A patient with negative troponins and stress test results reports recurring chest pain that is similar to their pain on admission. According to the American Nurses Association's Cardiovascular Nursing: Scope and Standards of Practice, the cardiac-vascular nurse's next action is to:

Correct Answer: C

Rationale: In this scenario, the correct answer is C) obtain a 12-lead electrocardiogram. The rationale behind this choice is that even though the patient has negative troponins and stress test results, the recurrence of chest pain similar to their initial presentation raises concern for possible cardiac issues. A 12-lead ECG can provide immediate information on the patient's cardiac status, helping to identify any acute changes or abnormalities in the heart's electrical activity. Option A) to activate the cardiac catheterization team may be premature without further diagnostic information from the ECG. Option B) to administer analgesics should not be the initial response as it does not address the underlying cause of the chest pain. Option D) to promote relaxation and monitor the response is not appropriate in this case as it does not address the urgent need to assess the patient's cardiac status. In an educational context, understanding the importance of timely and appropriate diagnostic interventions in cardiovascular nursing is crucial for providing safe and effective patient care. Nurses need to be able to recognize concerning symptoms, prioritize interventions based on evidence-based practice, and collaborate with the healthcare team to ensure optimal patient outcomes.

Correct Answer: C

Rationale: The correct answer is C) Age 32, thickened coronary arterial walls with narrowed vessel lumen. In coronary artery disease (CAD), the fibrous stage is characterized by the formation of fibrous plaques within the arterial walls. At age 32, with thickened coronary arterial walls and narrowed vessel lumen, the patient is likely in the fibrous stage of CAD where the plaques have started to develop and cause narrowing of the vessels. Option A) Age 40, thrombus adhered to the coronary artery wall, indicates a more advanced stage of CAD with the presence of a thrombus, suggesting complications like plaque rupture and thrombosis which occur in the complicated stage, not the fibrous stage. Option B) Age 50, rapid onset of disease with hypercholesterolemia, suggests an accelerated progression of CAD due to uncontrolled hypercholesterolemia, typically seen in the progression from fatty streaks to atheroma formation, not the fibrous stage. Option D) Age 19, elevated low-density lipoprotein (LDL) cholesterol, lipid-filled smooth muscle cells, indicates early stages of atherosclerosis with lipid accumulation and smooth muscle cell proliferation, which is not specific to the fibrous stage of CAD. Understanding the different stages of CAD progression is crucial for healthcare providers to manage patients effectively and prevent complications. Identifying the characteristics of each stage helps in determining appropriate interventions and treatment strategies tailored to the patient's disease progression.

Correct Answer: A

Rationale: The correct answer is A) is relieved by nitroglycerin. This is a characteristic symptom of stable angina, which is chest pain resulting from reduced blood flow to the heart muscle due to narrowed coronary arteries. Nitroglycerin helps dilate blood vessels, improving blood flow to the heart and relieving angina symptoms. Option B) is a sensation of tightness or squeezing, which is a common description of angina pain but is not specific to differentiating between stable angina and myocardial infarction (MI). Option C) states that the pain does not radiate to the neck, back, or arms. While this can be a feature of stable angina, it is not a definitive indicator as pain radiation can vary among individuals. Option D) mentions that the pain is precipitated by physical or emotional exertion. This is also a characteristic feature of stable angina, as exertion increases the heart's demand for oxygen, leading to angina symptoms. Educationally, understanding the differences in symptoms between stable angina and MI is crucial for nurses to provide accurate and timely care. Recognizing that nitroglycerin relieves chest pain in stable angina can help guide treatment decisions and differentiate between these two serious cardiac conditions.

Correct Answer: B

Rationale: In this scenario, the correct answer is B) β-adrenergic blocker. When a patient with hypertension experiences a myocardial infarction (MI), it is crucial to decrease the workload on the heart to prevent further damage and improve outcomes. β-adrenergic blockers, also known as beta-blockers, are indicated in this situation because they reduce the heart rate and myocardial contractility, thus decreasing the workload on the heart and oxygen demand. Option A) ACE inhibitor is primarily used in hypertension to lower blood pressure by inhibiting the angiotensin-converting enzyme. While it is beneficial in managing hypertension, it does not directly reduce the workload on the heart after an MI. Option C) Calcium channel blockers are used in various cardiovascular conditions, including hypertension, but they do not specifically target reducing the workload on the heart after an MI. Option D) Angiotensin II receptor blockers (ARBs) are also commonly used in hypertension management but may not directly reduce the workload on the heart post-MI. Educationally, understanding the rationale behind selecting the appropriate medication post-MI in a patient with hypertension is crucial for nursing and medical students. This knowledge helps in making informed decisions based on the pathophysiology and pharmacological actions of different drug classes. It also highlights the importance of individualized patient care and the impact of medication choices on clinical outcomes.

Correct Answer: D

Rationale: The correct answer is D) All of the above. Oxygen delivery systems are crucial in providing supplemental oxygen to patients with respiratory issues. Nasal cannula (option A) is a common method that delivers low to medium concentrations of oxygen. It is comfortable and allows the patient to eat, drink, and talk while receiving oxygen. Face mask (option B) is used to deliver higher concentrations of oxygen to patients who require more oxygen supplementation. It covers the nose and mouth, ensuring a higher amount of oxygen is delivered. Ventilator (option C) is a mechanical device that helps with breathing by delivering breaths to the patient. It is used in cases where a patient is unable to breathe adequately on their own. The correct answer includes all these methods because each plays a specific role in oxygen delivery based on the patient's needs. Understanding the different methods is crucial for healthcare providers to effectively administer oxygen therapy and support patients with respiratory issues.