MONA or ONAM...for NCLEX?

Nursing Students NCLEX

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I have always been taught that it is oxygen first while in school, but every time I answer one of these questions on Kaplan it is always morphine. I am torn with how to answer this type of question on NCLEX. Any suggestions?

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Specializes in psych/dementia.

Are you talking specifically for MI? If so, think about the purpose of giving each. What is the purpose of oxygen in the case of an MI? Why do we give morphine for an MI? Which action is more important in the case of MI?

"Oxygen first, always" has that pesky word "always" in it, which probably means there are exceptions ;)

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Yes for MI. Thanks for your response I will ponder it a bit :)

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Are the kaplan questions you are doing from older editions of the book? The only other reason I would think you would get it wrong would be based on the actual wording of the options. If it said "always administer oxygen" or if the question was asking more specifically what medication would the nurse anticipate the MD to order etc. I would ensure you are reading the question slowly and thoroughly and not just seeing MI and thinking oxygen.

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It was in question trainer 7. That wasn't the wording it was a client comes in with severe chest pain radiating to the left arm what would you antcipate the nurse would do first? One answer was administer O2 and another answer was administer morphine. Morphine was the right answer.

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Morphine first. Know the effect of giving morphine to know the broad rationale about it. It dilates the coronary artery which improves blood flow to the myocardium, slows heart rate to decrease O2 demand workload and it may improve O2 delivery when you intervene giving O2 next. What's the use of giving O2 if the blood circulating in the artery is impeded. Always think like a nurse. Not a test taker. You know the rationale. Just dig deeper until you get the point of what the question is really asking. I hope this make sense.

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[quote=jujubee

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Yes that does! Thanks so much for you input, talking things out with others always helps me out!

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Don't put in your mind that O2 is always the first intervention. Sometimes they put that either to trick or blind you. The test is all about critical thinking. When you read questions, imagine the whole scenario and think that you are the actual nurse on that moment. And always ask why would I do this or what could make this thing help the patient? Good luck on your exam.

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Thanks so much for all your advice I will make sure to ask myself those questions. Take the test tomorrow and it's so nice to have a place to ask last minute advice. I have been studying all month and feel pretty confident but a bit anxious too.

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Give us an update after your test. That would help others. Mark 11:24. Read that verse tonight!

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Mild anxiety is actually conducive to successful studying...you get more focused under mild anxiety! Also, MONA is correct: Morphine to reduce oxygen needs of the myocardium, dilate vessels, and reduce pain/anxiety (all of which will improve oxygenation; Oxygen to provide essential needs for the myocardium and systemically; Nitroglycerin for vasodilation; Aspirin to thin blood for clot reduction. GOOD LUCK!

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