Question 1

A patient who has recently started taking rosuvastatin (Crestor)and niacin (Nicobid)reports all the following symptoms to the nurse.Which one is most important to communicate to the physician?

Accepted Answer

Generalized muscle aches and pains are a potentially serious side effect of statin medications like rosuvastatin. It could indicate rhabdomyolysis, which is a breakdown of muscle tissue that can cause kidney damage. The physician should be notified immediately so that appropriate action can be taken. Skin flushing, dizziness, and nausea are common side effects of niacin and are usually not a cause for concern.

Question 2

For which of the following patient conditions is the use of garlic as a complementary therapy to help lower blood pressure contraindicated?

Accepted Answer

Garlic may lower blood sugar levels, so it is contraindicated for patients with diabetes who are already taking medication to lower their blood sugar levels. Garlic has shown potential benefits in lowering blood pressure in patients with pre-existing hypertension, and it may also provide benefits for patients who are overweight or who have osteoarthritis.

Question 3

A patient who has chest pain is admitted to the ED,and the following diagnostic tests are ordered.Which one will the nurse arrange to be completed first?

Accepted Answer

An ECG will provide information about the electrical activity of the heart and can quickly indicate if the patient is having an acute myocardial infarction (heart attack). This information is critical and should be obtained as soon as possible to guide further intervention.

Question 4

When caring for a patient who has survived a sudden cardiac death event and has no evidence of an AMI,what will the nurse anticipate teaching the patient?

Accepted Answer

Outpatient Holter monitoring is typically used to identify underlying rhythm abnormalities and identify potential causes of sudden cardiac death, making it important to educate the patient on this testing. There is no evidence that sudden cardiac death events rarely recur, and self-administration of heparin or limiting activities would not be appropriate interventions for this patient.

Question 5

Three weeks after his hospitalization for an AMI,a patient returns to the cardiac centre for follow-up.When the nurse asks about his sleep patterns,the patient tells the nurse that he sleeps fine but that his wife moved into the spare bedroom to sleep when he returned home.He states,"I guess we will never have sex again after this." What is the best response to the patient?

Accepted Answer

Sexual activity can indeed be gradually resumed after an AMI, similar to other physical activities. The comparison to climbing two flights of stairs is a guideline often used by healthcare professionals to help patients gauge their readiness for sexual activity, ensuring it does not overly strain the heart.

Question 6

Three days after an MI,the patient develops chest pain that radiates to the back and left arm and is relieved by sitting in a forward position.On auscultation of the patient's chest,what would the nurse expect to hear?

Accepted Answer

The patient's symptoms suggest pericarditis, which is inflammation of the pericardium, the sac around the heart. A pericardial friction rub is a typical finding in pericarditis and would be heard on auscultation of the chest. The other answer choices are not typically associated with pericarditis.

Question 7

Which of the following is the mechanism of action of aspirin that is commonly prescribed for patients that have had acute coronary syndrome?

Accepted Answer

The answer of Which of the following is the mechanism...

Question 8

The nurse evaluates the outcomes of preoperative teaching with a patient scheduled for a coronary artery bypass graft using the internal mammary artery.Which of the following statements by the patient helps the nurse identify that additional teaching is needed?

Accepted Answer

DB) The internal mammary artery, not a vein from the leg, is used for the graft in the described surgery, indicating a misunderstanding.D) The description of the procedure sounds more like a minimally invasive or robotic-assisted surgery, not the typical approach for a coronary artery bypass graft using the internal mammary artery, suggesting a need for further clarification.

Question 9

During early assessment of the patient with an MI,the nurse is aware that which of the following diagnostic tests is the most important to determine the extent and treatment of an MI?

Accepted Answer

Serial ECGs are the most important diagnostic test to determine the extent and treatment of an MI because they can show the location and size of the infarction, as well as the presence of any complications such as arrhythmias or heart failure.

Question 10

In preparing a patient for discharge from the hospital following an MI,which of the following statements by the patient indicates to the nurse that further instruction is needed?

Accepted Answer

Although cardiac rehabilitation can improve the health of the patient's heart, it will not make it "as good as new." This statement indicates a misunderstanding of the limitations of the heart after an MI and requires further clarification by the nurse. The other statements are accurate and demonstrate the patient's understanding of the importance of exercise and its role in reducing CAD risk factors. Option D is a helpful exercise tip for patients with joint pain.

Question 11

A patient who is being admitted to the ED with severe chest pain gives the nurse the following list of medications taken at home.Which medication has the most immediate implications for the patient's care?

Accepted Answer

Sildenafil (Viagra) is a medication used to treat erectile dysfunction and can interact dangerously with nitroglycerin (a medication commonly used to treat chest pain) and other nitrate medications, leading to severe hypotension (low blood pressure). The nurse should immediately inform the healthcare provider and withhold sildenafil until further orders are given.

Question 12

During the initial stages of hospitalization for an MI,the patient has been in denial,stating "I just had a little chest pain." What is the most appropriate intervention for the nurse to plan for the patient at this time?

Accepted Answer

Allowing the patient to use denial as a coping mechanism until he is ready to confront the reality of his condition is the most appropriate intervention at this time. Forcing the patient to face the reality of his situation before he is ready can lead to increased anxiety and resistance to care. The nurse can continue to monitor the patient's denial and provide education and support when the patient is ready to receive it. The patient's family can also be involved in providing emotional support and encouragement for the patient to accept his condition.

Question 13

Which of the following signs would the patient experience when the nurse evaluates that fibrinolytic therapy has not been successful in restoring perfusion to the myocardium?

Accepted Answer

Continuing chest pain is a sign that fibrinolytic therapy has not been successful in restoring perfusion to the myocardium. Other signs such as dyspnea and tachycardia, rise in CK enzyme or increase in premature ventricular contractions may not necessarily indicate failure of fibrinolytic therapy.

Question 14

A patient has had an elevated temperature of 38.2°C for 3 days since experiencing an MI.What does the nurse understand that this fever indicates?

Accepted Answer

Fever after a myocardial infarction (MI) is a common response due to the inflammatory process associated with the necrosis of heart tissue.

Question 15

Which of the following is a mnemonic to assist the nurse in obtaining thorough information from a patient who has chest pain?

Accepted Answer

PQRST is a widely used mnemonic that stands for Provokes, Quality, Region, Severity, Timing. This helps the nurse obtain important information about the patient's chest pain, including what triggers it, the type of pain, where it is located, how severe it is, and when it occurs. The mnemonic ABCDEF is used for assessment of cardiac arrest, AQSP is not a commonly used mnemonic, and PAIN is too general and not specific to chest pain.

Question 16

For a patient who was admitted the previous day to the CCU with an AMI,the nurse will anticipate teaching the patient about which one of the following?

Accepted Answer

Cardiac rehabilitation is a critical component of recovery for patients who have experienced an Acute Myocardial Infarction (AMI), and it typically begins soon after the event or hospitalization. It is designed to improve the patient's physical, emotional, and functional status, including exercise training, education on heart-healthy living, and counseling to reduce stress and help the patient return to an active life.

Question 17

Which of the following is an absolute contraindication for the use of fibrinolytic therapy?

Accepted Answer

Intracranial neoplasm (tumor) is a contraindication for fibrinolytic therapy because it can increase the risk of bleeding and worsening of the condition. Diabetes and laser eye surgery do not pose a significant risk with fibrinolytic therapy. Pregnancy is a relative contraindication and may require careful consideration of risks and benefits.

Question 18

The nurse has just received a change-of-shift report about the following four patients.Which patient should the nurse assess first?

Accepted Answer

The patient who has just returned to the unit after a coronary arteriogram and percutaneous coronary intervention (PCI) should be assessed first due to the risk of complications such as bleeding from the catheter insertion site, arrhythmias, or changes in hemodynamic status following the procedure.

Question 19

Fibrinolytic therapy is prescribed for a 64-year-old patient with an STEMI.During the administration of the fibrinolytic agent,the nurse recognizes that the therapy should be stopped when the patient experiences which of the following signs?

Accepted Answer

A sudden decrease in the level of consciousness may indicate a serious complication of fibrinolytic therapy, such as intracranial hemorrhage. Bleeding from the gums or surface bleeding from the IV site are expected side effects of fibrinolytic therapy and do not necessarily require the therapy to be stopped. Premature ventricular contractions and ventricular tachycardia may be related to the underlying cardiac condition and are not indications to stop fibrinolytic therapy.

Quiz 36: Nursing Management: Coronary Artery Disease and Acute Coronary Syndrome

A patient who has recently started taking rosuvastatin (Crestor) and niacin (Nicobid) reports all the following symptoms to the nurse.Which one is most important to communicate to the physician?