Exam Guide
The Medication Chewed Immediately During a Heart Attack
Cardiac · Question from the ATI RN Medical-Surgical 2023 Proctored Exam study set
Correct answer: B. Aspirin
Why this is the answer
Chewing aspirin (162–325 mg) gets it absorbed faster than swallowing it whole, and its antiplatelet effect can limit how much the clot grows during an evolving MI. Nitroglycerin (A) helps relieve chest pain through vasodilation, but it's given sublingually, not chewed, and doesn't stop platelet aggregation the way aspirin does. Morphine (C) manages pain but is not chewed and doesn't slow clot progression. Metoprolol (D), a beta-blocker, is part of later MI management to reduce cardiac workload, but it isn't the immediate chewed medication.
The bigger concept
The MONA/MONA-B mnemonic (Morphine, Oxygen, Nitroglycerin, Aspirin, ± Beta-blocker) is the classic framework for initial MI management, but aspirin's chewed, immediate antiplatelet action is specifically what limits clot growth in the first critical minutes — which is why it's singled out this way on exams.
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