injections. The client reports feeling increasingly fatigued. Which laboratory value should the nurse review?

A male client who had abdominal surgery 5 days ago, and hospitalized because of a surgical wound infection, tells the nurse that he feels like his insides just spilled out when he coughed. Which action should the nurse take first?

The nurse is teaching a client with cancer about skin care for the portal site receiving external beam radiation. Which client action about skin care indicates a need for further teaching?

A client arrives to the emergency department (ED) following a motor vehicle collision. The nurse observes the client experiencing increasing dyspnea and notes absent breath sounds on the left side. Which procedure should the nurse prepare the client for?

Which nursing problem has the highest priority when planning care for a client with osteomalacia?

A client with edema receives a prescription for a one time dose of furosemide 20 mg IV. The medication is available in a 10 mg/mL vial. How many mL should the nurse administer? (Enter numerical value only.)

The nurse is administering the second unit of whole blood to an older adult client who was admitted yesterday with gastrointestinal (GI) bleeding. Which parameters should the nurse monitor that indicate fluid overload?

Exhibits

Click to indicate if the listed symptoms are consistent with angina, myocardial infarction, or both. Each column must have at least one response option selected.