The client usually has central chest pressure when mowing the lawn that is relieved with rest and nitroglycerin. Today while sitting and reading the paper, he got pain that is now left sided, radiating down his arm, rated “4”. He took 3 nitroglycerin 5 minutes apart without relief. What is the understanding of this situation?

The client now has developed a myocardial infarction

The client has developed Prinzimetal’s angina.

The client now has stable angina.

The client now has unstable angina.

Answer and Explanation

The Correct Answer is D

A. The client now has developed a myocardial infarction:

A myocardial infarction (heart attack) is characterized by prolonged ischemia leading to damage or death of heart muscle cells. While the symptoms described could be concerning for a heart attack, the term "myocardial infarction" would typically imply a more sustained and severe ischemic event.

B. The client has developed Prinzmetal's angina:

Prinzmetal's angina, also known as variant angina, is characterized by chest pain that usually occurs at rest and is caused by vasospasm of the coronary arteries. The given scenario does not specifically describe the typical characteristics of Prinzmetal's angina.

C. The client now has stable angina:

Stable angina typically follows a predictable pattern and is relieved with rest and/or nitroglycerin. However, the scenario describes a change in the usual pattern of chest pain.

D. The client now has unstable angina:

Unstable angina is characterized by a change in the usual pattern of stable angina, often occurring at rest or with minimal exertion and not relieved by usual measures. This option seems to align with the information provided.

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Correct Answer is D

Explanation

A. The client now has developed a myocardial infarction:

B. The client has developed Prinzmetal's angina:

C. The client now has stable angina:

Stable angina typically follows a predictable pattern and is relieved with rest and/or nitroglycerin. However, the scenario describes a change in the usual pattern of chest pain.

D. The client now has unstable angina:

A. The client with a history of a myocardial infarction who has a p wave before every QRS complex. B. The client diagnosed with heart failure who has bilateral 2+ pitting pedal edema. C. The client with sinus bradycardia (HR 56/min) that is reporting fatigue. D. The client diagnosed with coronary artery disease who is now reporting new onset of severe indigestion.

Correct Answer is D

Explanation

A. The client with a history of a myocardial infarction who has a p wave before every QRS complex.

This may indicate a heart block, which requires attention. However, it's not an immediate life-threatening situation.

B. The client diagnosed with heart failure who has bilateral 2+ pitting pedal edema.

Bilateral pitting pedal edema is a sign of fluid overload, which is concerning and requires attention.

C. The client with sinus bradycardia (HR 56/min) that is reporting fatigue.

While bradycardia and fatigue are concerns, they might not be as urgent as the client with fluid overload.

D. The client diagnosed with coronary artery disease who is now reporting new onset of severe indigestion.

New onset of severe indigestion in a client with coronary artery disease raises concern for a potential cardiac event, and this should be addressed promptly.

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Naxlex Comprehensive Predictor Exams

Correct Answer is D

Explanation

The nurse is caring for a team of assigned clients. Which client is a priority for the nurse to check on first?

Correct Answer is D

Explanation

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