Question 1

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. D

Question 2

After the nurse has finished teaching a patient about the use of sublingual nitroglycerin (Nitrostat),which patient statement indicates that the teaching has been effective?

Accepted Answer

A)   "I can expect some nausea as a side effect of nitroglycerin."
B)   "I should only take the nitroglycerin if I start to have chest pain."
C)   "I will call an ambulance if I still have pain after taking 3 nitroglycerin 5 minutes apart."
D)   "Nitroglycerin helps prevent a clot from forming and blocking blood flow to my heart." C

Question 3

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. B

Question 4

After reviewing information shown in the accompanying figure from the medical records of a 43-year-old,which risk factor modification for coronary artery disease should the nurse include in patient teaching?

Accepted Answer

A)   Importance of daily physical activity
B)   Effect of weight loss on blood pressure
C)   Dietary changes to improve lipid levels
D)   Ongoing cardiac risk associated with history of tobacco use

Question 5

A patient who has had chest pain for several hours is admitted with a diagnosis of rule out acute myocardial infarction (AMI).Which laboratory test should the nurse monitor to help determine whether the patient has had an AMI?

Accepted Answer

A)   Myoglobin
B)   Homocysteine
C)   C-reactive protein
D)   Cardiac-specific troponin

Question 6

A patient who is being admitted to the emergency department with intermittent chest pain gives the following list of medications to the nurse.Which medication has the most immediate implications for the patient's care?

Accepted Answer

A)   Sildenafil (Viagra) 
B)   Furosemide (Lasix) 
C)   Captopril (Capoten) 
D)   Warfarin (Coumadin)

Question 7

A patient who has recently started taking pravastatin (Pravachol)and niacin (Nicobid)reports the following symptoms to the nurse.Which is most important to communicate to the health care provider?

Accepted Answer

A)   Generalized muscle aches and pains
B)   Dizziness when changing positions quickly
C)   Nausea when taking the drugs before eating
D)   Flushing and pruritus after taking the medications

Question 8

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

Question 9

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 10

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.

Question 11

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 12

When caring for a patient with acute coronary syndrome who has returned to the coronary care unit after having angioplasty with stent placement,the nurse obtains the following assessment data.Which data indicate the need for immediate action by the nurse?

Accepted Answer

A)   Heart rate 102 beats/min
B)   Pedal pulses 1+ bilaterally
C)   Blood pressure 103/54 mm Hg
D)   Chest pain level 7 on a 0 to 10 point scale

Question 13

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 14

After receiving change-of-shift report about the following four patients,which patient should the nurse assess first?

Accepted Answer

A)   39-year-old with pericarditis who is complaining of sharp, stabbing chest pain
B)   56-year-old with variant angina who is to receive a dose of nifedipine (Procardia) 
C)   65-year-old who had a myocardial infarction (MI)  4 days ago and is anxious about the planned discharge
D)   59-year-old with unstable angina who has just returned to the unit after having a percutaneous coronary intervention (PCI)

Question 15

Following an acute myocardial infarction (AMI),a patient ambulates in the hospital hallway.When the nurse is evaluating the patient's response to the activity,which assessment data would indicate that the exercise level should be decreased?

Accepted Answer

A)   Blood pressure (BP)  changes from 118/60 to 126/68 mm Hg.
B)   Oxygen saturation drops from 99% to 95%.
C)   Heart rate increases from 66 to 92 beats/minute.
D)   Respiratory rate goes from 14 to 20 breaths/minute.

Question 16

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 17

A patient with diabetes mellitus and chronic stable angina has a new order for captopril (Capoten).The nurse should teach the patient that the primary purpose of captopril is to

Accepted Answer

A)   lower heart rate.
B)   control blood glucose levels.
C)   prevent changes in heart muscle.
D)   reduce the frequency of chest pain.

Question 18

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 19

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 20

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

Exam 30: Nursing Management: Coronary Artery Disease and Acute Coronary Syndrome

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

After the nurse has finished teaching a patient about the use of sublingual nitroglycerin (Nitrostat) ,which patient statement indicates that the teaching has been effective?

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?

After reviewing information shown in the accompanying figure from the medical records of a 43-year-old,which risk factor modification for coronary artery disease should the nurse include in patient teaching?

A patient who has had chest pain for several hours is admitted with a diagnosis of rule out acute myocardial infarction (AMI) .Which laboratory test should the nurse monitor to help determine whether the patient has had an AMI?

A patient who is being admitted to the emergency department with intermittent chest pain gives the following list of medications to the nurse.Which medication has the most immediate implications for the patient's care?

A patient who has recently started taking pravastatin (Pravachol) and niacin (Nicobid) reports the following symptoms to the nurse.Which is most important to communicate to the health care provider?

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?

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?

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

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 caring for a patient with acute coronary syndrome who has returned to the coronary care unit after having angioplasty with stent placement,the nurse obtains the following assessment data.Which data indicate the need for immediate action by the nurse?

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?

After receiving change-of-shift report about the following four patients,which patient should the nurse assess first?

Following an acute myocardial infarction (AMI) ,a patient ambulates in the hospital hallway.When the nurse is evaluating the patient's response to the activity,which assessment data would indicate that the exercise level should be decreased?

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) ?

A patient with diabetes mellitus and chronic stable angina has a new order for captopril (Capoten) .The nurse should teach the patient that the primary purpose of captopril is to

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 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?

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) ?