nurs 1400 test bank exam coronary artery diseaseand acute coronary syndrome questions with answers
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NURS 1400 TEST BANK EXAM-CORONARY ARTERY
DISEASEAND ACUTE CORONARY SYNDROME QUESTIONS
WITH ANSWERS
1. 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
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.
i. Because family history, gender, and age are nonmodifiable risk factors, the nurse should focus on
the patient’s LDL level. Decreases in LDL will help reduce the patient’s risk for developing CAD.
2. Which nursing intervention will be most effective when assisting the patient with coronary artery disease (CAD) to
make appropriate dietary changes?
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.
i. Lifestyle changes are more likely to be successful when consideration is given to the patient’s values
and preferences. The highest percentage of calories from fat should come from monosaturated fats.
Although low-sodium and low-cholesterol foods are appropriate, providing the patient with a list
alone is not likely to be successful in making dietary changes. Completely removing saturated fat from
the diet is not a realistic expectation. Up to 7% of calories in the therapeutic lifestyle changes (TLC)
diet can come from saturated fat. Telling the patient about the increased risk without assisting further
with strategies for dietary change is unlikely to be successful.
d. Inform the patient that a diet containing no saturated fat and minimal salt will be necessary.
3. Which assessment data collected by the nurse who is admitting a patient with chest pain suggest that the pain is caused
NURS 1400 TEST BANK EXAM-CORONARY ARTERY
DISEASEAND ACUTE CORONARY SYNDROME QUESTIONS
WITH ANSWERS
,NURS 1400 TEST BANK EXAM-CORONARY ARTERY
DISEASEAND ACUTE CORONARY SYNDROME QUESTIONS
WITH ANSWERS
by an acute myocardial infarction (AMI)?
a. The pain increases with deep breathing.
b. The pain has lasted longer than 30 minutes.
i. Chest pain that lasts for 20 minutes or more is characteristic of AMI. Changes in pain that occur with
raising the arms or with deep breathing are more typical of musculoskeletal pain or pericarditis.
Stable angina is usually relieved when the patient takes nitroglycerin.
c. The pain is relieved after the patient takes nitroglycerin.
d. The pain is reproducible when the patient raises the arms.
4. Which information given by a patient admitted with chronic stable angina will help the nurse confirm this diagnosis?
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.
i. Chronic stable angina is typically relieved by rest or nitroglycerin administration. The level of pain is
not a consistent indicator of the type of angina. Pain occurring at rest or with increased frequency is
typical of unstable angina.
5. 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?
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.”
i. The emergency medical services (EMS) system should be activated when chest pain or other
symptoms are not completely relieved after 3 sublingual nitroglycerin tablets taken 5 minutes apart.
Nitroglycerin can be taken to prevent chest pain or other symptoms from developing (e.g., before
intercourse). Gastric upset (e.g., nausea) is not an expected side effect of nitroglycerin. Nitroglycerin
NURS 1400 TEST BANK EXAM-CORONARY ARTERY
DISEASEAND ACUTE CORONARY SYNDROME QUESTIONS
WITH ANSWERS
,NURS 1400 TEST BANK EXAM-CORONARY ARTERY
DISEASEAND ACUTE CORONARY SYNDROME QUESTIONS
WITH ANSWERS
does not impact the underlying pathophysiology of coronary artery atherosclerosis.
d. “Nitroglycerin helps prevent a clot from forming and blocking blood flow to my heart.”
6. 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. “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.”
i. Although only 30% of the daily calories should come from fats, most of the fat in the TLC diet should
come from monosaturated fats such as are found in nuts, olive oil, and canola oil. The patient can
include peanut butter sandwiches as part of the TLC diet. The other patient comments indicate a
good understanding of the TLC diet.
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?
a. “Carvedilol will help my heart muscle work harder.”
b. “It is important not to suddenly stop taking the carvedilol.”
i. Patients who have been taking β-adrenergic blockers can develop intense and frequent angina if the
medication is suddenly discontinued. Carvedilol (Coreg) decreases myocardial contractility. Shortness
of breath that occurs when taking β-adrenergic blockers for angina may be due to bronchospasm and
should be reported to the health care provider. Carvedilol works by decreasing myocardial oxygen
demand, not by increasing blood flow to the coronary arteries.
c. “I can expect to feel short of breath when taking carvedilol.”
d. “Carvedilol will increase the blood flow to my heart muscle.”
8. 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
NURS 1400 TEST BANK EXAM-CORONARY ARTERY
DISEASEAND ACUTE CORONARY SYNDROME QUESTIONS
WITH ANSWERS
, NURS 1400 TEST BANK EXAM-CORONARY ARTERY
DISEASEAND ACUTE CORONARY SYNDROME QUESTIONS
WITH ANSWERS
AMI?
a. Myoglobin
b. Homocysteine
c. C-reactive protein
d. Cardiac-specific troponin
i. Troponin levels increase about 4 to 6 hours after the onset of myocardial infarction (MI) and are highly
specific indicators for MI. Myoglobin is released within 2 hours of MI, but it lacks specificity and its use
is limited. The other laboratory data are useful in determining the patient’s risk for developing
coronary artery disease (CAD) but are not helpful in determining whether an acute MI is in progress.
9. Diltiazem (Cardizem) is ordered for a patient with newly diagnosed Prinzmetal’s (variant) angina. When teaching
the patient, the nurse will include the information that diltiazem will
a. Reduce heart palpitations
b. Decrease spasm of the coronary arteries
i. Prinzmetal’s angina is caused by coronary artery spasm. Calcium channel blockers (e.g., diltiazem,
amlodipine [Norvasc]) are a first-line therapy for this type of angina. Lipid-lowering drugs help reduce
atherosclerosis (i.e., plaque formation), and β-adrenergic blockers decrease sympathetic stimulation of
the heart (i.e., palpitations). Medications or activities that increase myocardial contractility will
increase the incidence of angina by increasing oxygen demand.
c. Increase the force of the heart contractions
d. Help prevent plaque from forming in the coronary arteries
10. The nurse will suspect that the patient with stable angina is experiencing a side effect of the prescribed
metoprolol (Lopressor) if the
a. patient is restless and agitated.
b. blood pressure is 90/54 mm
Hg.
NURS 1400 TEST BANK EXAM-CORONARY ARTERY
DISEASEAND ACUTE CORONARY SYNDROME QUESTIONS
WITH ANSWERS
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