The client tells the nurse, "My physician told me that I had a non-ST elevation myocardial infarction (NSTEMI). " I thought all heart attacks were the same. Can you explain this to me?" The nurse's best response to the client's question would be: "NSTEMI is

similar to the angina attacks you had in the past."

a condition characterized by coronary arteries vasodilating."

a term used to describe an irregular heartbeat."

is a less severe type of heart attack compared to STEMI."

Answer and Explanation

The Correct Answer is D

A. Similar to the angina attacks you had in the past:
This response is not entirely accurate. Angina refers to chest pain that occurs when the heart's demand for oxygen exceeds its supply, usually due to partial blockage of the coronary arteries. NSTEMI (non-ST elevation myocardial infarction) is different from angina in that it involves actual heart muscle injury or damage due to partial or intermittent blockage of a coronary artery, whereas angina does not cause permanent heart muscle damage. Therefore, describing NSTEMI as similar to past angina attacks would be misleading.

B. A condition characterized by coronary arteries vasodilating:
This is incorrect. NSTEMI occurs due to a partial blockage or narrowing of the coronary arteries, usually caused by a blood clot that forms around a ruptured atherosclerotic plaque. The blockage restricts blood flow to the heart muscle, causing injury or infarction. Vasodilation (the widening of blood vessels) is not a characteristic of NSTEMI; in fact, it is the constriction or blockage of the coronary arteries that leads to this type of heart attack.

C. A term used to describe an irregular heartbeat:
This is incorrect. NSTEMI is not related to an irregular heartbeat or arrhythmia directly. While arrhythmias (irregular heartbeats) can occur as a result of a heart attack, NSTEMI specifically refers to a type of heart attack that is not accompanied by the characteristic ST-segment elevation seen on an electrocardiogram (ECG) in a STEMI (ST-elevation myocardial infarction). It indicates a partial blockage of a coronary artery and is generally less severe than STEMI.

D. Is a less severe type of heart attack compared to STEMI:
This is the most accurate response. NSTEMI is a type of heart attack that is often considered less severe than STEMI, but still involves heart muscle injury. The difference between NSTEMI and STEMI lies in the ECG findings: STEMI involves a full-thickness myocardial infarction with a significant blockage of the artery, as indicated by ST-segment elevation on an ECG. In NSTEMI, there is a partial blockage or temporary decrease in blood flow, and the ST-segment does not elevate on the ECG, but biomarkers (like troponin) are elevated, indicating heart muscle damage. NSTEMI is often less severe in terms of the extent of damage compared to STEMI, but it still requires urgent treatment to prevent further complications.

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Correct Answer is A

Explanation

A. "Reports taking an extra dose each day of their anticholinesterase medication."
This client is at highest risk for developing a cholinergic crisis. A cholinergic crisis occurs when there is overdose or excessive stimulation of acetylcholine receptors due to too much anticholinesterase medication. Symptoms include muscle weakness, respiratory distress, salivation, sweating, and bradycardia. Taking an extra dose of the medication can result in an overdose of acetylcholine, triggering these symptoms. Therefore, this client is at the greatest risk for a cholinergic crisis.

B. "Is experiencing a respiratory infection and is short of breath."
While respiratory infections can worsen symptoms of myasthenia gravis due to increased muscle weakness, this client is not directly at risk for a cholinergic crisis. Respiratory infections can increase the risk of myasthenic crisis, which is a different complication where muscle weakness worsens to the point of respiratory failure. A myasthenic crisis is caused by insufficient anticholinesterase medication or a disease exacerbation, not an overdose.

C. "Has a family history of autoimmune disorders."
A family history of autoimmune disorders may suggest a genetic predisposition to autoimmune diseases, but it does not increase the risk of a cholinergic crisis specifically. The risk of a cholinergic crisis is more directly related to medication management, not family history.

D. "Has a past medical history of type 2 diabetes mellitus."
Type 2 diabetes mellitus does not directly increase the risk of a cholinergic crisis. While diabetes may influence overall health and immune function, it does not have a direct impact on anticholinesterase therapy or the risk of cholinergic crisis in myasthenia gravis.

A. Expect fluctuations of symptoms with temperature change B. New surgical techniques offer the best hope for a cure C. Information about genetic testing D. The disease process is intense but short in duration

Correct Answer is C

Explanation

A. Expect fluctuations of symptoms with temperature change: While symptom fluctuations may occur due to various factors, temperature changes are not a hallmark feature of Huntington's Disease (HD). HD is characterized by progressive motor, cognitive, and psychiatric symptoms, including involuntary movements (chorea), cognitive decline, and mood disturbances. Although other neurological conditions may show symptom fluctuations with temperature changes, this is not specific to HD.

B. New surgical techniques offer the best hope for a cure: There are currently no cures for Huntington's Disease, and while medical management can help manage symptoms (such as using medications for chorea or psychiatric symptoms), surgical techniques do not offer a cure for HD. The disease is progressive, and interventions typically focus on symptom management rather than cure. Families should be informed that while research is ongoing, a cure is not currently available.

C. Information about genetic testing: Huntington's Disease (HD) is a genetic disorder caused by a mutation in the HTT gene. It is inherited in an autosomal dominant pattern, meaning that a person with a parent who has HD has a 50% chance of inheriting the disease. Genetic testing is a critical part of the diagnosis process, and it can confirm the presence of the mutated gene before symptoms appear, which is important for family planning and early intervention. However, while genetic testing can provide information about whether an individual will develop the disease, it does not alter the course of the disease or provide a cure. It is essential to provide this information to clients and families, so they understand the role of genetic counseling and testing in managing the disease.

D. The disease process is intense but short in duration: Huntington's Disease is progressive and long-lasting. The disease usually begins in mid-adulthood (typically between ages 30-50), and the symptoms worsen over time. Individuals with HD may live for 15-20 years after symptom onset. The disease duration is long-term, not short, and it becomes increasingly debilitating as it progresses. The intensity of symptoms increases over time, and the disease is not characterized by a short duration.

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The client tells the nurse, "My physician told me that I had a non-ST elevation myocardial infarction (NSTEMI). " I thought all heart attacks were the same. Can you explain this to me?" The nurse's best response to the client's question would be: "NSTEMI is

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Naxlex Comprehensive Predictor Exams

Which of the following clients diagnosed with myasthenia gravis would the nurse identify as most at risk for developing a cholinergic crisis? A client who

Correct Answer is A

Explanation

The nurse is teaching the client and family about Huntington's Disease (HD). What information should the nurse include?

Correct Answer is C

Explanation

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