Deck 24: Coronary Circulation Disorders

Question 1

When assessing patient with reduced cerebral perfusion, the nurse should be alert for which early finding?

A) Angina
B) Claudication
C) Altered mental status
D) Dyspnea

Answer 1

Altered mental status

Question 2

To obtain information about a patient's major modifiable risk factors for coronary artery disease, which question should the nurse ask?

A) "How much alcohol do you drink?"
B) "Do you have sleep apnea?"
C) "Do you smoke cigarettes?"
D) "Do you suffer from depression?"

Answer 2

"Do you smoke cigarettes?"

Question 3

Which characteristics in an adult patient would the nurse assess as having poor cardiovascular health using the American Heart Association's Life's Simple 7?

A) Blood glucose 126 mg/dL, lack of physical activity, current smoker
B) 60 minutes/week of moderate physical activity, weight of 26 kg/m², quit 9 smoking months ago
C) Cholesterol 150 mg/dL, quit smoking cigarettes 15 months ago, weight of 24 kg/m²
D) Systolic blood pressure 124 mm Hg, blood glucose 105 mg/dL, 3 healthy diet components

Answer 3

Blood glucose 126 mg/dL, lack of physical activity, current smoker

Question 4

Which of the following teaching points about atherosclerosis would the school nurse include when speaking to parents of middle school-aged children?

A) Atherosclerotic buildup begins in middle adulthood.
B) Early eating habits do not affect adult risk of atherosclerosis.
C) A healthy blood pressure in childhood reduces the risk of heart disease as adults.
D) A healthy lifestyle should be started by age 40 years old to reduce risk of atherosclerosis as adults.

Question 5

Which explanation of cardiac risk assessment should the nurse give to a patient asking about his risk for heart disease?

A) "Risk assessment will tell us if you will have a heart attack."
B) "If you reduce your risk for heart disease, you will prevent heart disease."
C) "Risk assessment takes into consideration accumulated long-term exposure to risk factors."
D) "Risk assessment can guide us in helping you reduce your risk for heart disease."

Question 6

Which electrocardiographic change would the emergency department nurse expect to observe in a patient experiencing subendocardial cardiac injury?

A) ST-segment elevation
B) ST-segment depression
C) Shortened PR interval
D) Prolonged PR interval

Question 7

Which medications should the nurse anticipate administering in the patient with an initial diagnosis of stable angina?

A) Antiplatelet, long-acting nitrate
B) Beta blocker, ACE inhibitor
C) Antiplatelet, beta blocker
D) ACE inhibitor, long-acting nitrate

Question 8

Which manifestation would the nurse expect in a patient with stable angina?

A) Pain that is relieved with oxygen administration
B) Pain that is relieved by a long-acting nitrate
C) Pain that persists with rest
D) Pain that is relieved with short-acting nitroglycerin

Question 9

Which laboratory finding is expected in the patient experiencing unstable angina?

A) Normal cardiac troponin levels
B) Elevated creatine kinase MB
C) Elevated myoglobin
D) Elevated creatine kinase

Question 10

Which of the following interventions would the emergency department nurse anticipate in a patient being treated for a non-ST-segment elevation myocardial infarction (NSTEMI)?

A) Sublingual nitroglycerin for up to three doses 5 minute apart
B) Intravenous nitroglycerin, if the patient has recently used a phosphodiesterase inhibitor drug
C) Enteric-coated aspirin
D) Intravenous beta blocker

Question 11

The plan of care for a patient with a STEMI, treated in a non-percutaneous coronary intervention capable (PCI) hospital, includes:

A) evaluation in the cardiac catheterization lab within 90 minutes of non-PCI hospital arrival.
B) transfer to a PCI-capable hospital within 3 hours.
C) fibrinolytic therapy if transfer causes a delay of more than 120 minutes for door to balloon.
D) stabilizing patient for 24 hours, then transferring to a PCI-capable hospital.

Question 12

How should the nurse interpret the electrocardiogram (ECG) of a patient which shows an atrial rate of 300-600 bpm, ventricular rate of 100-180 bpm, irregularly irregular rhythm, variable P:QRS, and PR interval that cannot be measured?

A) Atrial flutter
B) Atrial fibrillation
C) Paroxysmal supraventricular tachycardia
D) Sinus tachycardia

Question 13

Which patient statement indicates that more teaching about the Zio Patch arrhythmia monitor is needed?

A) "It is very convenient that I don't have a bulky monitor to carry around."
B) "This will record my heart rhythm over two weeks."
C) "My doctor will call me if I have an arrhythmia while I am wearing this monitor."
D) "There are no wires to for me to worry about coming loose."

Question 14

When performing cardiopulmonary resuscitation, in which order should the nurse perform the steps?

A) Airway, breathing, compressions
B) Breathing, airway, compressions
C) Compressions, breathing, airway
D) compressions, airway, breathing

Question 15

Which physical assessment findings would the nurse expect in a patient with a left ventricular aneurysm?

A) S3
B) Apical impulse displaced to right
C) Diastolic murmur
D) Opening snap

Question 16

The nurse is assessing for pulsus paradoxus in a patient who was in a car accident. Which of the following results suggest the patient is developing cardiac tamponade?

A) A decrease of 10 mm Hg in systolic blood pressure during inspiration
B) An increase of 10 mm Hg in systolic blood pressure during inspiration
C) A decrease of 10 mm Hg in diastolic blood pressure during inspiration
D) An increase of 10 mm Hg in diastolic blood pressure during inspiration

Question 17

The nurse is caring for a patient with cardiac tamponade who underwent pericardiocentesis to remove fluid. What findings would indicate to the nurse that the procedure has been effective?

A) Hear rate 92 bpm
B) Respiratory rate 34 breaths/minute
C) Jugular venous distention
D) Pulsus paradoxus of 14 mm Hg

Question 18

When auscultating the heart of a patient with mitral stenosis, the nurse is most likely to hear which sounds?

A) Diastolic murmur and opening snap.
B) Holosystolic murmur
C) Systolic click murmur
D) Loud, harsh holosystolic murmur

Question 19

Which finding is the nurse likely to assess in a patient with pericarditis?

A) Pain that worsens on exhalation
B) Pain that worsens on sitting upright
C) Pain that worsens when lying prone
D) Pain that worsens with deep inspiration

Question 20

How should the nurse respond when a patient with coronary artery disease asks why C-reactive protein (CRP) levels are being drawn for laboratory analysis?

A) "An elevated CRP level is a predictor of coronary artery disease."
B) "An elevated CRP level means you will have a heart attack."
C) "CRP is released from the heart during a heart attack."
D) "CRP is released from atherosclerotic plaques."