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

Crushing chest pain

Epigastric burning

Dyspnea and fatigue

Vague complaints

None of the above

Answer and Explanation

The Correct Answer is A

Choice A reason: Crushing chest pain is the classic sign of an AMI, but it can be absent in some older men with an AMI. This is because older men may have a reduced pain perception due to aging, diabetes, or other conditions that affect the nerve endings. Older men may also have atypical or silent AMIs, which do not cause chest pain or other obvious symptoms.

Choice B reason: Epigastric burning is not a classic sign of an AMI, but it can be a symptom of an AMI in some older men. Epigastric burning may be mistaken for indigestion, heartburn, or gastritis, but it can also indicate ischemia or injury to the lower part of the heart.

Choice C reason: Dyspnea and fatigue are not classic signs of an AMI, but they can be symptoms of an AMI in some older men. Dyspnea and fatigue may be attributed to aging, deconditioning, or other chronic diseases, but they can also indicate reduced oxygen supply to the heart and the body.

Choice D reason: Vague complaints are not classic signs of an AMI, but they can be symptoms of an AMI in some older men. Vague complaints may include anxiety, restlessness, nausea, dizziness, or weakness, which may be overlooked or dismissed as minor ailments, but they can also indicate a serious cardiac event.

Choice E reason: None of the above is not the correct answer, as there is one choice that is the classic sign of an AMI that can be absent in an older man with an AMI.

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Correct Answer is D

Explanation

Choice A reason: ASA (aspirin) is not the best choice, as it can cause bleeding, ulcers, and allergic reactions in some older adults. ASA is also metabolized by the liver, which may be affected by chronic kidney disease.

Choice B reason: Meperidine (Demerol) is not the best choice, as it is a narcotic analgesic that can cause respiratory depression, sedation, and dependence in older adults. Meperidine is also excreted by the kidneys, which may be impaired by chronic kidney disease.

Choice C reason: Ibuprofen (Advil, Motrin) is not the best choice, as it is a nonsteroidal anti-inflammatory drug (NSAID) that can cause kidney damage, fluid retention, and hypertension in older adults. Ibuprofen is also contraindicated in patients with chronic kidney disease.

Choice D reason: Acetaminophen (Tylenol) is the best choice, as it is a mild analgesic that can relieve pain without causing significant side effects in older adults. Acetaminophen is also safe to use in patients with chronic kidney disease, as long as the dose is adjusted according to the liver function.

Choice E reason: None of the above is not the correct answer, as there is one choice that is the best choice for treating mild back pain in an older adult who has chronic kidney disease.

A. The use of restraints on older patients helps prevent injuries from falls. B. About 50% to 70% of falls in hospitals occur while transferring between bed and chair. C. Falls that do not cause physical injury are not significant. D. The get-up-and-go test provides a measure of a patient's energy and initiative. E. None of the above.

Correct Answer is B

Explanation

Choice A: The use of restraints on older patients helps prevent injuries from falls - This statement is not true. The use of restraints can increase the risk of injury and is generally discouraged¹.

Choice B: About 50% to 70% of falls in hospitals occur while transferring between bed and chair - This statement is true. Transfers are a high-risk activity for falls, and appropriate precautions should be taken¹.

Choice C: Falls that do not cause physical injury are not significant - This statement is not true. Even falls without injury can have significant psychological impacts, leading to fear of falling and reduced mobility¹.

Choice D: The get-up-and-go test provides a measure of a patient's energy and initiative - This statement is not true. The get-up-and-go test is used to assess a person's mobility and balance, not their energy and initiative¹.

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

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Which of the following would be the best choice for treating mild back pain in an older adult who has chronic kidney disease? Liver enzymes are within normal limits.

Correct Answer is D

Explanation

Which one of the following is a true statement about mobility and safety for older adults?

Correct Answer is B

Explanation

You notice that your older adult male client frequently knocks his arm or hand against door frames or chair backs and then develops a purpura. What do you advise your client to do? (Select all that apply.)

An older adult who is on bed rest after surgery is prescribed morphine for pain. Which of the following is the nurse’s priority for preventive care?

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Which factors in the patient care environment should be routinely assessed to decrease the risk of falls? (Select all that apply.)

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