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Questions 158

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Question 1 of 5

A 40-year-old client has been admitted to the hospital with severe substernal chest pain radiating down his left arm. The nurse caring for the client establishes the following priority nursing diagnosis--Alteration in comfort, pain related to:

Correct Answer: A

Rationale: Anaerobic metabolism results because the decreased blood supply to the myocardium causes a release of lactic acid. Lactic acid is an irritant to the myocardial neural receptors, producing chest pain. Chest pain is caused by a decrease in the O2 supply to the myocardial cells. Treatment modalities for chest pain are aimed toward increasing the blood flow through coronary arteries. Chest pain causes an increase in the stimulation of the sympathetic nervous system. This stimulation increases the heart rate and blood pressure, causing an increase in myocardial workload aggravating the chest pain. Chest pain and anxiety cause increased secretion of catecholamines by stimulating the sympathetic nervous system. This stimulation increases chest pain by increasing the workload of the heart.

Question 2 of 5

In the coronary care unit, a client has developed multifocal premature ventricular contractions. The nurse should anticipate the administration of:

Correct Answer: C

Rationale: Lidocaine is the drug of choice to treat ectopic ventricular beats.

Question 3 of 5

The nurse would be sure to instruct a client on the signs and symptoms of an eye infection and hemorrhage. These signs and symptoms would include:

Correct Answer: B

Rationale: Eye pain is a symptom of hemorrhage, and itching is associated with infection. The other options include symptoms not typically related to eye infection or hemorrhage.

Question 4 of 5

The nurse is caring for a client with a history of ankylosing spondylitis. The nurse should expect the client to have:

Correct Answer: A

Rationale: Ankylosing spondylitis causes chronic inflammation of the spine, leading to spinal stiffness, especially in the morning.

Question 5 of 5

A client with a history of rheumatoid arthritis is admitted with complaints of joint swelling. The nurse should give priority to:

Correct Answer: A

Rationale: Anti-inflammatories reduce joint swelling and pain in rheumatoid arthritis, improving function.

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