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A patient presents to the emergency department (ED) complaining of nausea, vomiting, and the “worst headache he has ever experienced.”. While examining the patient, the nurse notes left leg and arm weakness.The patient is immediately sent to the radiology department for a CT scan. The registered nurse (RN) identifies the immediate need for treatment because:

 

A.

A hemorrhagic brain attack is more common than an ischemic brain attack.

B.

A thrombolytic drug will cause the peripheral and central reflexes to become hyper-reactive.

C.

A hemorrhagic brain attack requires immediate intervention to prevent further damage.

D.

An ischemic brain attack is less severe than a hemorrhagic brain attack.

Answer and Explanation

The Correct Answer is C

Choice A rationale

 

A hemorrhagic brain attack (stroke) is less common than an ischemic brain attack. Ischemic strokes account for the majority of strokes.

 

Choice B rationale

 

Thrombolytic drugs are used to treat ischemic strokes, not hemorrhagic strokes. They do not cause hyper-reactive reflexes.

 

Choice C rationale

 

A hemorrhagic brain attack requires immediate intervention to prevent further damage. Hemorrhagic strokes involve bleeding in the brain, which can rapidly worsen and cause severe damage.

 

Choice D rationale

 

An ischemic brain attack is not necessarily less severe than a hemorrhagic brain attack. Both types of strokes are serious, but hemorrhagic strokes often require more urgent intervention due to the risk of ongoing bleeding.


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Correct Answer is C

Explanation

Choice A rationale

Hyperkalemia can cause weakness and fatigue, but it is not directly related to acute coronary syndrome (ACS). ACS is primarily associated with chest pain and other cardiac symptoms.

Choice B rationale

Experiencing chest pain when climbing a flight of stairs may indicate stable angina, which is a form of chronic coronary artery disease. However, it does not meet the criteria for ACS, which involves more severe and persistent symptoms.

Choice C rationale

Persistent and severe chest pain when at rest is a hallmark symptom of acute coronary syndrome (ACS). This condition requires immediate medical attention as it can lead to myocardial infarction (heart attack) or other serious complications.

Choice D rationale

Paroxysmal nocturnal dyspnea (PND) is a symptom of heart failure, not acute coronary syndrome (ACS). While heart failure can coexist with ACS, PND alone does not indicate ACS4.

Correct Answer is A

Explanation

Choice A rationale

Decreasing coronary artery constriction by giving aspirin is a primary objective in managing unstable angina. Aspirin inhibits platelet aggregation, reducing the risk of clot formation and improving blood flow in the coronary arteries. This helps to alleviate chest pain and prevent myocardial infarction.

Choice B rationale

Increasing afterload for the left ventricle to maximize cardiac output is not a desirable objective in managing unstable angina. Increasing afterload would increase the workload on the heart, which is counterproductive in patients with angina. The goal is to reduce the heart’s workload and improve blood flow.

Choice C rationale

Increasing preload to reduce overall cardiac workload is not a primary objective in managing unstable angina. Increasing preload would increase the volume of blood returning to the heart, potentially worsening symptoms. The focus is on reducing myocardial oxygen demand and improving coronary perfusion.

Choice D rationale

Reducing arterial inflammation by administering statins is a long-term strategy for managing cardiovascular disease, but it is not the immediate objective in managing unstable angina. Statins help to lower cholesterol levels and reduce inflammation, but the immediate goal in unstable angina is to relieve chest pain and prevent myocardial infarction.

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