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A series of multiple choice questions and answers related to the management of patients with coronary vascular disorders. It covers topics such as the composition of plaque in arteries, the causes of angina, nursing diagnoses related to angina, the management of myocardial infarction, and the use of medications like nitroglycerin and amlodipine. A concise overview of key concepts and clinical considerations in the care of patients with coronary artery disease.
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The nurse is caring for client who has been diagnosed with an elevated cholesterol level. the nurse is aware that plaque on the inner lumen of the arteries is composed chiefly of what? a. lipids and fibrous tissue b. white blood cells c. lipoproteins d. high-density cholesterol โโa. lipids and fibrous tissue A client presents to the clinic reporting intermittent chest pain on exertion, which is eventually attributed to angina. the nurse should inform the client that angina is most often attributable to what cause? a. decreased cardiac output b. decreased cardiac contractility c. infarction of the myocardium d. coronary arteriosclerosis โโd. coronary arteriosclerosis Arteriosclerosis is a cause of angina pectoris The nurse is caring for an adult client who had symptoms of unstable angina upon admission to the hospital. what nursing diagnosis underlines the discomfort associated with angina? a. ineffective breathing pattern related to decreased cardiac output b. anxiety related to fear of death c. ineffective cardiopulmonary tissue perfusion related to coronary artery disease (CAD) d. impaired skin integrity related to CAD โโc. ineffective cardiopulmonary tissue perfusion related to coronary artery disease (CAD) This nursing DX results in the symptoms of discomfort associated with angina. The triage nurse in the ED assesses a 66-year-old male patient who presents to the ED with complaints of midsternal chest pain that has lasted for the last 5 hours. If the patient's symptoms are due to an MI, what will have happened to the myocardium? A) It may have developed an increased area of infarction during the time without treatment. B) It will probably not have more damage than if he came in immediately. C) It may be responsive to restoration of the area of dead cells with proper treatment. D) It has been irreparably damaged, so immediate treatment is no longer necessary. โโA) It may have developed an increased area of infarction during the time without treatment. When the client experiences a lack of oxygen to myocardium cells during an MI, the sooner treatment is initiated, the more likely the treatment will prevent or minimize myocardial tissue necrosis. a delay will lead to increase myocardial damage.
Family members bring a client to the ED with pale skin, sudden mid-sternal chest pain unrelieved with rest, and a history of CAD. how should the nurse best interpret these initial data? a. the symptoms indicate angina and should be treated as such. b. the symptoms indicate a pulmonary etiology rather than a cardiac etiology. c. the symptoms indicate an acute coronary episode and should be treated as such. d. treatment should be determined pending the results of an exercise stress test. โโc. the symptoms indicate an acute coronary episode and should be treated as such. The symptoms are unrelieved by rest suggest an acute coronary episode rather than angia. An OR nurse is preparing to assist with a coronary artery bypass graft (CABG). The OR nurse knows that the vessel most commonly used as source for a CABG is what? A) Brachial artery B) Brachial vein C) Femoral artery D) Greater saphenous vein โโD. Greater saphenous vein This is the vein commonly used grafting sire for CABG. A client with type 2 and hypertension has a routine follow up appointment after a cardiac stent placement. On assessment the nurse notes that client weighs 250lb, waist circumference of 40 inches, blood pressure is 162/84, and fasting blood sugar is 220 mg/dl. based on these findings, which syndrome should the nurse most suspect? a. adams-nance syndrome b. postpericardiotomy syndrome c. metabolic syndrome d. alagille syndrome โโc. metabolic syndrome A cluster of metabolic abnormalities known as metabolic syndrome is a major risk factor for cardiovascular disease. The diagnosis is made when the client has 3 of the 5 risk factors.
b. diet and drug therapy c. diet therapy only d. diet therapy and smoking cessation โโd. diet therapy and smoking cessation due to the absence of symptoms, diet & smoking cessation would be the first-line treatment for possible CAD. the nurse is working with a client who had an MI and is now in active rehabilitation. the nurse should teach this client to cease activity if which of the follow occurs? a. the client experiences chest pain, palpitations, or dyspnea b. the client experiences a noticeable increase in heart rate during activity c. the client's oxygen saturation level drop below 96% d. the client's respiratory rate exceeds 30 breaths/min โโa. the client experiences chest pain, palpitations, or dyspnea any activity or exercise that cause these s/s should be stop in pt w/CAD a client with cardiovascular disease is being treated with amlodipine, which is intended to cause what therapeutic effect? a. reducing the heart's workload by decreasing heart rate and myocardial contraction b. preventing platelet aggregation and subsequent thrombosis c. reducing myocardial oxygen consumption by blocking adrenergic stimulation to the heart. d. increasing the efficiency of myocardial oxygen consumption, thus decreasing ischemia and relieving pain. โโa. reducing the heart's workload by decreasing heart rate and myocardial contraction A nurse is providing care for a client with high cholesterol and triglyceride values. in teaching the client about therapeutic lifestyle changes such as diet and exercise, the nurse realizes that the desired goal for cholesterol levels is which of the following? a. high HDL values and high triglyceride values b. absence of detectable total cholesterol level c. elevated blood lipids, fasting glucose less than 100 d. low LDL values and high HDL values โโd. low LDL values and high HDL values LDL are harmful and HDL promotes the use of total cholesterol. a nurse educator is conducting an inservice for nursing students about how tobacco use impacts coronary artery disease (CAD)? what are the primary ways that tobacco use impacts CAD? select all that apply. a. decreases the supply of oxygen to the myocardium b. increases platelet adhesion c. raises the heart rate and blood pressure d. causes the coronary arteries to dilate e. increases the blood carbon monoxide level โโa, b, c, e Nicotinic acid in tobacco triggers the release of catecholamines, which raise the heart rate and blood pressure. also cause the coronary arteries to constrict.
An adult client is admitted to the ED with chest pain. the client states that there was unrelieved chest pain for approximately 20 minutes before coming to the hospital. to minimize cardiac damage, the nurse should expect to administer which of the following interventions? a. thrombolytic, oxygen administration, and non-steroidal anit-inflammatories b. morphine sulfate, oxygen, and bed rest. c. oxygen and beta-adrenergic blockers d. bed rest, albuterol nebulizer treatments, and oxygen โโb. morphine sulfate, oxygen, and bed rest. MONA: morphine, oxygen, nitroglycerin, aspirin a client with hypertension is ambulating in the hospital hallway and reports chest pain. in which order would the nurse assess and treat this client? a. the first set of vital signs are done. b. the nurse assesses the client angina c. a 12 lead electrocardiogram d. the client is instructed to stop all activity e. the client receives the first dose of nitroglycerin f. the client is transferred to a higher acuity unit โโD, B, A, C, E, F when assessing a client with angina pectoris, it is most important for the nurse to gather what information? a. the client's activities, limitations, and level of consciousness after the attacks b. the client's symptoms and the activities that precipitate attacks c. the client's understanding of the pathology of angina d. the client's coping strategies surrounding the attacks โโb. the client's symptoms and the activities that precipitate attacks the hospital nurse is caring for a client who reports that an angina attack is beginning. which action is the nurse's most appropriate initial action? a. have the client sit down and put the head between the knees b. have the client perform pursed-lip breathing c. have the client stand still and bend over at waist d. place the client on bed rest in a semi-fowler position โโd. place the client on bed rest in a semi- fowler position rest in bed in semi-fowler position reduce the oxygen requirements of the ischemic myocardium. the ED nurse is caring for a client with suspected MI. what drug should the nurse anticipate administering to this client? a. oxycodone b. warfarin c. morphine d. acetaminophen โโc. morphine MONA: morphine, oxygen, nitroglycerin, aspirin.
a client in a cardiac step down unit has begun bleeding from the PCI access site in the femoral region. what is the nurse's most appropriate action? a. call for assistance and initiate CPR b. reposition the client's leg in a nondependent position c. promptly remove the femoral sheath d. call for help and apply pressure to the access site โโd. call for help and apply pressure to the access site The sheath produces pressure on the access site, pressure will temporarily reduce bleeding and allow for follow up interventions. An ED nurse is assessing an adult woman for a suspected MI. When planning the assessment, the nurse should be cognizant of what signs and symptoms of MI that are particularly common in female patients? Select all that apply. A) Shortness of breath B) Chest pain C) Anxiety D) indigestion E) nausea โโD, E atypical s/s of Mi in females include indigestion, nausea, palpitations, and numbness. a client who is postoperative day 1 following a CABG has produced 20 ML of urine in the past 3 hours and the nurse has confirmed the patency of the urine catheter. what is the nurse's most appropriate actions? a. document the client low urine output and monitor closely for the next hour b. contact the dietitian and suggest the need for increased oral fluid intake c. contact the provider and continue to assess fluid balance and renal functions. d. increase the infusion rate of the client's IV fluid to prompt an increase in renal function. โโc. contact the provider and continue to assess fluid balance and renal functions. nurse management includes accurate measurement of urine output. an output less than 0.5 ml/kg/hr may indicate hypovolemia or renal insufficiency. a client is recovering from cardiac surgery, the nurse has identified the diagnosis of risk for ineffective airway clearance related to pulmonary secretions. what intervention best addresses this risk? a. administration of bronchodilators by nebulizer b. administration of inhaled corticosteroids by metered dose inhaler
c. client consistent performance of deep-breathing and coughing exercises d. client's active participation in a cardiac rehab program. โโc. client consistent performance of deep- breathing and coughing exercises clearance of pulmonary secretions is accomplished by frequent repositioning, suctioning, chest physical therapy, deep breathing and coughing.