American Association of Critical-Care Nurses (AACN) Certification Practice Test

What type of treatment is generally avoided in NSTEMI?

1. Immediate PCI

2. Administration of aspirin

3. Nitrate therapy

4. Long-term beta blocker therapy

The correct answer is: Immediate PCI

In the context of Non-ST-Elevation Myocardial Infarction (NSTEMI), the approach to treatment emphasizes the stabilization of the patient and risk-stratification rather than the immediate intervention often associated with other types of acute coronary syndromes. Percutaneous Coronary Intervention (PCI) is typically a key treatment for patients with ST-elevation myocardial infarction (STEMI), where rapid revascularization is critical. However, in NSTEMI, immediate PCI is generally not the first line of action for all patients. Instead, the management of NSTEMI often includes medical therapy with antiplatelet agents, anticoagulants, nitrates, beta-blockers, and statins while assessing the patient's overall risk. If a patient is stable or presents as having a lower risk, they may be managed conservatively with medications before determining if PCI is warranted at a later time, which may limit unnecessary procedures that carry potential risks. Immediate PCI is reserved for those who show significant signs of instability or ongoing ischemic symptoms. By understanding this rationale, one can appreciate the careful decision-making process in the management of NSTEMI patients, ensuring that interventions are both timely and appropriate based on individual patient needs.