Nokea
Which client would most likely be misdiagnosed for having a myocardial infarction?
- A. A 55-year-old Caucasian male with crushing chest pain and diaphoresis.
- B. A 60-year-old Native American male with an elevated troponin level.
- C. A 40-year-old Hispanic female with a normal electrocardiogram.
- D. An 80-year-old Peruvian female with a normal CK-MB at 12 hours.
Correct Answer: C
Rationale: A 40-year-old Hispanic female with normal ECG (C) is most likely to be misdiagnosed, as women often present atypically and normal ECGs can occur in MI. Typical symptoms (A), elevated troponin (B), and normal CK-MB at 12 hours (D) are less likely to be missed.
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According to the nurse, when is the correct time to note the diastolic blood pressure reading?
- A. When the loud knocking sounds become muffled
- B. When the last loud knocking sound is heard
- C. When the swishing sound is a second
- D. When the swishing sound becomes faint
Correct Answer: B
Rationale: The diastolic blood pressure is recorded at the point when the last loud knocking sound (Korotkoff phase V) is heard, indicating the pressure at which blood flow is fully restored.
If the client's severe chest pain is typical of other people who experience myocardial infarction (MI), the client is most likely to tell the nurse that the discomfort radiates to which area?
- A. Flank
- B. Groin
- C. Abdomen
- D. Shoulder
Correct Answer: D
Rationale: MI pain typically radiates to the shoulder, arm, or jaw due to referred pain from cardiac ischemia.
The client with pericarditis is prescribed a nonsteroidal anti-inflammatory drug (NSAID). Which teaching instruction should the nurse discuss with the client?
- A. Explain the importance of tapering off the medication.
- B. Discuss that the medication will make the client drowsy.
- C. Instruct the client to take the medication with food.
- D. Tell the client to take the medication when the pain level is around '8.'
Correct Answer: C
Rationale: NSAIDs irritate the stomach; taking with food (C) reduces GI upset. Tapering (A) is for steroids, drowsiness (B) is not typical, and waiting for severe pain (D) delays relief.
The nurse identifies the concept of tissue perfusion as a client problem. Which is an antecedent of tissue perfusion?
- A. The client has a history of coronary artery disease (CAD).
- B. The client has a history of diabetes insipidus (DI).
- C. The client has a history of chronic obstructive pulmonary disease (COPD).
- D. The client has a history of multiple fractures from a motor-vehicle accident.
Correct Answer: A
Rationale: CAD (A) directly impairs cardiac perfusion due to atherosclerosis, an antecedent to perfusion issues. DI (B), COPD (C), and fractures (D) are less directly related.
An adult is admitted with venous thromboembolism. What treatment should the nurse expect during the acute stage?
- A. Application of an elastic stocking
- B. Ambulation three times a day
- C. Passive range of motion exercises to the legs
- D. Use of ice packs to control pain
Correct Answer: A
Rationale: Elastic stockings promote venous return and reduce swelling in the acute stage of venous thromboembolism. Ambulation, passive exercises, or ice packs may increase risk or be less effective.