The nurse knows which of the following types of angina is most closely related with an impending myocardial infarction (MI)?

Unstable

Variant

Chronic stable

Nocturnal

Answer and Explanation

The Correct Answer is A

A) Unstable:
Unstable angina is the type of angina most closely related to an impending myocardial infarction (MI). It is characterized by unpredictable chest pain that occurs at rest or with minimal exertion, or that increases in severity or frequency. Unstable angina represents a medical emergency and can progress to an MI if not promptly treated. It occurs when there is increased myocardial oxygen demand and a partially occluded coronary artery, often due to a ruptured atherosclerotic plaque.

B) Variant (Prinzmetal's) angina:
Variant angina, also known as Prinzmetal's angina, is caused by a spasm of the coronary artery, which temporarily narrows or obstructs blood flow. Although it can be severe and may occur at rest, it is typically transient and is not directly related to the development of an MI. Variant angina usually responds to medications such as nitrates or calcium channel blockers, and while it can be dangerous, it is not the most likely type of angina associated with a myocardial infarction.

C) Chronic stable angina:
Chronic stable angina occurs with predictable patterns, typically with exertion or stress, and resolves with rest or nitroglycerin. It does not usually indicate an impending MI, as it is a chronic condition caused by atherosclerosis that limits the heart's blood supply under stress. While chronic stable angina increases the risk of MI over time, it is not directly associated with an imminent heart attack.

D) Nocturnal angina:
Nocturnal angina refers to chest pain that occurs during the night or early morning hours, often during sleep. It may be associated with sleep apnea, GERD, or increased sympathetic tone during sleep. This type of angina is less commonly linked to an impending MI compared to unstable angina, although it should still be evaluated for any underlying cardiovascular issues.

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Correct Answer is B

Explanation

A) Treatment plan will need to be changed to achieve the desired effect:
The decrease in the carcinoembryonic antigen (CEA) levels from 50 ng/mL to 10 ng/mL suggests that the cancer is responding to the current treatment, not that the treatment plan needs to be changed. A drop in CEA levels typically indicates a positive response to treatment, such as chemotherapy, in reducing the number or size of cancer cells.

B) Cancer treatment is having the desired effect on killing cancer cells:
Carcinoembryonic antigen (CEA) is a tumor marker that is often elevated in individuals with certain cancers, particularly colorectal cancer. A decrease in CEA levels, as noted in this case (from 50 ng/mL to 10 ng/mL), usually signifies that the treatment is successfully targeting the cancer and reducing the tumor burden. This drop suggests that the chemotherapy is effectively killing cancer cells and reducing the size or activity of the tumor.

C) Client is at greater risk for tumor lysis syndrome:
Tumor lysis syndrome typically occurs when large numbers of cancer cells die rapidly, releasing their intracellular contents into the bloodstream, which can lead to metabolic disturbances like hyperkalemia, hyperphosphatemia, and renal failure. It is more common in aggressive hematologic cancers, such as leukemia or lymphoma, and typically presents with a rapid rise in tumor marker levels, not a decrease.

D) Cancer has increased size and metastatic sites:
An increase in tumor size or the development of metastatic sites would typically result in an increase in CEA levels, not a decrease. Since CEA levels have dropped, it is more likely that the cancer is shrinking or responding to the current treatment. This finding is more indicative of a positive response rather than disease progression.

A. chemical burns to the posterior neck, chest, and back B. radiation burns to shoulder and bridge of nose C. electrical burns to the hands causing dysrhythmias D. thermal burns to the head, neck, face, and airway.

Correct Answer is D

Explanation

A) Chemical burns to the posterior neck, chest, and back:
Chemical burns primarily affect the skin and underlying tissues where the chemicals have come into contact. Although chemical burns can cause significant damage, particularly to the respiratory system if inhaled, chemical burns to the posterior neck, chest, and back would not typically require endotracheal intubation or tracheostomy unless there is evidence of inhalation injury or airway compromise.

B) Radiation burns to shoulder and bridge of nose:
Radiation burns, such as those from sunburn or therapeutic radiation, generally do not cause immediate airway compromise or respiratory distress unless the radiation exposure has affected the lungs or upper respiratory tract.

C) Electrical burns to the hands causing dysrhythmias:
Electrical burns can cause significant tissue damage, especially if there is a deep tissue injury and potential for electrical burns to the internal organs. They can lead to dysrhythmias, but these burns are more related to cardiac complications rather than direct airway injury. Endotracheal intubation may be required if there are signs of airway compromise or respiratory failure, but the primary concern with electrical burns would be cardiac monitoring and fluid resuscitation.

D) Thermal burns to the head, neck, face, and airway:
The upper airway (including the mouth, throat, and vocal cords) is particularly vulnerable to thermal injury from inhaling hot gases, smoke, or steam. This can lead to edema and airway obstruction, which can rapidly progress to respiratory failure. Endotracheal intubation or even a tracheostomy may be required to secure the airway and prevent suffocation. Inhalation injury is a significant concern in thermal burns involving the head, neck, and face.

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The nurse knows which of the following types of angina is most closely related with an impending myocardial infarction (MI)?

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Naxlex Comprehensive Predictor Exams

The nurse is reviewing lab results for a client receiving chemotherapy for the treatment of cancer. The nurse notes the carcinoembryonic antigen (CEA) was previously 50 ng/ mL and is now 10 ng/mL (normal range 0-2.5 ng/mL) The nurse is aware this finding indicates the:

Correct Answer is B

Explanation

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Correct Answer is D

Explanation

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