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Acute Coronary Syndrome: Test Questions and Answers for NRSG 327 Week 3, Exams of Nursing

Montana State UniversityNursing

A series of test questions and answers related to acute coronary syndrome (acs), covering topics such as angina, virchow's triad, pulmonary emboli, myocardial ischemia and infarction, risk factors for acs, types of angina, collateral circulation, diagnostic tests for myocardial infarction, ecg interpretation, cardiac markers, pci procedures, and thrombolytics. It is designed to help students in nrsg 327 week 3 prepare for their exams.

Typology: Exams

2024/2025

Available from 03/14/2025

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NRSG 327 WEEK 3 - ACUTE CORONARY SYNDROME: TEST
QUESTIONS WITH CORRECT ANSWERS
What sensation of angina is indicative of a abdominal or pulmonary problem? -- Answer
✔✔ 1. A sharp sensation
2. Possibly heartburn
***This pain changes with either ambulation or for every respiration.
What sensation of angina is indicative of a cardiac problem? -- Answer ✔✔ A pressing/
tight pressure
***This pain is constant - there is no change even with ambulation.
What are the three components of Virchow's triad? -- Answer ✔✔ 1. Venous stasis
(either due to poor cardiac output, or immobility)
2. Venous damage (due to trauma)
3. Hypercoagulability (a normal occurrence intra-op d/t bleeding).
What are the signs and symptoms of a pulmonary emboli? -- Answer ✔✔ 1. Sharp pain/
angina
2. General respiratory distress (dyspnea, tachypnea)
3. Dysrhythmias (tachycardia)
4. Hemoptysis (due to injury to pulmonary arteries)
5. Anxiety and restlessness (associated with respiratory distress)
6. Dizziness (associated with respiratory distress d/t decreased O2 intake)
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Download Acute Coronary Syndrome: Test Questions and Answers for NRSG 327 Week 3 and more Exams Nursing in PDF only on Docsity!

NRSG 327 WEEK 3 - ACUTE CORONARY SYNDROME: TEST

QUESTIONS WITH CORRECT ANSWERS

What sensation of angina is indicative of a abdominal or pulmonary problem? -- Answer ✔✔ 1. A sharp sensation

  1. Possibly heartburn ***This pain changes with either ambulation or for every respiration. What sensation of angina is indicative of a cardiac problem? -- Answer ✔✔ A pressing/ tight pressure ***This pain is constant - there is no change even with ambulation. What are the three components of Virchow's triad? -- Answer ✔✔ 1. Venous stasis (either due to poor cardiac output, or immobility)
  2. Venous damage (due to trauma)
  3. Hypercoagulability (a normal occurrence intra-op d/t bleeding). What are the signs and symptoms of a pulmonary emboli? -- Answer ✔✔ 1. Sharp pain/ angina
  4. General respiratory distress (dyspnea, tachypnea)
  5. Dysrhythmias (tachycardia)
  6. Hemoptysis (due to injury to pulmonary arteries)
  7. Anxiety and restlessness (associated with respiratory distress)
  8. Dizziness (associated with respiratory distress d/t decreased O2 intake)

What are the medications given for a pulmonary emboli? -- Answer ✔✔ 1. Anti- coagulants (***they do not break the clots down, rather, they prevent and delay the new formation of clots). 1a. Unfractioned heparin 1b. Fractioned heparin (LMWH): Dalteparin, Enoxaparin, Nadroparin 1c. Warfarin 1d. FondaparinUX (EDIT: I previously listed Fondaparinux as a thrombolytic — it is in fact an anti- coagulant). Considering the physiology of myocardial ISCHEMIA and INFARCTION, what two factors (directly related to the myocardium) can exacerbate ischemia/ infarction? -- Answer ✔✔ 1. Decreased myocardial O2 supply (d/t decreased respiratory function, causing hypoxia;) (d/t blood loss, causing hypotension and reflex vasospasm).

  1. Increased myocardial demand (d/t dysrhythmias secondary to decreased O2 and fluid loss) (d/t impaired thermoregulation intra-op) (d/t increased myocardial wall stress [heart has to increase cardiac output to compensate for fluid losses]) What the the general risk factors for Acute Coronary Syndrome (ACS) (Focusing on the modifiable risk factors) -- Answer ✔✔ 1. Diet
  2. Hypertension
  3. High cholesterol
  4. Patient weight
  5. Lifestyle
  1. It occurs in response to a blockage in the main arteries in order to supply the surrounding myocardium affected by the blockage.
  2. It takes a long time for these auxiliary arteries to develop. What diagnostic tests are often ordered for a patient with myocardial infarction? -- Answer ✔✔ 1. D-dimer: tests for coagulability; diagnoses DVTs and PEs.
  3. BNP: diagnoses heart failure
  4. Troponin: elevated troponin indicates muscle damage
  5. Creatinine Kinase MB: elevated CK-MB may indicate myocardial damage
  6. A 12-lead ECG: Visualizes the extent and type of myocardial infarction (i.e., STEMI vs NSTEMI). How does a 12-lead ECG work -- Answer ✔✔ The 12-lead ECG monitors the electrical activity via action potential (repolarization and depolarization) of the left ventricle, which presents itself as PQRST waves. (***The left side of the heart contains the most amount of coronary arteries, hence why it is used more often than the right-side which is monitored via a 15-lead ECG) What does the P wave represent? -- Answer ✔✔ The P wave represents the depolarization of the ATRIA What does the QRS complex represent? -- Answer ✔✔ The QRS complex represents the depolarization of the ventricles

What can a Q wave diagnose? -- Answer ✔✔ Q wave depression is an indication for a previous or ongoing myocardial infarction. A more detailed diagnosis is done through the ST segment. What does the T wave represent? -- Answer ✔✔ The T wave complex represents the relaxation/ repolarization of the ventricles What does the ST segment represent? -- Answer ✔✔ The ST segment represents the time between the depolarization of the ventricles ("S"), and the repolarization of the ventricles ("T"). What can the ST segment diagnose? -- Answer ✔✔ 1. NSTEMI - Can present itself in two ways through the ST segment: 1.a. S wave depression 1.b. T wave inversion

  1. STEMI - An elevated ST wave How is the isoelectric line used for the PQRST wave? -- Answer ✔✔ The isoelectric line serves as a reference point to gauge the extent/ severity of Q wave depression, and ST segment abnormalities What are the five assessment pieces for the ECG/ PQRST wave? -- Answer ✔✔ 1. Is there a P-wave, and is it upright
  2. Is there a QRS complex for each P-wave

  • tid-bit: (the absence or irregularity of the QRS complex for each P-wave can indicate differing severities of heart-block.)

  • i.e., a type-2 second degree heart block shown in image.

For thrombolytics, which directly destroy fibrin clots, there are relative and absolute contraindications.

  1. What defines a relative vs an absolute contraindication?
  2. What are examples of relative contraindications?
  3. What are examples of complete contraindications? -- Answer ✔✔ 1. The risk vs benefit that thrombolytics pose on a patient suffering from an MI BASED on their history/ existing risk factors 2a. An ischemic stroke >3 months 2b. A high INR panel value 2c. Frequent anticoagulant use (i.e., for patients with mechanical valves) 2d. A recent bleed 2e. Controlled hypertension 3a. Intracranial hemorrhage (current or hx) 3b. An ischemic stroke <3 months 3c. Brain cancer 3d. Aortic dissection 3e. Active bleeding 3f. Uncontrolled hypertension There are three types of Percutaneous Coronary Intervention (PCI);
  4. What are these types?
  5. What are they for? -- Answer ✔✔ 1. Primary PCI — It is the first intervention for a blockage (if that 90 minute window is achieved)
  6. Rescue PCI — It is sequentially the second intervention for a blockage (i.e., if a thrombolytic was given first).
  1. Planned PCI — Blockages are known, but are not acutely alarming, thus, they are planned for a future date What is a CABG, and what is the purpose of this operation? -- Answer ✔✔ Coronary Artery Bypass Graft: it is a surgical intervention of re-routing blood flow around an obstructed artery. ***This is often done with multiple clots, as it is more efficient to do one CABG over multiple PCIs.