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When assessing a patient with a possible myocardial infarction (MI), which sign or symptom should the nurse assess for?
- A. Pain radiating to left arm and jaw
- B. Visual Hallucinations
- C. Pallor
- D. Diaphoresis
- E. Apprehension
- F. Dyspnea
Correct Answer: A,C,D,E,F
Rationale: Pain radiating to the left arm and jaw, pallor, diaphoresis, apprehension/anxiety and dyspnea are signs and symptoms present in patients with an MI.
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What is the major cause of cardiac valve disease in past years?
- A. Rheumatic fever
- B. Long history of malnutrition
- C. Drug abuse
- D. Obesity
Correct Answer: A
Rationale: Rheumatic fever, a streptococcal infection, was the major cause of cardiac valve disease in past years.
A patient, age 72, was admitted to the medical unit with a diagnosis of angina pectoris. Which is a characteristic signs and symptoms of angina pectoris?
- A. substernal pain that radiates down the left arm.
- B. epigastric pain that radiates to the jaw.
- C. indigestion, nausea, and eructation.
- D. fatigue, shortness of breath, and dyspnea.
Correct Answer: A
Rationale: The pain often radiates down the left inner arm to the little finger and also upward to the shoulder and jaw.
Which statement would lead the nurse to offer more instruction about taking warfarin?
- A. I eat a banana every morning with breakfast.'
- B. I try to eat more green leafy vegetables, especially broccoli, spinach, and kale.'
- C. I try to eat a well-balanced, low-fat diet.'
- D. I don't drink alcohol or caffeine.'
Correct Answer: B
Rationale: Avoid marked changes in eating habits, such as dramatically increasing foods high in vitamin K (e.g., broccoli, spinach, kale, greens). Limit alcohol intake to small amounts.
What is the third step in the impulse pattern of conduction through the heart?
- A. Atrial wall
- B. Atrial-ventricular (AV) node
- C. Purkinje fibers
- D. Sinoatrial (SA) node
- E. Bundle branches
- F. Bundle of His
Correct Answer: B
Rationale: The conduction begins with the impulse from the SA node that travels down the atrial wall to the AV node, to the Bundle of His, to the bundle branches, and finally to the Purkinje fibers.
A 70 year female patient arrives to the emergency department, reporting nausea, vomiting, fatigue and abdominal discomfort. The health care provider requests myocardial infarction (MI) protocols to begin. For which reason is this protocol beginning?
- A. The provider is concerned a lawsuit could occur due to missed diagnosis.
- B. Women tend to have less classic symptoms of a myocardial infarction.
- C. Women are more likely to die from breast or cervical cancer than an MI.
- D. The troponin I level is not as accurate for females as it is in male patients.
Correct Answer: B
Rationale: Women experiencing an MI tend to experience symptoms that are unrelated to chest pain: nausea, vomiting, fatigue, indigestion, shortness of breath, and upper back or abdominal discomfort.