NCLEX-RN Case Study: Acute Myocardial
Infarction (AMI)
Client Scenario:
A 55-year-old male arrives at the Emergency Department (ED) via EMS. He reports
"crushing" substernal chest pain (9/10) that started 45 minutes ago while mowing the lawn.
He states the pain radiates to his left jaw and he feels "like an elephant is sitting on my
chest."
Initial Assessment:
General: Diaphoretic, pale, and appearing anxious.
Respiratory: RR 24, slightly labored; SpO2 91% on room air.
Cardiovascular: BP 102/68, HR 110 (sinus tachycardia on monitor).
History: Hypertension, Hyperlipidemia, and 20-year smoking history.
Item 1: Recognizing Cues (Highlighting)
Question: Click to highlight the findings that are most indicative of acute cardiac ischemia.
Findings: 55-year-old male; crushing substernal chest pain; radiates to his left jaw;
diaphoretic; SpO2 91%; BP 102/68; HR 110.
Rationale: Crushing chest pain radiating to the jaw is the hallmark of MI. Diaphoresis
(sweating) indicates sympathetic nervous system activation due to low cardiac output or
severe pain. Tachycardia and hypoxia are compensatory responses to failing myocardial
perfusion.
Item 2: Analyzing Cues (Select All That Apply)