When I was reviewing, I chose number 2 as my answer and I am super confident at that moment with smile and swag haha. But to my big surprise,it turned out that the NCLEX answer was number 4. (whhhaaaaattt???).yeah it is haha, And as far as I can remember, eliminating 1 and 3 first which leave you number 2 and 4 which are the most concern. But comparing the two choices,the rationale that I've read stated that 4 should be the answer since the goal is to eliminate MI chest pain. Presence of pain even in the lowest rate can still compromise oxygen perfusion since this pain indicates that there's still Infarction going on. And I have read in La Charity sthat there are only two kinds of pain that can/might overpower are famous A-B-C sequence.
First, the M.I. pain
Second,the pain from compartment syndrome that needs emergency fasciotomy
Hope these helped you even a little (lol), I'm just sharing what I read and my ideas,but you'll still have the last say or just research it on your own when you have time so that you will be sure cause you might get confused of different answers shared by members including me.hehe. It is really good to find it on your own so that when exam comes,you will have your OWN FIRM ANSWER to attack the question =)
Godbless and Mahalo from Hawaii =)