studying for nclex, confused on question:

[IHeartPeds87]

Hi there, I am studying for the nclex and don't understand this question:

The client is admitted to the ER reporting crushing chest pain, shortness of breath, and left arm pain. Which action, if taken by the nurse is Best?

1. administer oxygen

2. place in a semi-Fowler's position

3. Administer morphine sulfate

4. Administer lidocaine

why isn't the answer 1, administer oxygen? The question answer is 3, administer morphine sulfate.

I don't understand the wording of the question....when questions ask "which action is best" what does that mean? Are they asking what would you do first? Or if you could only do one thing what would it be? I don't understand...

Thanks for any/all insight....

[fvelasquez71]

In this question you can do only one thing

This patient is presenting symptoms of a MI

Pain is caused for deprivation of oxygen to the heart

Morphine will decrease oxygen demands

[JoseQuinones]

The morphine calms the patient and lowers their need for oxygen. Giving supplemental oxygen isn't much use if they are in panic and thrashing about - or if their heart can't take the strain and they go into cardiac arrest.

[Alisonisayoshi, LVN]

Because MONA. MONA is the order of administration as far as I understand it (I'm NCLEX studying too). So Morphine is the most correct as M is the first letter. Morphine will decrease oxygen demand.

[TheCommuter, BSN, RN]

Due to the fact that the content of this thread pertains directly to NCLEX, it has been moved to the NCLEX Discussion forum. We wish you the best of luck!

[springchick1, ADN, RN]

Some school are now teaching ONAM but we were taught MONA. Is the study book you are using the most recent edition?

[NICUmiiki, DNP, NP]

I was taught MONA in school also. Then, I was told the NCLEX would want OANM (per Hurst - They specifically mentioned the change from MONA to OANM), so I would have picked oxygen.

*caution - real life* Oxygen and nitro are the first things given in my ER. Oxygen is easy and readily available. EMS pts come in with nitro paste already.

[PghRN15]

I was also taught Mona.

[JaaaeyRN]

This question the patient presents with Chest pain that radiates to the arm. It's a hallmark sign of MI. The treatment would be MONA. If you give oxygen first and the heart still can't pump effectively. Your patient won't be able to utilize that oxygen. So in this case, you will treat the heart with morphine. Because morphine will decrease oxygen consumption and improve cardiac output.

[IHeartPeds87]

Thanks everyone! Here's the thing though...if the original question asked what would you do first or what is the priority would the answer then have been oxygen?

[Alisonisayoshi, LVN]

Thanks everyone! Here's the thing though...if the original question asked what would you do first or what is the priority would the answer then have been oxygen?

Idk? Hmmmm, if it's OANM then first action is O2. I had the same question on my virtual ATI as the OP, and that's supposed to be super recent to NCLEX, and the answer was Morphine. I'm going to ask my virtual tutor lol.

[Dressagern]

Look at the wording…if the question was asking for first then the answer would be oxygen. if the question was asking for best (means you can only due one thing what would be most beneficial)..answer is then morphine! :)