How to Answer Question Scenario Chester Questions (Complete Guide)

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This topic involves question scenario chester. A strong answer should include explanation, application, and examples.

Original Question

Question 1 Scenario: Chester is a 63 year old man of African descent who is an accountant. He arrives to the emergency department for evaluation of chest pain that was a sudden onset while getting out of his vehicle. It was associated with dizziness and difficulty breathing. Chester tells you that he knows what it is as his father died of a heart attack when he was 59 years of age and now it’s my turn. What is the first diagnostic test that you will perform? 1. Cardiac stress test 2. ECG 3. Echocardiogram 4. Troponin Q.2. His wife takes you aside and tells you that he had been treated for hypertension, high cholesterol levels, and diet controlled diabetes but that he has refused medication for the past year. He eats what he wants and does not get much exercise during the school year. According to his wife, Helen he is 23 kg overweight. She also tells you the he quit smoking couple of months ago. Based on the information about Chester that has been provided above, and the previous question identify six potential cardiac risk factors. (0.5 each -3 marks) Question.3. When obtaining your subjective assessment for pain, you will be using the PQRST mnemonic to gather as much data as possible. Identify at least one to two assessment data for each of the PQRST and what should the nurse consider? (10 marks) Question.4. When assessing pain in chest pain presentation for Chester, what are descriptor words of concern used for describing chest pain/discomfort? What would the differential diagnoses that you would be most concerned with? (4marks) Question.5.Upon your objective assessment you note the following: Heart rate = 104 Respiratory rate = 22 BP = 172/102 SPO2 = 95% on room air No visible pulsations, heaves, or lifts evident with the precordium Pain = 10/10 No cyanosis is observed, and an apical impulse is palpable at the 5th intercostal space His skin is cool and moist, and his clothes are damp from perspiration He feels nauseated but had not vomited Shortness of breath noted with tachypnea Describes the pain he experienced as intense Currently he is unable to find a position of comfort due to pain When you auscultate his chest you note that S1 and S2 are present. Describe the difference between the two sounds, and the best location to hear them. (2.5 marks each portion = 5 marks) Question.6.Select the differences in cardiac chest pain symptoms for women. Select all that apply. 1. stomach discomfort 2. chest pain described as pressure/squeezing 3. dizzy or lightheaded 4. unexplained fatigue, tiredness 5. SOB, N& V 6. nausea 7. chest pain described as “elephant on chest” 8. sleep difficulty Question.7. From the list below choose the diagnostic tests applicable to Chester’s condition. Select all that apply. 1. cardiac protein 2. ABG 3. liver function studies 4. cardiac enzyme 5. lipid studies 6. outpatient stress test Question.8. What are some ethnic considerations to keep in mind in Chester’s case? 1 mark Question 9 There are different cardiac tests that may be ordered for a cardiac patient. Match the diagnostic test to the description. 1.ECG 2.ABG 3.VBG 4.echocardiogram 5.stress test 6.CRP a. Primarily lacking in O2 & relatively high in carbon dioxide b. Assess cardiovascular capacity, heart rate, blood flow within the heart, severity of existing heart condition c. Used to detect heart disease, assess if heart problems cause of SOB, or chest pain and/or shows pumping strength, damage to heart muscle, heart size d. Blood marker of inflammation in arteries of heart e. Test that measures the electrical activity of the heartbeat f. Evaluate lung function & detect acid-base imbalance that could indicate respiratory, metabolic or kidney disorder Question 10 Chester is exhibiting shortness of breath with some crackles in the lower bases. What additional blood test would be ordered for Chester to differentiate between a non-cardiac cause and cardiac cause such as ventricular dysfunction? 1MARK Question.11. As a nurse completing the cardiovascular assessment, it is important to obtain data that helps to differentiate between ACS and aortic dissection. This will guide the nurse with the care plan, the frequency of monitoring, when to become concerned and notify the physician. Match the data to ACS and aortic dissection(10marks) 1. ACS 2.ACS 3.ACS 4.ACS 5.AAA 6.AAA 7.AAA 8.AAA 9.ACS 10.AAA A. May have pallor, diaphoresis, possible cyanosis or mottling coloring B. may have pallor, diaphoresis or peripheral cyanosis C. Hypertension is a major predisposing factor D. Region of pain that is substernal and can radiate to the neck, throat, jaw, and face, interscapular back, abdomen E. resulting from a continuum of cardiac ischemic processes F. sudden, excruciating, severe pain G. Region of pain in the chest, substernal area, epigastrium, neck, jaw, or ulnar aspect of the left arm or elbow H. will have ECG changes I. Tachycardia or bradycardia, hypotension or hypertension, bilateral arm BP may have slight variation, tachypnea J. may have significant right and left arm BP variation, may have tachycardia, dimished peripheral pulses

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