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Clinical Manifestations and Assessment

- The clinical manifestations and assessment of MI and angina pectoris depend on the severity, location, and duration of ischemia

- The cardinal symptom of both conditions is chest pain, which is usually described as heavy, squeezing, or crushing and may radiate to the left arm, jaw, neck, or shoulder blades

- The pain of MI is more severe, persistent (lasting more than 15 minutes), and unrelieved by rest or nitroglycerin

- The pain of angina is less severe, intermittent (lasting less than 15 minutes), and relieved by rest or nitroglycerin

- Other symptoms that may accompany chest pain include:

  •   Shortness of breath
  •   Indigestion
  •   Nausea and vomiting
  •   Diaphoresis
  •   Pallor
  •   Cool, clammy skin
  •   Tachycardia and/or palpitations
  •   Decreased level of consciousness
  •   Anxiety or fear of death

Questions on Clinical Manifestations and Assessment

Correct Answer is B

Explanation

This choice is incorrect because placing the client in a supine position is not the priority action in a suspected MI. The client's position should be adjusted based on their comfort and ability to breathe effectively.

Correct Answer is A

Explanation

This choice is incorrect because microvascular angina is characterized by chest pain caused by abnormalities in the small blood vessels in the heart. It may not always be relieved by nitroglycerin, and it is not the most likely diagnosis in this presentation.

Correct Answer is D

Explanation

This choice is correct. Nitroglycerin is a vasodilator that helps to relax and widen blood vessels, improving blood flow and relieving chest pain during an angina episode. Teaching the client to use nitroglycerin as needed for chest pain relief is a priority in angina management.

Correct Answer is C

Explanation

This choice is incorrect because mild, intermittent chest discomfort during activity is more typical of stable angina, not an acute MI. Acute MI pain is usually more severe, prolonged, and occurs at rest or with minimal exertion.

Correct Answer is D

Explanation

<p>This choice is incorrect because while keeping the tablets in their original bottle and away from moisture and heat is important for medication storage, it is not directly related to the administration of nitroglycerin. The client should be instructed on proper sublingual administration for immediate chest pain relief.Questions</p>

Correct Answer is B

Explanation

This choice is incorrect because increased heart rate and contractility can be associated with certain conditions but are not the primary cause of MI. MI is primarily caused by atherosclerotic plaque formation and subsequent thrombus formation in the coronary arteries.

Correct Answer is C

Explanation

This choice is incorrect because gender (male) is a non-modifiable risk factor for angina pectoris. While men are generally at higher risk for angina than premenopausal women, gender cannot be changed to alter the risk.

Correct Answer is D

Explanation

This choice is correct. A family history of MI is a non-modifiable risk factor because it is based on genetic factors that cannot be changed through lifestyle modifications. Having a close relative with a history of MI increases an individual's risk of developing MI, but it cannot be altered or eliminated through lifestyle changes.

Correct Answer is B

Explanation

This choice is incorrect because chest pain caused by the heart muscle overworking is more typical of conditions like heart failure, not angina pectoris.

Correct Answer is A

Explanation

This choice is incorrect because controlling stress through relaxation techniques and counseling is beneficial for overall well-being, but it may not be the most effective approach to reduce the risk of MI when compared to regular physical activity and weight management. Stress management is still an important aspect of cardiovascular health, but it should be combined with other lifestyle changes for optimal risk reduction.Questions

Correct Answer is C

Explanation

This choice is incorrect because radiating pain to the left arm is associated with both angina pectoris and myocardial infarction (MI), but it is not specific enough to differentiate between the two conditions.

Correct Answer is A

Explanation

This choice is incorrect because bradycardia (slow heart rate) is not an early sign of an MI. Tachycardia (rapid heart rate) is more commonly associated with an acute MI as the body attempts to compensate for the decreased cardiac output.

Correct Answer is A

Explanation

This choice is incorrect because providing oxygen therapy may be beneficial if the client is hypoxic, but it is not the priority during an angina episode. The priority is to administer nitroglycerin to relieve chest pain.

Correct Answer is B

Explanation

This choice is incorrect because shortness of breath and wheezing may occur in both stable angina and MI, especially if the heart's pumping ability is compromised. These symptoms are not specific to MI and can also be seen in other cardiac and respiratory conditions.

Correct Answer is D

Explanation

This choice is correct. An elevated ST segment on the electrocardiogram (ECG) is an important sign of an acute myocardial infarction (MI). It indicates myocardial ischemia and injury. The nurse should take immediate action, such as notifying the healthcare provider and implementing appropriate interventions for the client's acute coronary syndrome. Prompt medical intervention is crucial to minimize cardiac damage and improve the client's prognosis.Questions

Correct Answer is A

Explanation

This choice is incorrect because a chest X-ray can help identify other conditions like pulmonary edema or lung disorders, but it is not the primary diagnostic test for MI.

Correct Answer is A

Explanation

This choice is incorrect because cardiac catheterization is an invasive procedure used to measure pressures within the heart and evaluate coronary artery blockages. It is not typically the initial diagnostic test for angina pectoris or MI.

Correct Answer is C

Explanation

This choice is incorrect because a stress test is not used to visualize the coronary arteries for blockages. It is a non-invasive test primarily used to assess the heart's functional capacity.

Correct Answer is C

Explanation

This choice is incorrect because assessing the heart's function using sound waves is characteristic of an echocardiogram, not coronary angiography.Questions

Correct Answer is B

Explanation

This choice is incorrect because administering aspirin is an essential intervention during an MI to help reduce platelet aggregation and prevent further clot formation. However, obtaining a 12-lead ECG takes precedence in the initial assessment to confirm the diagnosis and guide further interventions.

Correct Answer is C

Explanation

<p>This choice is incorrect because oxygen administration does not prevent further clot formation in coronary arteries. Aspirin and other anticoagulant medications are used to prevent clot formation in acute coronary syndrome.</p>

This choice is correct. After taking sublingual nitroglycerin for chest pain relief, the client should sit or lie down and avoid sudden position changes. Nitroglycerin can cause systemic vasodilation and may lead to orthostatic hypotension, increasing the risk of dizziness or falls if the client sta

This choice is incorrect because nitroglycerin is a vasodilator used to relieve chest pain (angina) by dilating blood vessels and increasing blood flow to the heart muscle. While it helps reduce anginal symptoms, it does not directly reduce myocardial oxygen demand as metoprolol does.

This choice is incorrect because sublingual nitroglycerin is not meant for daily or preventive use. It is specifically used to treat acute episodes of chest pain (angina) and should be taken only when needed. Clients with angina may be prescribed long-acting nitroglycerin preparations for prophylact

This choice is incorrect because while aspirin is used to relieve pain and reduce inflammation, its primary role in MI management is its antiplatelet effect, as mentioned earlier.

This choice is incorrect because metoprolol is a beta-blocker used to reduce heart rate and blood pressure, but it is not an antiplatelet agent like clopidogrel.

This choice is incorrect because the description provided is more characteristic of coronary artery bypass grafting (CABG) surgery, not PCI.

This choice is incorrect because heparin is not a pain reliever. It does not directly address chest discomfort during angina episodes; its role is in preventing and managing thrombosis.

This choice is incorrect because although fibrinolytic therapy does improve blood flow to the heart muscle by dissolving clots, its primary purpose is not to improve oxygen supply directly. Rather, it aims to restore blood flow by eliminating the clot causing the infarction.

This choice is correct. Coronary artery bypass grafting (CABG) is a surgical procedure that involves taking a healthy blood vessel from another part of the body and grafting it to the blocked coronary artery. The graft bypasses the blockage, restoring blood flow to the heart and improving myocardial

This choice is incorrect because ranolazine is not an antiplatelet medication. Its mechanism of action is related to its effects on myocardial oxygen demand and utilization, not its impact on platelet aggregation and clot formation.Questions

This choice is incorrect because cardiac rehabilitation does involve physical exercise, but the primary goal is not to improve lung function and oxygenation. Instead, it aims to improve cardiovascular endurance, strength, and overall heart health.

This choice is incorrect because while exercise can have positive effects on mental health, such as reducing stress and anxiety, its primary benefit in cardiac rehabilitation is related to cardiovascular health.

This choice is incorrect because whole grains and legumes are sources of complex carbohydrates and plant-based proteins that can be part of a heart-healthy diet. They provide essential nutrients and fiber that are beneficial for heart health.

This choice is correct. Setting a quit date is an effective approach to quitting smoking. It allows individuals to mentally prepare for the change and commit to the process. Avoiding situations or triggers that may lead to smoking is also crucial for breaking the habit and preventing relapse.

This choice is incorrect because stress activates the sympathetic nervous system, leading to increased heart rate and blood pressure rather than suppressing these responses.

This choice is incorrect because beta-blockers do not directly prevent blood clot formation in coronary arteries. Anticoagulant or antiplatelet medications are used to reduce the risk of clot formation in individuals at high risk for recurrent heart attacks.

This choice is incorrect because suggesting over-the-counter medications without consulting the healthcare provider can be unsafe and may interact with prescribed medications. It is essential to address side effects with the healthcare team for appropriate management and adjustments to the medicatio

<p>This choice is correct. Troponin is the most specific biomarker for diagnosing MI. Elevated troponin levels in the blood indicate cardiac muscle damage, making it a reliable marker for myocardial infarction. Troponin levels rise shortly after the onset of MI and remain elevated for several days,

<p>This choice is incorrect because a similar episode of chest pain a few months ago is not indicative of the current acute event. The nurse should focus on the client&#39;s current symptoms and their acute presentation to determine the appropriate interventions.</p>

<p>This choice is incorrect because initiating cardiopulmonary resuscitation (CPR) is not indicated in this scenario. The client is still conscious and experiencing symptoms, indicating a need for prompt oxygen administration and further assessment.</p>
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