Practice Question
A nurse is assisting in the plan of care for a client who has a suspected myocardial infarction. Which of the following should the nurse plan to administer first?
Answer Choices:
Correct Answer:
Oxygen
Rationale:
🟦Oxygen is given first because myocardial infarction (MI) is an issue of decreased oxygen supply to heart muscle, and the priority is to improve tissue oxygenation.
🟦In emergency care, the nurse follows ABCs (Airway, Breathing, Circulation), so supporting breathing and oxygenation comes before pain relief or other drugs.
🟦Providing supplemental oxygen increases the amount of oxygen available to ischemic myocardium, helping limit the size of the infarct.
🟦Oxygen can also help relieve associated symptoms like shortness of breath and restlessness, which may be early signs of hypoxia.
🟦 While other medications are also important in MI, oxygen is the immediate priority intervention to protect vital organs from hypoxic damage.
Nitroglycerin:
🟦 Nitroglycerin helps by causing coronary vasodilation, improving blood flow to the heart muscle and reducing myocardial oxygen demand.
🟦 It is typically administered after initial assessment and once blood pressure is confirmed adequate, because nitroglycerin can cause hypotension.
🟦 Although nitroglycerin is part of MI treatment, it is not the first priority ahead of supporting oxygenation. 🟦 Giving nitroglycerin before oxygen could delay correction of underlying hypoxia, which is more immediately life-threatening.
🟦 Therefore, while very important, nitroglycerin is a subsequent step after oxygen in the initial management sequence.
Aspirin:
🟦 Aspirin is given to inhibit platelet aggregation, helping prevent additional coronary artery thrombosis and limiting further occlusion.
🟦 It is crucial in MI care because it reduces the risk of clot growth and improves outcomes.
🟦 However, aspirin works on the clotting process over time, not immediately on oxygen supply.
🟦 Because the most immediate threat is inadequate oxygenation, aspirin is not the very first intervention. 🟦 It is still administered early but follows the initial stabilization of airway, breathing, and circulation.
Morphine:
🟦 Morphine is used to relieve severe chest pain, decrease anxiety, and reduce preload and afterload, which can lower myocardial oxygen demand.
🟦 Despite these benefits, morphine is not the first intervention because it does not directly address oxygenation and can cause respiratory depression.
🟦 Giving morphine before assessing and supporting oxygenation might mask worsening symptoms such as increased pain or shortness of breath.
🟦 Morphine is usually given after oxygen and nitrates when pain remains severe.
🟦 Thus, morphine is important in MI pain management but is not prioritized over oxygen in the first step.
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This question is from ☑️Custom NSGP 132 Fall 25 Exam 2 which contains 39 questions.
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Question Details
- Category: RN Nursing Exam(s)
- Subcategory: ATI Exam(s)
- Domain: RN ATI MedSurg
- Answer Choices: 4