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Which of the following findings would support a diagnosis of acute myocardial infarction (AMI)? Select all that apply.
- A. Dizziness
- B. Hypotension
- C. Orthopnea
- D. Nausea
- E. Polyuria
- F. Pulsus paradoxus
Correct Answer: A,B,D
Rationale: Dizziness can result from reduced cardiac output in AMI. Hypotension may occur due to impaired cardiac function. C: Incorrect - Orthopnea is more typical of heart failure. D: Correct - Nausea is a common symptom of AMI. E: Incorrect - Polyuria is not associated with AMI. F: Incorrect - Pulsus paradoxus is linked to pericardial conditions like tamponade.
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The nurse is caring for a client with congestive heart failure (CHF). The nurse should anticipate a prescription for which medication?
- A. Enalapril
- B. Verapamil
- C. Lovastatin
- D. Gemfibrozil
Correct Answer: A
Rationale: Enalapril, an ACE inhibitor, reduces afterload and preload in CHF, improving cardiac function.
The following scenario applies to the next 1 items
The nurse in the emergency department is triaging a client.
Item 1 of 1
Nurses' Notes
Orders
Diagnostic Results
0819: The client reports feeling "tightness in the chest" for the last 30 minutes. The pain came on suddenly while he was in bed. He describes the pain as a pressure-like sensation radiating to his left arm. He states that the pain is 'severe.' The pain does not improve with rest or changing positions. The client reported one year ago, he had this chest pain that was relieved with nitroglycerin. Upon assessment, the client was anxious and had a flushed appearance. Clear lung sounds bilaterally. Peripheral pulses 2+. Physician was called to the triage room where verbal orders were received. Medical history of diabetes mellitus (type two), hypertension, and hyperlipidemia.
For each assessment finding below, click to specify if the finding is consistent with the condition of stable angina or unstable angina.
- A. Location of pain
- B. Onset of pain
- C. ECG findings
- D. Pain intensity
- E. Duration of pain
- F. Medical history
Correct Answer: B,C,D,E
Rationale: A: Both - Pain location (chest, radiating to arm) is similar in both stable and unstable angina. B: Unstable angina - Sudden onset while at rest is characteristic of unstable angina. C: Unstable angina - ECG changes (e.g., ST depression) are more likely in unstable angina. D: Unstable angina - Severe pain is typical of unstable angina. E: Unstable angina - Prolonged pain duration is associated with unstable angina. F: Both - Medical history (e.g., hypertension, diabetes) is relevant to both conditions.
The nurse is caring for a client with the following clinical data. Based on the laboratory tests, which medication would the nurse clarify with the primary healthcare provider (PHCP) prior to administration? See the exhibit for additional client information.
- A. bupropion 150 mg XL PO Daily
- B. clonidine 0.1 mg PO Daily
- C. albuterol 2.5 mg via nebulizer Daily
- D. captopril 12.5 mg PO Daily
Correct Answer: D
Rationale: Captopril, an ACE inhibitor, requires clarification if renal function is impaired (e.g., elevated creatinine), as it can worsen kidney injury.
The nurse is visiting a client who was recently prescribed antihypertensive medications. Which statement, if made by the client, requires follow-up?
- A. My pulse decreases after taking my metoprolol.
- B. I started taking my furosemide right before I went to sleep.
- C. I am seasoning my foods with salt substitutes while taking my hydrochlorothiazide.
- D. I wear my clonidine patch for seven days.
Correct Answer: B
Rationale: Taking furosemide, a diuretic, at bedtime can cause nocturia, disrupting sleep and increasing fall risk. It should be taken earlier.
The nurse is caring for a client with Buerger's disease. The nurse plans on suggesting that the client receives a referral for
- A. occupational therapy.
- B. speech therapy.
- C. smoking cessation.
- D. group psychotherapy.
Correct Answer: C
Rationale: Buerger's disease is strongly linked to smoking, so cessation is critical to prevent disease progression.