A nurse is assisting with the care of a client in the emergency department who reports severe radiating chest pain and shortness of breath. The client appears restless, frightened, and slightly cyanotic. The provider prescribes oxygen by nasal cannula at 4 L/min stat, cardiac enzyme levels, IV fluids, and a 12-lead ECG. Which of the following actions should the nurse take first?

Attach the leads for a 12-lead ECG.

Obtain a blood sample.

Initiate oxygen therapy.

Insert the IV catheter.

Answer and Explanation

The Correct Answer is C

Choice A reason: While attaching leads for a 12-lead ECG is important, it is not the most immediate action required for a client showing signs of distress and potential hypoxia.

Choice B reason: Obtaining a blood sample is necessary for diagnosing the cause of chest pain but is not the first priority in an emergency situation.

Choice C reason: Initiating oxygen therapy is the first and most critical step in managing a client with severe chest pain, shortness of breath, and cyanosis to ensure adequate oxygenation.

Choice D reason: Inserting an IV catheter is important for administering medications and fluids but comes after ensuring the client is receiving sufficient oxygen.

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

Explanation

Choice A reason: Sweating can be an atypical symptom of a myocardial infarction, especially if it is sudden and occurs without exertion.

Choice B reason: Fatigue, particularly if it is new or unexplained, can be a sign of a myocardial infarction.

Choice C reason: Shortness of breath without chest pain can also be an atypical presentation of a myocardial infarction.

Choice D reason: Dizziness, especially if associated with other symptoms, can indicate a myocardial infarction.

Choice E reason: Nausea is another atypical symptom that can occur with a myocardial infarction.

Choice F reason: Pain between the shoulder blades can be an atypical symptom of a myocardial infarction.

A. “It is done to increase blood flow to the myocardium.” B. “It will decrease blood flow to the coronary arteries.” C. “It cures coronary artery disease.” D. “It prevents spasms of the coronary arteries.”

Correct Answer is A

Explanation

Choice A Reason:Coronary artery bypass graft surgery (CABG) is not primarily performed to increase blood flow to the myocardium. Instead, it aims to restore blood flow to areas of the heart affected by blockages.

Choice B Reason:CABG does not intentionally decrease blood flow to the coronary arteries. On the contrary, it creates a new pathway to bypass blocked or partially blocked coronary arteries, improving blood flow to the heart muscle.

Choice C Reason:The primary purpose of CABG is to treat coronary artery disease by restoring blood flow to areas of the heart that aren't receiving enough blood. It involves using healthy blood vessels (usually from the chest or leg) to create a detour around blockages. By doing so, CABG improves heart function and reduces symptoms related to ischemia.

Choice D Reason:While CABG can indirectly prevent spasms of the coronary arteries by improving blood flow, it is not its primary purpose.

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Naxlex Comprehensive Predictor Exams

The licensed practical nurse is assisting with collecting data on a female patient. Which of the following findings should be reported to the registered nurse as possible atypical symptoms of a myocardial infarction in the absence of chest pain? Select all that apply.

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

Explanation

The nurse would evaluate a female patient, age 68, as understanding teaching on the purpose of coronary artery bypass graft surgery if she made which of the following statements?

Correct Answer is A

Explanation

A nurse is collecting data from a newly-admitted client who has bipolar disorder and is displaying manic behavior. Which of the following findings should the nurse expect? (Select all that apply.)

Which statement regarding the treatment of a myocardial infarction is incorrect?

A nurse is caring for a client who has heart failure and has been taking digoxin 0.25 mg daily. The client refuses breakfast and reports nausea. Which of the following actions should the nurse take first?

After hospitalization for a myocardial infarction, a patient is placed on a low-sodium diet. In discussing foods allowed on this diet, the nurse would inform the patient that this includes which of the following?

Which of the following is not true about depression?

A nurse is assisting in the care of a client who has acute onset pulmonary edema and is experiencing dyspnea with low oxygen saturation rates. The nurse should recognize the client is at risk for which of the following acid-base imbalances?

A newly admitted patient in an acute manic state has a nursing diagnosis of at risk for injury related to hyperactivity. Which nursing intervention is most appropriate?

Which tests can be used to assist in diagnosing a patient with coronary artery disease? Select all that apply.