A nurse in the emergency department is assessing a client who has a history of angina and reports chest pain. Which of the following findings is the priority?

A. Three doses of nitroglycerin relieve the client's pain is incorrect as the priority because relief of pain suggests that the angina may be controlled, indicating a lower immediate risk. B. Pain radiates to the client's left arm is correct. Radiation of chest pain to the left arm (or jaw, neck, or back) is a classic sign of myocardial ischemia or myocardial infarction. This finding indicates that the client may be experiencing a more serious cardiac event, making it the highest priority. Immediate assessment and intervention are needed to prevent complications. C. Pain is greatest in the client's substernal chest area is important but not the priority. Substernal pain is typical of angina, but the addition of radiating pain indicates potential progression to acute coronary syndrome. D. Pain began in the morning while the client was resting is also important clinically, as resting angina can indicate unstable angina, but the presence of radiation is more immediately concerning for myocardial injury and takes priority in triage and intervention.