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
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A reason: FACE pain rating scale is not the most useful assessment tool for a cognitively impaired patient who cannot accurately report pain, as it relies on the patient's ability to match their pain intensity to a series of facial expressions. The patient may not be able to understand or use the scale appropriately.
Choice B reason: OLDCART-based assessment tool is not the most useful assessment tool for a cognitively impaired patient who cannot accurately report pain, as it relies on the patient's ability to provide detailed information about the onset, location, duration, characteristics, aggravating factors, relieving factors, and treatment of their pain. The patient may not be able to recall or communicate this information effectively.
Choice C reason: PAINAD scale is the most useful assessment tool for a cognitively impaired patient who cannot accurately report pain, as it relies on the nurse's observation of the patient's behavior and physiological responses to pain. The scale consists of five items: breathing, vocalization, facial expression, body language, and consolability. Each item is scored from 0 to 2, and the total score ranges from 0 to 10. A higher score indicates more pain.
Choice D reason: 0 to 10 numeric pain scale is not the most useful assessment tool for a cognitively impaired patient who cannot accurately report pain, as it relies on the patient's ability to rate their pain intensity on a scale from 0 (no pain) to 10 (worst possible pain). The patient may not be able to comprehend or use the scale correctly.
Choice E reason: None of the above is not the correct answer, as there is one choice that is the most useful assessment tool for a cognitively impaired patient who cannot accurately report pain.
Correct Answer is C
Explanation
Choice A reason: A nasogastric tube may be necessary for some patients with dysphagia, which is difficulty swallowing, but not for dysarthria, which is difficulty speaking.
Choice B reason: Stems from severe rheumatoid arthritis is false because dysarthria is caused by damage to the nerves or muscles that control speech, not by inflammation of the joints.
Choice C reason: Physical therapy can be beneficial is true because dysarthria can be improved by exercises that strengthen the speech muscles and improve coordination.
Choice D reason: Can affect the balance is false because dysarthria does not affect the vestibular system, which is responsible for balance and spatial orientation.
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