Progressive Care Nursing Certification (PCCN) Practice Exam

What condition should a nurse suspect in a patient experiencing chest pain and shortness of breath three days after a STEMI?

1. Pneumothorax

2. Aortic dissection

3. Pulmonary embolism

4. Pericarditis

The correct answer is: Pulmonary embolism

In evaluating a patient who presents with chest pain and shortness of breath three days after experiencing a STEMI (ST-Elevation Myocardial Infarction), pericarditis is the condition that should be suspected. Pericarditis is an inflammation of the pericardial sac surrounding the heart, and it can occur as a complication of myocardial infarction. This condition often manifests with sharp, pleuritic chest pain that may improve when sitting upright and worsen when lying down. Additionally, patients may also exhibit signs of pericardial friction rub upon auscultation, indicative of the inflammatory process affecting the pericardium. While pulmonary embolism is also a possible condition in a patient post-STEMI, the timing of days after the event, alongside its characteristic symptoms such as sudden onset of dyspnea, pleuritic chest pain, and hemoptysis, makes pericarditis more likely. Pneumothorax and aortic dissection can present with similar symptoms but are generally more acute and associated with distinct clinical findings that help in differentiating them from pericarditis. Understanding the typical timeframe and presentation of post-MI complications allows for a more accurate assessment, emphasizing the importance of recognizing