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....

[alva78]

In this case, the best thing you can do since the patient is presenting what seems to be an MI coming on, is morphine. I had been confused on this too, but what's happening when you give morphine is that is decreases the preload and afterload of the heart (which like mentioned above, decreases the workload of the heart, decreasing oxygen demands).

[Bob Loblaw]

I also do some EMS work and some protocols have changed such as O2, where it used to be administered for just about everything as in apply O2 and diesel fuel- now O2SAT levels determine administration. If pt has good O2 levels what will giving O2 accomplish, it can possibly be harmful with toxicity.

Its like backboarding- big changes, you wont be seeing near the amount of boarding as you used to as the ambulance stretcher provides immobilization.