what are the signs of an acute myocardial infarction

ATI LPN

ATI PN Comprehensive Predictor 2023 with NGN

1. What are the signs of an acute myocardial infarction?

A. Chest pain radiating to the arm and shortness of breath
B. Nausea, vomiting, and high fever
C. Headache, confusion, and low blood pressure
D. Increased heart rate and bradycardia

Correct answer: A

Rationale: The correct answer is A: Chest pain radiating to the arm and shortness of breath. These are classic signs of an acute myocardial infarction. Choice B is incorrect because nausea, vomiting, and high fever are not typical signs of a heart attack. Choice C is incorrect as headache, confusion, and low blood pressure are not specific to myocardial infarction. Choice D is incorrect because an acute myocardial infarction typically presents with an increased heart rate, not bradycardia.

2. How should a healthcare provider assess a patient for fluid overload?

A. Monitor weight and assess for shortness of breath
B. Auscultate lung sounds and monitor blood pressure
C. Assess for edema in the extremities
D. Assess for jugular venous distension

Correct answer: A

Rationale: Correctly, the answer is to monitor weight and assess for shortness of breath when assessing a patient for fluid overload. Weight monitoring is crucial as sudden weight gain can indicate fluid retention. Shortness of breath can be a sign of fluid accumulation in the lungs. While auscultating lung sounds and monitoring blood pressure are important assessments in overall patient care, they may not be specific to fluid overload. Assessing for edema in the extremities is relevant, but it is not as sensitive as monitoring weight for detecting fluid overload. Assessing for jugular venous distension is more specific to assessing fluid status in heart failure rather than a general assessment for fluid overload.

3. A nurse manager is updating protocols for belt restraints. Which of the following guidelines should the nurse include?

A. Document the client's condition every 15 minutes.
B. Attach the restraints to a non-moving part of the bed.
C. Avoid requesting a PRN restraint prescription for clients who are aggressive.
D. Remove the client's restraints based on the client's condition.

Correct answer: A

Rationale: The correct answer is A: Document the client's condition every 15 minutes. When using belt restraints, it is crucial to document the client's condition regularly to ensure their safety and well-being. This guideline allows for ongoing assessment of the client's need for restraints and any potential adverse effects. Choice B is incorrect as restraints should not be attached to the bed frame but to a non-moving part of the bed to prevent harm in case of bed movement. Choice C is incorrect as PRN (as needed) restraint prescription should not be a routine practice and should only be considered after other interventions have been attempted. Choice D is incorrect as restraints should be removed and reevaluated based on the client's condition, not solely on a fixed time schedule.

4. A client undergoing radiation therapy is being taught about skin care by a nurse. Which of the following statements by the client indicates an understanding of the teaching?

A. I will use a heating pad to soothe the skin
B. I will avoid using perfumed lotions on the treated area
C. I will apply cold compresses to the area
D. I will scrub the area daily with soap and water

Correct answer: B

Rationale: The correct answer is B because avoiding perfumed lotions is important to prevent skin irritation after radiation therapy. Using a heating pad (A) can further damage the skin, applying cold compresses (C) may not be recommended, and scrubbing the area daily with soap and water (D) can be too harsh on the skin, leading to further irritation and damage.

5. A nurse is preparing to administer a client's morning medications. Which of the following actions should the nurse take to verify the client's identity?

A. Ask the client's full name
B. Scan the client's facility identification band
C. Call the client's name
D. Verify with a second nurse

Correct answer: B

Rationale: The correct action to verify a client's identity when administering medications is to scan the client's facility identification band. This method ensures accuracy and helps prevent medication errors. Asking the client's full name (Choice A) may not be reliable as names can be similar, leading to confusion. Calling the client's name (Choice C) may not be effective if there are multiple clients with the same name in the facility. Verifying with a second nurse (Choice D) is an important safety measure for certain tasks but is not specifically for verifying a client's identity.