1. A 65-year-old man with a history of hypertension,

diabetes, and chronic kidney disease presents to the

emergency department with chest pain, dyspnea, and

diaphoresis. He is diagnosed with an acute myocardial

infarction and is given aspirin, nitroglycerin, morphine, and

oxygen. He is also started on a heparin infusion and is

scheduled for a cardiac catheterization. What are the

nursing priorities for this patient? How would you monitor

his response to the treatment?

Answer: The nursing priorities for this patient are to

maintain his airway, breathing, and circulation; relieve his

pain and anxiety; prevent complications such as

arrhythmias, heart failure, or cardiogenic shock; and

prepare him for the cardiac catheterization. The nurse

would monitor his vital signs, cardiac rhythm, oxygen

saturation, pain level, urine output, and laboratory values

such as troponin, creatinine kinase, blood glucose,

electrolytes, and coagulation studies. The nurse would also

assess his chest pain characteristics, location, radiation,

severity, duration, and precipitating factors; administer

medications as ordered; provide emotional support; and

educate him about the procedure and post-procedure care.

Rationale: This question tests the student's ability to apply

the nursing process to a patient with an acute myocardial

infarction, which is a common and life-threatening

condition in older adults. The student should be able to