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 D

Explanation

A) Ice packs may be applied to the site for 30 minutes every hour for comfort:
This is not an appropriate recommendation for skin care related to radiation therapy. Applying ice packs to the skin can cause vasoconstriction and might worsen skin irritation or damage from radiation. Instead, the patient should be advised to avoid extreme temperatures, including hot or cold compresses, which could exacerbate skin issues in the radiation field.

B) Incorporate rest periods throughout the day:
While rest is important for overall well-being during radiation therapy, this instruction does not directly address the skin care needs associated with radiation. The primary concern with radiation therapy is protecting the skin from further irritation and damage, so specific skin care measures are more crucial in this context than general rest periods.

C) Do not share bathrooms/toilets with others for 48 hours after treatment:
This instruction is not necessary for most patients undergoing radiation therapy, especially for lung cancer. The concern about not sharing bathrooms or toilets generally applies to patients receiving brachytherapy or radioactive implants, where radiation is placed inside the body. For external radiation, there is no risk of contamination through shared bathroom use.

D) Wear loose, soft clothing over the treated area:
This is the most appropriate instruction for skin care during radiation therapy. Radiation therapy can cause the skin to become tender, red, and irritated, so wearing loose, soft clothing will help minimize friction and pressure on the skin. Tight or rough clothing can irritate the radiation site, increasing the risk of skin breakdown. Loose, breathable fabrics like cotton can help keep the skin comfortable and allow it to heal while protecting it from further damage.

A. insert an oral airway and suction as needed. B. withhold oral fluids and food. C. apply artificial pears to protect the cornea. D. speak clearly while facing the patient.

Correct Answer is B

Explanation

A) Insert an oral airway and suction as needed:
This is generally not the first intervention for impaired glossopharyngeal (CN IX) and vagus nerve (CN X) function. The glossopharyngeal and vagus nerves play a critical role in swallowing, gag reflex, and the ability to protect the airway. While an airway might be necessary in cases of severe dysfunction, withholding food and fluids is a more immediate and specific concern when these cranial nerves are impaired, as it prevents aspiration risk.

B) Withhold oral fluids and food:
The glossopharyngeal nerve (CN IX) is involved in taste and swallowing, and the vagus nerve (CN X) is crucial for the motor control of the pharynx and larynx, which are involved in swallowing and protecting the airway. Dysfunction of these nerves can lead to difficulty swallowing (dysphagia), increased risk for aspiration, and the inability to protect the airway effectively. Withholding oral fluids and food helps prevent aspiration, a major risk when these nerves are impaired, until further assessment and management can be done.

C) Apply artificial tears to protect the cornea:
While it is important to protect the cornea in patients with cranial nerve dysfunction (specifically the facial nerve, CN VII), this does not directly relate to the glossopharyngeal (CN IX) and vagus (CN X) nerves. The glossopharyngeal and vagus nerves affect swallowing and airway protection, not eye lubrication. Applying artificial tears would not address the risk associated with impaired swallowing or airway protection.

D) Speak clearly while facing the patient:
Although speaking clearly and facing the patient might be helpful for communication, especially if the patient has difficulty with speech due to nerve impairment, it does not address the immediate and more critical concern of impaired swallowing and airway protection associated with dysfunction of the glossopharyngeal and vagus nerves. The primary concern is ensuring the patient is not at risk for aspiration while eating or drinking.

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

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Which instruction is most important for the nurse to provide a client who is receiving radiation therapy for lung cancer when teaching about skin care?

Correct Answer is D

Explanation

The neurologic assessment of a patient indicated impaired function of the glossopharyngeal nerve (CN 10) and the vagus nerve (C.N X). Based on these findings, the nurse plans to;

Correct Answer is B

Explanation

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

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