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NCLEX Practice: Chest Pain Priority Question?

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NCLEX Practice Question

A 45-year-old patient with a history of hypertension and type 2 diabetes mellitus presents to the emergency department with complaints of severe chest pain that radiates to the left arm and jaw. The patient appears diaphoretic and anxious.

Vital signs include a blood pressure of 180/100 mm Hg, heart rate of 110 beats per minute, respiratory rate of 24 breaths per minute, and oxygen saturation of 94% on room air. An ECG shows ST-segment elevation in leads II, III, and aVF. The nurse should prioritize which of the following interventions?

A) Administering an analgesic for pain relief

B) Initiating fibrinolytic therapy

C) Obtaining a complete blood count (CBC)

D) Administering sublingual nitroglycerin

Please choose the best answer option, and we will provide an explanation in the comments box below!!

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Dec 05, 2023

correct answer is B) Initiating fibrinolytic therapy. Explanation: This patient is presenting with signs and symptoms suggestive of an acute myocardial infarction (MI) or heart attack. Several key findings in the scenario indicate the need for immediate action:

  1. Severe chest pain radiating to the left arm and jaw is a classic symptom of myocardial infarction.

  2. The ECG shows ST-segment elevation in leads II, III, and aVF, which is indicative of an ST-elevation myocardial infarction (STEMI). This finding suggests that there is active myocardial ischemia and damage occurring.

  3. Elevated blood pressure (180/100 mm Hg) and tachycardia (heart rate of 110 beats per minute) indicate increased cardiac workload and the need for immediate intervention.

In the context of a STEMI, the priority is…

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