Deck 15: Alterations in Myocardial Tissue Perfusion

Question 1

A patient tells the nurse that he smokes two packs of cigarettes per day,works 10-hour workdays most days of the week,eats out twice a day when working,and has no time to exercise.The nurse analyzes this data and suggests interventions to address which patient problem?

A)The patient has high anxiety related to the work environment.
B)The patient is not coping well with life demands.
C)The patient is not managing his health effectively.
D)The patient's dietary choices have led to obesity.

Answer 1

The patient is not managing his health effectively.

Question 2

The nurse has completed teaching regarding cardiac risk factor reduction.Which patient statement would best indicate an understanding of the instructions?

A)"I am going to start walking my dog for 30 or 40 minutes every day."
B)"I will substitute vegetables for some of the fruit I have been eating."
C)"I will increase weight-bearing activities."
D)"I will avoid becoming dependent on laxatives."

Answer 2

"I am going to start walking my dog for 30 or 40 minutes every day."

Question 3

The patient requires close monitoring during the first 24 hours after receiving thrombolytic therapy.What is the priority nursing intervention?

A)Monitor level of consciousness.
B)Administer pain medications.
C)Monitor for decreased output.
D)Monitor for pulmonary emboli.

Answer 3

Monitor level of consciousness.

Question 4

The nurse is performing a cardiovascular assessment.Which patient findings would indicate significant risk factors for the development of atherosclerosis? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Select all that apply.

A)The patient has diabetes mellitus.
B)The patient tends to become anemic.
C)The patient's mother and sister had myocardial infarctions before age 50.
D)The patient has high levels of low-density lipoproteins.
E)The patient is a 50-year-old male.

Question 5

A patient,admitted with chest pain,has a baseline cTnT level of 1.1 mcg/L.Which explanation would the nurse provide the patient for redrawing this level in 6 hours?

A)"Trends in this value will help us determine your diagnosis."
B)"If this level goes down we know your pain medication is working."
C)"Hopefully we will see this level rise as an indicator that your oxygen therapy has been effective."
D)"If this level does not increase,we will need to increase the rate of your intravenous fluid replacement."

Question 6

The nurse is assessing a patient whose body mass index is 23 kg/m².The nurse would suggest which lifestyle goal for this patient?

A)"To lose weight you should eat a lower fat diet."
B)"You might benefit from additional exercise each day."
C)"Add some calorie and nutrient dense foods to your diet to increase your weight."
D)"Be certain your daily sodium intake does not exceed 2400 mg."

Question 7

A patient tells the nurse that she has been experiencing a "pain in the chest" for the last 3 hours.What does this information suggest to the nurse?

A)The pain is of noncardiac origin.
B)The patient is in the midst of an acute myocardial infarction.
C)The patient is going to have a myocardial infarction within hours.
D)The patient is having continuous angina.

Question 8

A patient is diagnosed with atherosclerosis.How would the nurse explain the area injured by this inflammatory disorder?

A)"Your arteries have three layers that are all damaged by atherosclerosis."
B)"Atherosclerosis damages the lining of your arteries."
C)"Atherosclerosis is also called 'hardening of the arteries' because it damages the outside layer,making it hard for your artery to stretch."
D)"The middle layer of the wall of your arteries is injured by atherosclerosis,which allows plaque to build up."

Question 9

A patient is admitted with chest pain of approximately 2 hours in duration.The CK level was 8 U/L.Which additional order should the nurse expect in order for assessment of this patient to be adequate?

A)Repeat CK level in 48 hours
B)CTnT level
C)CK-MB in the a.m.
D)LDL and HDL levels

Question 10

A patient with acute coronary syndrome has received thrombolytic therapy.The nurse would monitor and report which findings that indicate this therapy was successful? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Select all that apply.

A)Respiratory rate of 18 per minute
B)Resolution of ST segment elevation
C)Resolution of chest pain
D)Occurrence of premature ventricular complexes
E)Occurrence of a headache

Question 11

The nurse is providing medication education for a patient who has been prescribed atorvastatin (Lipitor).Which information should be included?

A)This is one of the few medications that will not need to be monitored with periodic blood tests.
B)Contact your physician if you develop muscle pain.
C)It will take about 6 months before this medication will improve your low-density lipoprotein level.
D)This medication helps your kidneys eliminate LDL,the less desirable kind of cholesterol.

Question 12

A female patient presents to the emergency department with complaint of chest pain.Which findings would raise the nurse's suspicion that the chest pain is of cardiac origin? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Select all that apply.

A)The patient has 2+ edema in her ankles.
B)The patient has bilateral xanthomas.
C)The chest pain is described as a "burning" in the center of the chest that is worse when supine.
D)The patient has an S₃ heart sound.
E)The patient has a dull humming sound just below the xiphoid process.

Question 13

A patient has presented for a scheduled exercise stress test.Which patient comments should the nurse communicate immediately to the healthcare provider performing the test? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Select all that apply.

A)"I did tell you that I am allergic to iodine,didn't I?"
B)"I'm pretty hungry since I didn't eat breakfast."
C)"I had a cup of tea this morning instead of coffee."
D)"I took my propranolol early this morning when I first woke up."
E)"I am determined to quit smoking.I haven't had a cigarette for 2 days."

Question 14

A patient tells the nurse that he had chest pain into his left arm while moving a heavy trash can that lasted for about 10 seconds and stopped when he put the trash can down.This information would be included in which aspects of the PQRST assessment for chest pain? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Select all that apply.

A)P
B)Q
C)R
D)S
E)T

Question 15

A patient with diabetes is surprised to learn that he has been having angina when the only problem he has been experiencing is a "bit of fatigue and shortness of breath." How should the nurse explain this to the patient?

A)Shortness of breath is the first symptom of angina.
B)There is no classic symptom of angina.
C)Slight fatigue is usually the first symptom of angina.
D)Persons with diabetes may experience pain differently.

Question 16

At the conclusion of a stress echocardiogram it was determined that the patient has dyskinesis.The nurse would reinforce which explanation of this finding?

A)The patient's heart moves too slowly.
B)The patient's heart wall moves very quickly to impulses.
C)The patient's heart wall moves opposite from normal.
D)A portion of the patient's heart does not move at all.

Question 17

A patient's is admitted with complaint of chest pain.The electrocardiogram (ECG)reveals ST segment elevation.What is the nurse's priority intervention?

A)Give the patient 162 mg of aspirin.
B)Draw blood for serum cardiac markers.
C)Place the patient on a cardiac monitor.
D)Call for a portable chest x-ray.

Question 18

A patient is diagnosed with Prinzmetal angina.Which assessment findings would the nurse attribute to this diagnosis? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Select all that apply.

A)The patient experiences lightheadedness that occurs at rest.
B)The patient has chest pain that lasts several hours.
C)The patient can predict the level of activity that will cause the pain.
D)The patient is awakened from sleep by chest pain.
E)The patient has chest pain that is not related to physical activity.

Question 19

Which assessment finding would indicate to the nurse that the patient has an altered blood supply to the right coronary artery affecting the posterior wall of the myocardium?

A)cTnT of 0.0 mcg/L
B)CK-MB of 4%
C)ST segment depression in V1 and V2
D)Peaked T waves in aVF

Question 20

A lipid panel has been drawn on a patient who has a family history of atherosclerosis.The nurse would explain that which value on the panel is most implicated in development of atherosclerosis?

A)High-density lipoprotein
B)Total cholesterol level
C)Triglyceride level
D)Low-density lipoprotein