Dan G., a 65-year-old man, presents to your primary care office for the evaluation of chest pain and left-sided shoulder pain. Pain begins after strenuous activity, including walking
Pain is characterized as dull, aching; 8/10 during activity, otherwise 0/10. Began a few months ago, intermittent, aggravated by exercise, and relieved by rest. Has occasional nausea. Pain is retrosternal, radiating to left shoulder, definitely affects quality of life by limiting activity. Pain is worse today; did not go away after he stopped walking. BP 120/80. Pulse 72 and regular. Normal heart sounds, S1 and S2, no murmurs. Which of the following differential diagnoses would be most likely?
A. Musculoskeletal chest wall syndrome with radiation
B. Esophageal motor disorder with radiation
C. Acute cholecystitis with cholelithiasis
D. Coronary artery disease with angina pectoris
D
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A patient in a critical care unit has increased stress from the constant noise and light levels. What nursing intervention best attenuates these sources of stress?
A) Need for constant observation and evaluation B) Dimming lights during the night C) Frequent nursing group rounds for all patients D) Use of tile floors for ease in cleaning
What are the four structural heart anomalies that make up the tetralogy of Fallot? (Select the four that apply.)
a. Hypertrophied right ventricle b. Patent ductus arteriosus c. Ventral septal defect d. Narrowing of pulmonary artery e. Dextroposition of aorta
The nurse educator is preparing an in-service on pain management for the staff. One of the staff nurses asks, "What is the most important part of a pain assessment?" Which response by the nurse educator is the most appropriate?
1. "Pain is only partially subjective and primarily a physiologic experience, so vital signs are the most important assessment." 2. "A client's response to pain is always based on the underlying cause, so the client's admitting diagnosis is important." 3. "Vital signs are not reliable indicators of acute pain, because only some clients are able to elicit a change in blood pressure or pulse rate." 4. "The response to pain is unique and based on numerous factors, which need to be assessed."
An 80-year-old diabetic is to be tested with the fructosamine assay instead of the glycosylated hemoglobin (HbA1c) test because the fructosamine assay:
a. can evaluate level of ketoacidosis. b. is less influenced by age. c. determines the amount of circulating glu-cose. d. is more accurate for type 2 diabetes.