Question 1

Which statement made by a patient with coronary artery disease after the nurse has completed teaching about therapeutic lifestyle changes (TLC)diet indicates that further teaching is needed?

Accepted Answer

A)   "I will switch from whole milk to 1% milk."
B)   "I like salmon and I will plan to eat it more often."
C)   "I can have a glass of wine with dinner if I want one."
D)   "I will miss being able to eat peanut butter sandwiches." D

Question 2

A patient who is recovering from an acute myocardial infarction (AMI)asks the nurse about when sexual intercourse can be resumed.Which response by the nurse is best?

Accepted Answer

A)   "Most patients are able to enjoy intercourse without any complications."
B)   "Sexual activity uses about as much energy as climbing two flights of stairs."
C)   "The doctor will provide sexual guidelines when your heart is strong enough."
D)   "Holding and cuddling are good ways to maintain intimacy after a heart attack." B

Question 3

Which nursing intervention will be most effective when assisting the patient with coronary artery disease (CAD)to make appropriate dietary changes?

Accepted Answer

A)   Give the patient a list of low-sodium, low-cholesterol foods that should be included in the diet.
B)   Emphasize the increased risk for heart problems unless the patient makes the dietary changes.
C)   Help the patient modify favorite high-fat recipes by using monosaturated oils when possible.
D)   Inform the patient that a diet containing no saturated fat and minimal salt will be necessary. C

Question 4

During the administration of the thrombolytic agent to a patient with an acute myocardial infarction (AMI),the nurse should stop the drug infusion if the patient experiences

Accepted Answer

A)   bleeding from the gums.
B)   increase in blood pressure.
C)   a decrease in level of consciousness.
D)   a nonsustained episode of ventricular tachycardia.

Question 5

A patient had a non-ST-segment-elevation myocardial infarction (NSTEMI)3 days ago.Which nursing intervention included in the plan of care is most appropriate for the registered nurse (RN)to delegate to an experienced licensed practical/vocational nurse (LPN/LVN)?

Accepted Answer

A)   Evaluation of the patient's response to walking in the hallway
B)   Completion of the referral form for a home health nurse follow-up
C)   Education of the patient about the pathophysiology of heart disease
D)   Reinforcement of teaching about the purpose of prescribed medications

Question 6

A patient with hyperlipidemia has a new order for colesevelam (Welchol).Which nursing action is most appropriate when giving the medication?

Accepted Answer

A)   Have the patient take this medication with an aspirin.
B)   Administer the medication at the patient's usual bedtime.
C)   Have the patient take the colesevelam with a sip of water.
D)   Give the patient's other medications 2 hours after the colesevelam.

Question 7

After the nurse teaches the patient about the use of carvedilol (Coreg)in preventing anginal episodes,which statement by a patient indicates that the teaching has been effective?

Accepted Answer

A)   "Carvedilol will help my heart muscle work harder."
B)   "It is important not to suddenly stop taking the carvedilol."
C)   "I can expect to feel short of breath when taking carvedilol."
D)   "Carvedilol will increase the blood flow to my heart muscle."

Question 8

When caring for a patient who has just arrived on the medical-surgical unit after having cardiac catheterization,which nursing intervention should the nurse delegate to a licensed practical/vocational nurse (LPN/LVN)?

Accepted Answer

A)   Give the scheduled aspirin and lipid-lowering medication.
B)   Perform the initial assessment of the catheter insertion site.
C)   Teach the patient about the usual postprocedure plan of care.
D)   Titrate the heparin infusion according to the agency protocol.

Question 9

To improve the physical activity level for a mildly obese 71-year-old patient,which action should the nurse plan to take?

Accepted Answer

A)   Stress that weight loss is a major benefit of increased exercise.
B)   Determine what kind of physical activities the patient usually enjoys.
C)   Tell the patient that older adults should exercise for no more than 20 minutes at a time.
D)   Teach the patient to include a short warm-up period at the beginning of physical activity.

Question 10

A patient is recovering from a myocardial infarction (MI)and develops chest pain on day 3 that increases when taking a deep breath and is relieved by leaning forward.Which action should the nurse take next?

Accepted Answer

A)   Assess the feet for pedal edema.
B)   Palpate the radial pulses bilaterally.
C)   Auscultate for a pericardial friction rub.
D)   Check the heart monitor for dysrhythmias.

Question 11

Nadolol (Corgard)is prescribed for a patient with chronic stable angina and left ventricular dysfunction.To determine whether the drug is effective,the nurse will monitor for

Accepted Answer

A)   decreased blood pressure and heart rate.
B)   fewer complaints of having cold hands and feet.
C)   improvement in the strength of the distal pulses.
D)   the ability to do daily activities without chest pain.

Question 12

Which information about a patient who has been receiving thrombolytic therapy for an acute myocardial infarction (AMI)is most important for the nurse to communicate to the health care provider?

Accepted Answer

A)   No change in the patient's chest pain
B)   An increase in troponin levels from baseline
C)   A large bruise at the patient's IV insertion site
D)   A decrease in ST-segment elevation on the electrocardiogram

Question 13

Which assessment data collected by the nurse who is admitting a patient with chest pain suggest that the pain is caused by an acute myocardial infarction (AMI)?

Accepted Answer

A)   The pain increases with deep breathing.
B)   The pain has lasted longer than 30 minutes.
C)   The pain is relieved after the patient takes nitroglycerin.
D)   The pain is reproducible when the patient raises the arms.

Question 14

When developing a teaching plan for a 61-year-old man with the following risk factors for coronary artery disease (CAD),the nurse should focus on the

Accepted Answer

A)   family history of coronary artery disease.
B)   increased risk associated with the patient's gender.
C)   increased risk of cardiovascular disease as people age.
D)   elevation of the patient's low-density lipoprotein (LDL)  level.

Question 15

When admitting a patient with a non-ST-segment-elevation myocardial infarction (NSTEMI)to the intensive care unit,which action should the nurse perform first?

Accepted Answer

A)   Obtain the blood pressure.
B)   Attach the cardiac monitor.
C)   Assess the peripheral pulses.
D)   Auscultate the breath sounds.

Question 16

Which assessment finding by the nurse caring for a patient who has had coronary artery bypass grafting using a right radial artery graft is most important to communicate to the health care provider?

Accepted Answer

A)   Complaints of incisional chest pain
B)   Pallor and weakness of the right hand
C)   Fine crackles heard at both lung bases
D)   Redness on both sides of the sternal incision

Question 17

When titrating IV nitroglycerin (Tridil)for a patient with a myocardial infarction (MI),which action will the nurse take to evaluate the effectiveness of the medication?

Accepted Answer

A)   Monitor heart rate.
B)   Ask about chest pain.
C)   Check blood pressure.
D)   Observe for dysrhythmias.

Question 18

Which patient at the cardiovascular clinic requires the most immediate action by the nurse?

Accepted Answer

A)   Patient with type 2 diabetes whose current blood glucose level is 145 mg/dL
B)   Patient with stable angina whose chest pain has recently increased in frequency
C)   Patient with familial hypercholesterolemia and a total cholesterol of 465 mg/dL
D)   Patient with chronic hypertension whose blood pressure today is 172/98 mm Hg

Question 19

Which information given by a patient admitted with chronic stable angina will help the nurse confirm this diagnosis?

Accepted Answer

A)   The patient states that the pain "wakes me up at night."
B)   The patient rates the pain at a level 3 to 5 (0 to 10 scale) .
C)   The patient states that the pain has increased in frequency over the last week.
D)   The patient states that the pain "goes away" with one sublingual nitroglycerin tablet.

Question 20

After reviewing a patient's history,vital signs,physical assessment,and laboratory data,which information shown in the accompanying figure is most important for the nurse to communicate to the health care provider?

Accepted Answer

A)   Q waves on ECG
B)   Elevated troponin levels
C)   Fever and hyperglycemia
D)   Tachypnea and crackles in lungs

Exam 34: Nursing Management: Coronary Artery Disease and Acute Coronary Syndrome

Which statement made by a patient with coronary artery disease after the nurse has completed teaching about therapeutic lifestyle changes (TLC) diet indicates that further teaching is needed?

A patient who is recovering from an acute myocardial infarction (AMI) asks the nurse about when sexual intercourse can be resumed.Which response by the nurse is best?

Which nursing intervention will be most effective when assisting the patient with coronary artery disease (CAD) to make appropriate dietary changes?

During the administration of the thrombolytic agent to a patient with an acute myocardial infarction (AMI) ,the nurse should stop the drug infusion if the patient experiences

A patient had a non-ST-segment-elevation myocardial infarction (NSTEMI) 3 days ago.Which nursing intervention included in the plan of care is most appropriate for the registered nurse (RN) to delegate to an experienced licensed practical/vocational nurse (LPN/LVN) ?

A patient with hyperlipidemia has a new order for colesevelam (Welchol) .Which nursing action is most appropriate when giving the medication?

After the nurse teaches the patient about the use of carvedilol (Coreg) in preventing anginal episodes,which statement by a patient indicates that the teaching has been effective?

When caring for a patient who has just arrived on the medical-surgical unit after having cardiac catheterization,which nursing intervention should the nurse delegate to a licensed practical/vocational nurse (LPN/LVN) ?

To improve the physical activity level for a mildly obese 71-year-old patient,which action should the nurse plan to take?

A patient is recovering from a myocardial infarction (MI) and develops chest pain on day 3 that increases when taking a deep breath and is relieved by leaning forward.Which action should the nurse take next?

Nadolol (Corgard) is prescribed for a patient with chronic stable angina and left ventricular dysfunction.To determine whether the drug is effective,the nurse will monitor for

Which information about a patient who has been receiving thrombolytic therapy for an acute myocardial infarction (AMI) is most important for the nurse to communicate to the health care provider?

Which assessment data collected by the nurse who is admitting a patient with chest pain suggest that the pain is caused by an acute myocardial infarction (AMI) ?

When developing a teaching plan for a 61-year-old man with the following risk factors for coronary artery disease (CAD) ,the nurse should focus on the

When admitting a patient with a non-ST-segment-elevation myocardial infarction (NSTEMI) to the intensive care unit,which action should the nurse perform first?

Which assessment finding by the nurse caring for a patient who has had coronary artery bypass grafting using a right radial artery graft is most important to communicate to the health care provider?

When titrating IV nitroglycerin (Tridil) for a patient with a myocardial infarction (MI) ,which action will the nurse take to evaluate the effectiveness of the medication?

Which patient at the cardiovascular clinic requires the most immediate action by the nurse?

Which information given by a patient admitted with chronic stable angina will help the nurse confirm this diagnosis?

After reviewing a patient's history,vital signs,physical assessment,and laboratory data,which information shown in the accompanying figure is most important for the nurse to communicate to the health care provider?