Which classic sign of an acute myocardial infarction (AMI) can be absent in an older man with an AMI?

Choice A reason: Allowing the client to remain in bed but sharing that getting up will be required at least twice a day starting the next morning is not an effective intervention, as it does not address the client's current pain or anxiety, and may increase the client's resistance or fear of mobilization.

Choice B reason: Using the Hoyer lift to get her out of bed so that the knee will not experience much movement and so there will be little pain is not an appropriate intervention, as it does not respect the client's autonomy or preference, and may cause more pain or injury to the knee or other joints.

Choice C reason: Sharing with the client that it is important to get out of bed and that there is pain medication available if it does hurt is not a sufficient intervention, as it does not provide the client with adequate pain relief or reassurance, and may imply that the client's pain is not taken seriously or validated.

Choice D reason: Offering pain medication, administering the medication, and waiting 30 minutes before getting her out of bed is the best intervention, as it provides the client with effective pain management, reduces the client's anxiety, and facilitates the client's mobilization and recovery.

Choice A reason: This statement is incorrect because wellness is not only dependent on the absence of disease, but also on the physical, mental, emotional, social, and spiritual aspects of health. The nurse should educate the client on how to cope with his condition and enhance his quality of life, not focus on the negative aspects of his disease.

Choice B reason: This statement is incorrect because aggressive medical interventions may not be appropriate or beneficial for a terminally ill client. The nurse should respect the client's wishes and preferences regarding his care, and provide comfort and palliative measures, not cause unnecessary pain or suffering.

Choice C reason: This statement is incorrect because wellness is still a real option for a terminally ill client. The nurse should not assume that the client has given up on his health or happiness, but rather support him in finding meaning and purpose in his life, and achieving his goals and values.

Choice D reason: This statement is correct because it reflects the nurse's role in promoting wellness for a terminally ill client. The nurse should provide nursing interventions that can help the client maintain his dignity, autonomy, and sense of control, as well as address his physical, emotional, social, and spiritual needs. The nurse should also empower the client to make informed decisions about his care, and facilitate his communication with his family and health care team.