The nurse is providing care for a client admitted to rule out a myocardial infarction who is experiencing chest pain while walking to the bathroom. Which action should the nurse implement first?

Obtain a STAT electrocardiogram

Have the client sit down immediately

Assess the client's vital signs

Administer sublingual nitroglycerin

Answer and Explanation

The Correct Answer is B

A. Obtaining an ECG is important but not the first action. The priority is to stop activity, as exertion can worsen myocardial oxygen demand.
B. Having the client sit down immediately is correct. Stopping activity reduces cardiac workload and oxygen demand, preventing further ischemia or infarction.
C. Assessing vital signs is important but should follow stopping activity. Chest pain requires immediate action to reduce cardiac strain.
D. Administering sublingual nitroglycerin is appropriate but should be done after ensuring the client is seated. This prevents hypotension and syncope from occurring while standing.

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Correct Answer is A

Explanation

A. Preventing bronchospasms and promoting bronchodilation is correct. Ipratropium is an anticholinergic bronchodilator that relaxes airway muscles, reducing airway resistance and improving airflow in COPD patients.
B. Monitoring blood pressure is unrelated to ipratropium use. It primarily acts on the respiratory system, not the cardiovascular system.
C. Relieving nasal congestion is incorrect in this context, though ipratropium nasal spray can be used for rhinorrhea.
D. Reducing coughing is not the primary purpose. While bronchodilation may indirectly reduce cough by improving airflow, it is not a cough suppressant.

A. Metformin B. Nitroglycerin C. Atorvastatin D. Carvedilol

Correct Answer is A

Explanation

A. Metformin is correct. The combination of iodinated contrast dye and metformin increases the risk of contrast-induced nephropathy (CIN) and lactic acidosis, especially in clients with pre-existing kidney dysfunction. Metformin should be held before and after the procedure until renal function is reassessed.
B. Nitroglycerin is used for angina and does not interact with contrast dye.
C. Atorvastatin (a statin) is used for cholesterol management and has no significant interaction with contrast dye.
D. Carvedilol (a beta-blocker) is used for heart failure and hypertension but does not increase the risk of contrast-induced kidney injury.

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The nurse is providing care for a client admitted to rule out a myocardial infarction who is experiencing chest pain while walking to the bathroom. Which action should the nurse implement first?

Nursing Test Bank

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The nurse is providing care for a client admitted to rule out a myocardial infarction who is experiencing chest pain while walking to the bathroom. Which action should the nurse implement first?