In planning care for a patient with acute myocardial infarction (AMI), which of the following should the nurse identify as the highest priority goal of care?

Stable ECG rhythm

Ability to verbalize causes and eﬀects of CHD/CAD

Adequate relief of pain

Compliance with prescribed bedrest

Answer and Explanation

The Correct Answer is C

Choice A reason : While maintaining a stable ECG rhythm is important, it is not the highest priority. The primary concern is to address life-threatening complications.

Choice B reason : Educating the patient about the causes and eﬀects of coronary heart disease (CHD) or coronary artery disease (CAD) is important for long-term management but is not the immediate priority during acute care.

Choice C reason : Adequate relief of pain is the highest priority in the care of a patient with AMI. Pain is an indicator of ongoing ischemia and can increase the workload of the heart, thereby worsening the condition.

Choice D reason (AMI): While bedrest is part of the care plan, it is not the highest priority compared to pain relief, which has direct implications on the patient's immediate physiological status.

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Correct Answer is ["A","B","D","E"]

Explanation

Choice A reason: Nasogastric suction reduces intestinal distention, which can help alleviate abdominal pressure and pain.

Choice B reason: Eliminating oral intake and gastric suction reduces gastric secretion, decreasing stimulation of the pancreas.

Choice C reason: Monitoring intake and output is important but not a direct treatment for pancreatitis.

Choice D reason: Nasogastric decompression helps alleviate nausea and vomiting, which are common symptoms of pancreatitis.

Choice E reason: Reduction of gastric secretions that stimulate pancreatic enzymes directly addresses the cause of pancreatitis.

A. A client who told an assistive personnel he is short of breath B. A client who has a prescription for discharge C. A client who received oral pain medication 30 minutes ago D. A client who is scheduled for an abdominal x-ray and is awaiting transport

Correct Answer is A

Explanation

Choice A reason (client care): A client reporting shortness of breath may be experiencing a life-threatening situation that aligns with the ABCs (Airway, Breathing, Circulation) of patient prioritization. This client requires immediate assessment and intervention.

Choice B reason (client care): While discharge is important, it does not take precedence over a client with potential respiratory distress.

Choice C reason (client care): A client who received pain medication 30 minutes ago is likely stable and can be seen after more urgent cases are addressed.

Choice D reason (client care): A client waiting for an abdominal x-ray is not a priority over a client with respiratory issues.

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In planning care for a patient with acute myocardial infarction (AMI), which of the following should the nurse identify as the highest priority goal of care?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is ["A","B","D","E"]

Explanation

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Correct Answer is A

Explanation

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