The client tells the nurse, "My physician told me that I had an NSTEMI. I thought all heart attacks were the same. Can you explain this to me?" What would be the nurse's best response?

You have had some heart muscle damage but it involved a small area."

"This is no different than the angina attacks that you have had in the past."

"You have had a very serious heart attack and will need open heart surgery."

The cardiac catheterization will diagnose this problem and correct it."

Answer and Explanation

The Correct Answer is A

A. NSTEMI (Non-ST-Elevation Myocardial Infarction) refers to a heart attack where there is partial blockage or damage to the heart muscle but less severe than in STEMI (ST-Elevation Myocardial Infarction). The damage in NSTEMI typically affects a smaller area of the heart muscle, and it may not involve a full-thickness injury like in STEMI. This response provides the client with a clear, understandable explanation of their condition.

B. This statement is incorrect because NSTEMI is not the same as angina. Angina is chest pain due to temporary lack of blood flow to the heart, while NSTEMI involves actual damage to the heart muscle due to a more significant reduction in blood flow, even if the heart attack is less severe than a STEMI.

C. While NSTEMI is a serious condition, it does not automatically require open heart surgery. Treatment often involves medications (like antiplatelets or anticoagulants) and procedures like angioplasty or stenting to address the blockage, not necessarily surgery.

D. This response is somewhat misleading. Cardiac catheterization may be used to assess the severity and location of the blockage, but it is not always used to directly correct the problem. Procedures such as angioplasty or stent placement may follow the catheterization, but not all patients with NSTEMI will need immediate intervention.

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Correct Answer is A

Explanation

A. Difficulty swallowing and speaking associated with descending muscle weakness: Amyotrophic lateral sclerosis (ALS) primarily affects motor neurons, leading to progressive muscle weakness. Difficulty swallowing (dysphagia) and speaking (dysarthria) are common symptoms, and these occur as the muscle weakness affects the tongue, throat, and other muscles responsible for these functions. The weakness typically starts in the limbs and then progresses to involve other areas of the body.

B. Movement and behavioral unpredictability with declining cognitive abilities: While ALS primarily affects motor function, some patients may experience mild cognitive changes or frontotemporal dementia (FTD), but this is not a characteristic feature for most individuals. Behavior and cognitive decline are not typically seen in the majority of ALS cases.

C. Muscle weakness starting in bilateral legs with weakness ascending upwards: This description is more consistent with Guillain-Barré Syndrome (GBS), which often presents with ascending muscle weakness that starts in the lower limbs. In ALS, muscle weakness generally starts in one area (e.g., a limb) and progresses asymmetrically, rather than ascending in a symmetrical pattern.

D. Ptosis, fatigue, and generalized muscle weakness: Ptosis (drooping eyelids) is not a primary or common symptom of ALS. While generalized muscle weakness and fatigue are common in ALS, ptosis is more characteristic of other neuromuscular disorders such as myasthenia gravis.

A. The client will be turned every 2 hours B. The client will need to be monitored every one-half hour C. Documentation of the event will include interventions attempted prior to initiating restraints D. The physician must be present at the time of the restraint episode

Correct Answer is C

Explanation

A. The client will be turned every 2 hours is a general nursing care practice for all immobile clients to prevent pressure injuries, but it is not specific to the protocol surrounding the use of restraints.

B. The client will need to be monitored every one-half hour is incorrect because clients in restraints must be monitored more frequently—typically every 15 minutes, depending on facility policy and client condition, to assess circulation, skin integrity, and psychological well-being.

C. Documentation of the event will include interventions attempted prior to initiating restraints is the correct answer. Before applying restraints, it is a legal and ethical requirement to document all less restrictive interventions that were attempted and found ineffective. This ensures that restraints are used only as a last resort and that the client's rights and safety are protected.

D. The physician must be present at the time of the restraint episode is incorrect. While a physician's order is required for restraint use, the physician does not need to be physically present at the time of application. However, the physician must conduct a face-to-face evaluation within a specific timeframe, usually within 1 hour of the restraint being applied, depending on regulatory guidelines.

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The client tells the nurse, "My physician told me that I had an NSTEMI. I thought all heart attacks were the same. Can you explain this to me?" What would be the nurse's best response?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is A

Explanation

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Correct Answer is C

Explanation

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