A 45-Year-Old Man Is Alert and Oriented, Complaining of Chest

question 41

Multiple Choice

A 45-year-old man is alert and oriented, complaining of chest pain. He describes a two-day history of worsening pain, described as a burning sensation below his left breast that radiates across his chest. He states that the pain seems to get better right after eating, but then worsens again. Medical history includes myocardial infarction, hypertension, and type 2 diabetes. His medications include Inderal, Vasotech, Glucotrol, and Lopid. Physical examination reveals cool, dry skin; clear lungs; and no JVD or peripheral edema. HR = 102, BP = 132/86, RR = 12, SaO₂ = 98%. The patient is on oxygen by nasal cannula at 4 liters per minute. Which of the following should be done next?

• A) Give 81 mg aspirin by mouth.
• B) Start precautionary IV of normal saline and transport.
• C) Give 0.4 mg nitroglycerin sublingually.
• D) Do a 12-lead ECG.

---

Definitions:

Newborns

Infants in their first few weeks of life, characterized by rapid development and adjustment to the external world outside the womb.

General Anesthesia

Elimination of pain by putting a person to sleep.

Uterine Contractions

Rhythmic muscle contractions of the uterus, occurring naturally during menstrual cycles and more prominently during labor, facilitating childbirth.

Neonate

An infant from birth through the first four weeks of life.