a nurse is assessing a client with suspected myocardial infarction which finding supports this diagnosis
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PN ATI Capstone Proctored Comprehensive Assessment Form B

1. A nurse is assessing a client with suspected myocardial infarction. Which finding supports this diagnosis?

Correct answer: A

Rationale: The correct answer is A. Pain radiating to the left arm is a classic symptom of myocardial infarction, commonly known as a heart attack. This occurs due to the referred pain pathways shared by the heart and the left arm. Choices B, C, and D are incorrect. Pain relieved by rest (choice B) is more indicative of musculoskeletal pain rather than cardiac-related pain. Pain worsening with deep breathing (choice C) is often seen in conditions like pleurisy or pulmonary embolism, not myocardial infarction. Pain relieved by antacids (choice D) suggests gastrointestinal issues like heartburn or acid reflux, not cardiac-related pain.

2. A charge nurse is discussing the use of applying ice to a client’s injured knee with a newly licensed nurse. Which of the following is a benefit of this treatment?

Correct answer: C

Rationale: The correct answer is C: Decreased capillary permeability. Ice application helps decrease capillary permeability, which in turn reduces swelling and inflammation at the injury site. This vasoconstriction effect helps to limit the extent of the injury. Choices A, B, and D are incorrect. Applying ice locally does not produce a systemic analgesic effect but rather a localized numbing effect. It does not increase metabolism but rather slows down metabolic processes in the affected area. Additionally, ice application causes vasoconstriction, not vasodilation.

3. A client with a new prescription for an albuterol metered-dose inhaler is being taught by a nurse. Which of the following instructions should the nurse include in the teaching?

Correct answer: B

Rationale: The correct instruction is to hold your breath for 10 seconds after inhaling the medication. This allows the medication to settle in the lungs and maximize its effectiveness. Choice A is incorrect as inhaling quickly may lead to improper medication delivery. Choice C is wrong because taking a second puff immediately after the first without waiting for the prescribed interval may cause an overdose. Choice D is also incorrect as exhaling fully after using the inhaler may result in the medication being exhaled rather than absorbed by the lungs.

4. A nurse is assessing a client for potential drug interactions. Which of the following factors should the nurse consider?

Correct answer: D

Rationale: Correct! All of these factors should be considered when assessing a client for potential drug interactions. The client's diet can interact with certain medications, the client's age can affect metabolism and drug sensitivity, and genetic background can impact how the body processes medications. Therefore, it is essential for the nurse to take into account all these factors to ensure safe and effective drug therapy. Choices A, B, and C are incorrect because each of these factors alone can contribute to potential drug interactions, making it crucial to consider all of them together.

5. A nurse is teaching a client about the use of sildenafil. Which of the following should be included?

Correct answer: B

Rationale: The correct answer is to monitor for headaches when taking sildenafil. This medication can cause headaches and other side effects, so it is crucial to inform clients about these potential adverse reactions. Choice A is incorrect because sildenafil should not be taken with nitrates due to the risk of severe hypotension. Choice C is incorrect as sildenafil is a prescription medication, not an over-the-counter one. Choice D is incorrect because sildenafil, like any medication, can have side effects that should be discussed with the client.

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