ANSWERS GRADED A+ 100% VERIFIED.
A 58-year-old man is complaining of chest pain. Select the question that best
evaluates the quality of the patient's pain.
a. "When did the pain begin?"
b. "How would you describe your pain?"
c. "Does anything make the pain better or worse?"
d. "Where is your discomfort?" ANS >>> b. "How would you describe your pain?"
A 48-year-old male is sitting upright in bed in respiratory distress. He describes an
acute onset of difficulty breathing and chest pain during the night that has been
worsening for the past 3 hours. He also complains of nausea. Pain is described as a
substernal pressure radiating to his left shoulder. Physical examination reveals
cool, diaphoretic skin and rales on auscultation bilaterally. Medical history
includes two prior myocardial infarctions. Medications include Zestril and
metoprolol. HR = 132, BP = 140/100, RR = 25, SaO2? = 92%. Which of the
following is NOT indicated?
,a. Adenosine
b. Enalapril
c. Morphine
d. Nitro-glycerine ANS >>> a. Adenosine
Which of the following clinical findings is LEAST suggestive of left side heart
failure?
a. An S3 gallop
b. Sacral enema
c. Crackles in the lungs
d. Shortness of breath ANS >>> b. Sacral enema
A 65-year-old male is complaining of "chest pressure." His past medical history is
significant for an MI 4 years ago and hypertension. Medications include nitro-
glycerine, Cardizem, and Lasix. The patient states his pain began approximately 30
minutes ago and has not been relieved by rest or the three nitro-glycerine tablets
he has taken thus far. His blood pressure is 144/78 and and his respiratory rate is
18. He is awake, oriented, and extremely anxious. Contraindications for nitro-
glycerine administration include:
a. Right ventricular infarction; systolic BP < 90 mm Hg.
b. Suspected ischemic-type pain; acute myocardial infarction.
c. Hypertension; right ventricular infarction.
d. Congestive heart failure; acute myocardial infarction. ANS >>> a. Right
ventricular infarction; systolic BP < 90 mm Hg.
,Which of the following ECG findings may occur with unstable angina?
a. ST segment depression
b. T wave elevation
c. Q wave formation
d. U wave ANS >>> a. ST segment depression
Medical management of the patient with stable angina often includes all of the
following EXCEPT:
a. Nitrates.
b. Lifestyle adjustment.
c. Beta-blockers.
d. Diuretics. ANS >>> d. Diuretics.
A 48-year-old male is complaining of chest pain that he describes as dull, located
substernal, but radiating to his neck. He rates the pain a 6 on a scale of 1 to 10 and
complains of nausea and light-headedness. His skin is cool and diaphoretic. HR =
96, BP = 124/82, RR = 14, SaO2 = 97%. The 12-lead ECG is nondiagnostic. In
addition to oxygen, an IV of normal saline at a keep open rate, and transport to
the emergency department, which of the following would be most appropriate?
a. Nitro-glycerine, morphine, and furosemide
b. Reassurance that likely his condition is not cardiac in nature
c. Nitro-glycerine
, d. Aspirin, nitro-glycerine, and morphine ANS >>> d. Aspirin, nitro-glycerine, and
morphine
Hypertension may increase myocardial oxygen demand, exacerbating myocardial
ischemia or infarction.
a. True
b. False ANS >>> a. True
Tachycardia, jugular venous distention, fatigue, diaphoresis, and dependent
enema are signs and symptoms of ______ heart failure.
a. Right heart failure
b. Left heart failure
c. cur-pulmonale
d. Uncontrolled Hypertension ANS >>> a. Right heart failure
Ventricular _____________ is abnormal in a bundle branch block.
a. Depolarization
b. Repolarization ANS >>> a. Depolarization
A 65-year-old male is complaining of a sudden onset of chest pain. He is awake,
alert, and diaphoretic. Questions asked of the patient thus far reveal a possible
acute coronary syndrome.