The nurse assesses a male client who is brought to the emergency department (ED) by his family who believes he is having a heart attack. Which finding is the best indicator that a client is experiencing an acute myocardial infarction (AMI)?

Pain in the neck, jaw, or medial side of the left arm.

Anterior thorax pain that radiates between the scapulae.

Localized sternal border pain intensified by palpation.

Chest pain that intensifies upon chest excursion.

Answer and Explanation

The Correct Answer is A

A.   Pain radiating to the neck, jaw, or medial side of the left arm is a classic symptom of an acute myocardial infarction (AMI). This type of referred pain occurs because the heart's pain signals are often perceived in other areas of the body. This finding is a strong indicator of AMI and is consistent with the typical presentation of myocardial infarction.
B.   Pain in the anterior thorax that radiates between the scapulae can be associated with various conditions, including myocardial infarction, but it is less specific than pain radiating to the neck, jaw, or arm. While this type of pain can occur in AMI, it is not as distinctive as the classic left arm pain and may also be seen in conditions like angina or musculoskeletal issues.
C.   Localized sternal border pain that worsens with palpation is more indicative of a musculoskeletal issue, such as costochondritis, rather than an acute myocardial infarction. AMI typically presents with diffuse chest pain that is not localized or worsened by palpation.
D.   Chest pain that worsens with chest movement, such as deep breathing or coughing, is more characteristic of pleuritic pain or musculoskeletal pain rather than an acute myocardial infarction. In AMI, the pain is generally persistent and not influenced by respiratory movements.

Nursing Test Bank

Quiz #1: RN Exams Pharmacology Exams Quiz #2: RN Exams Medical-Surgical Exams Quiz #3: RN Exams Fundamentals Exams Quiz #4: RN Exams Maternal-Newborn Exams Quiz #5: RN Exams Anatomy and Physiology Exams Quiz #6: RN Exams Obstetrics and Pediatrics Exams Quiz #7: RN Exams Fluid and Electrolytes Exams Quiz #8: RN Exams Community Health Exams Quiz #9: RN Exams Promoting Health across the lifespan Exams Quiz #10: RN Exams Multidimensional care Exams

Get 100+ Naxlex Exit Exams for $79 Try Naxlex NCLEX-RN (14 Day Free-Trial)

Naxlex Comprehensive Predictor Exams

Quiz #1: Naxlex RN Comprehensive online practice 2019 B with NGN Quiz #2: Naxlex RN Comprehensive Predictor 2023 Quiz #3: Naxlex RN Comprehensive Predictor 2023 Exit Exam A Quiz #4: Naxlex HESI Exit LPN Exam Quiz #5: Naxlex PN Comprehensive Predictor PN 2020 Quiz #6: Naxlex VATI PN Comprehensive Predictor 2020 Quiz #8: Naxlex PN Comprehensive Predictor 2023 - Exam 1 Quiz #10: Naxlex HESI PN Exit exam Quiz #11: Naxlex HESI PN EXIT Exam 2

Free Nursing Study Resources

Correct Answer is A

Explanation

A. A urine dipstick test is a preliminary screening tool that can quickly provide information about the presence of glucose, protein, nitrites, and leukocytes in the urine. In the context of uncontrolled diabetes with symptoms of painful urination, this test is useful for identifying signs of a urinary tract infection (UTI), which is a common complication in diabetic patients.
B. A rapid strep test is used to diagnose streptococcal infections, particularly strep throat. It is not relevant to the symptoms of frequent and painful urination and does not help in assessing diabetic complications or urinary issues.

C. Nitrazine pH strips are primarily used to assess amniotic fluid in pregnant women to determine if labor has started. They are not used for diagnosing urinary tract infections or evaluating symptoms related to diabetes.
D. A fingerstick glucose test measures blood glucose levels and is useful for assessing the client's current glycemic control. While monitoring blood glucose levels is important for managing diabetes, it does not directly address the issue of painful urination or the presence of a urinary tract infection.

A. Compare the skin turgor of the client's upper and lower leg. B. Observe the specific location and appearance of the ulceration. C. Note any change in the color of the ulcer when the leg is moved. D. Measure the degree of joint range of motion in the extremity.

Correct Answer is B

Explanation

A. Skin turgor assesses skin elasticity and hydration, which is more indicative of general hydration status rather than specific types of insufficiency. While poor skin turgor might be observed in various conditions, it does not specifically differentiate between venous and arterial ulcers.
B. The location and appearance of the ulcer can provide significant clues about its etiology. Venous ulcers often appear on the lower legs, particularly around the medial malleolus (inside of the ankle), and tend to have irregular, shallow, and often wet or weepy edges.
C. Changes in color upon movement can provide insight into the type of insufficiency. For arterial ulcers, the leg may appear pale or blanched when elevated and may develop a reddish or purple color when lowered due to poor blood flow.
D. Measuring joint range of motion assesses flexibility and mobility rather than the type of ulcer. While joint mobility issues can be associated with various conditions, including those affecting the vascular system, it does not directly help in distinguishing between venous and arterial insufficiency ulcers.

View Question and Answer

Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.

Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today

The nurse assesses a male client who is brought to the emergency department (ED) by his family who believes he is having a heart attack. Which finding is the best indicator that a client is experiencing an acute myocardial infarction (AMI)?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is completing an assessment for a client with uncontrolled diabetes mellitus (DM) who came to the clinic reporting frequent, painful urination. Which screening test should the nurse perform first?

Correct Answer is A

Explanation

The nurse is assessing an ulcer on a client's lower extremity, which is likely the result of either venous or arterial insufficiency. Which assessment technique should the nurse use to differentiate the pathophysiology causing the ulcer?

Correct Answer is B

Explanation

In assessing a male client's level of consciousness, the nurse determines that the client does not open his eyes spontaneously. Which should the nurse do next?

In reading a client's record, the nurse notes that the client is experiencing tinnitus. Which assessment provides the nurse with the information needed to evaluate the effects of this condition?

The nurse reorients a male client to the correct time, day, date, and location, but he is only able to remember his name and where he is. Based on these findings, which should the nurse document?

While performing a health history the nurse asks the client, "You don't use recreational drugs, do you?" This approach is most likely to elicit which response from the client?

In assessing a client's nailbeds, the nurse notes that the angle between the nail and the nailbed is 200 degrees. Which action should the nurse take?

During a routine health screening of an adult female, the nurse notes several changes that have occurred over the past year. Which change indicates the need for a bone density screening?

During the admission assessment, the nurse observes that a client has a limping gait. Which assessment should the nurse complete next?