Question 1

The nurse is concerned that a patient is at risk for MI because of the latest total cholesterol level.Which level did the nurse use to cause this concern?

Accepted Answer

Total cholesterol levels greater than 200 mg/dL increase the risk of MI.A.B.C.These levels are below 200 mg/dL which reduces the patient's risk for an MI.

Question 2

The physician prescribes nitroglycerin for a patient with anterior MI.The patient's vital signs are apical pulse 52 beats/min and blood pressure 80/60 mm Hg.What action should the nurse take?

Accepted Answer

The vital signs are low and should be reported to the RN prior to giving medication,as the physician should be notified and will likely give orders to hold the medication.A.Administering the drug as prescribed would not be safe.C.Rechecking the vital signs in 30 minutes would be unsafe.D.Changing a prescribed dose of medication is beyond the nurse's scope of practice.

Question 3

A male patient is prescribed a long-acting nitroglycerin medication for stable angina.Which medication should the nurse remind the patient to avoid while taking the nitroglycerin?

Accepted Answer

Patients prescribed nitrates should not use drugs,such as sildenafil (Viagra),for erectile dysfunction,because this drug dilates blood vessels and may cause a significant drop in blood pressure if used together.B.C.D.There is no reason for the patient to avoid taking warfarin,penicillin,or hydrochlorothiazide while taking a nitrate medication.

Question 4

The nurse is reinforcing teaching provided to a patient who has been prescribed a new medication.For which medication should the patient be instructed there is the possibility of developing a cough when taking the drug?

Accepted Answer

Angiotensin-converting enzyme inhibitors may cause a persistent cough to develop in 20% of patients.A.B.C.Cough is not an adverse effect of statins,beta blockers,or calcium channel blockers.

Question 5

The nurse is contributing to a patient's teaching plan.What should be included when teaching a patient about the use of nitroglycerin? (Select all that apply.)

Accepted Answer

The patient should be instructed on how to take the medication sublingually,taking time to rise slowly after taking the medication,to sit or lie down when taking the medication,and to take the medication before an activity known to cause chest pain.A.This medication is not taken routinely every morning.F.The patient needs a 6 month supply of the medication.

Question 6

The spouse of a patient experiencing an acute MI does not understand why the patient is receiving morphine sulfate for pain.What should the nurse explain to the patient and spouse? (Select all that apply.)

Accepted Answer

Morphine sulfate is the most commonly used narcotic for MI.In addition to pain relief,morphine helps decrease anxiety,opens bronchioles,and increases peripheral blood pooling to decrease preload (blood returning to heart)and afterload (pressure within the aorta),which can help increase blood supply and oxygen to the myocardium.E.Morphine does not affect myocardial oxygen needs.

Question 7

A patient is recovering from stent placement in an occluded coronary artery.Which medication should the nurse expect to be prescribed for this patient?

Accepted Answer

Antiplatelet medications are recommended after stent placement to help prevent clot formation.B.C.D.Beta blockers,ACI-inhibitors,and calcium channel blockers are not indicated after stent placement for an occluded vessel.

Question 8

A patient with chest pain is a candidate for thrombolytic therapy.How soon should this medication be provided to the patient?

Accepted Answer

For patients who are candidates for thrombolytic therapy,a "door to needle" interval of 30 minutes should be the goal.B.C.D.This time interval is too long to wait to provide the medication.

Question 9

The nurse is contributing to the plan of care for a patient experiencing chest pain for 7 hours.The laboratory tests reveal elevated troponin I and myoglobin levels.What action should the nurse take when caring for this patient? (Select all that apply.)

Accepted Answer

Rest and providing a bedpan for elimination will reduce the strain on the heart.A.B.D.Elevating the head of the bed,encouraging ambulation,and offering a regular diet with hot tea would increase strain on the heart.

Question 10

A patient scheduled for a carotid endarterectomy asks what is going to happen in the procedure.What should the nurse explain to the patient?

Accepted Answer

An endarterectomy is commonly performed on the carotid artery.The artery is clamped on both sides of the occlusion,and an incision is made into the artery.The plaque is removed with forceps.A.This procedure has not changed.C.A carotid endarterectomy is not performed on heart vessels.D.This explains a cardiac catheterization.

Question 11

The nurse is caring for a patient with a cardiac history.Which actions should the nurse take when administering diltiazem (Cardizem)? (Select all that apply.)

Accepted Answer

Monitoring for constipation,monitoring laboratory values on liver and renal function,notifying the physician of a slow heart rate and low blood pressure,and measuring apical pulse and blood pressure before administration are all actions that should be performed when administering this medication.B.A round face is associated with steroid administration.

Question 12

During a home visit,the nurse is reinforcing teaching provided about nitroglycerin therapy.Which patient statement about the supply indicates that teaching has been effective?

Accepted Answer

Nitroglycerin needs to be replaced every 6 months.A.B.The supply does not need to be replaced every 2 or 4 months.D.The supply needs to be replaced before 10 months.

Question 13

A patient with low back pain is returning from an abdominal computed tomography (CT)scan that revealed an aortic aneurysm.For which finding should the nurse immediately intervene?

Accepted Answer

Severe,sudden back,flank,or abdominal pain and a pulsating abdominal mass can indicate an aneurysm may be about to rupture.C.A sense of abdominal fullness is not associated with an abdominal aneurysm or impending rupture.B.The patient's blood pressure is stable with normal variability.D.Hypertension and heredity may play a role in the development of an abdominal aneurysm,but this is not the priority.

Question 14

The nurse is participating in the preparation of a seminar on coronary heart disease for a group of community members.What should modifiable risk factors for atherosclerosis should the nurse include in this presentation? (Select all that apply.)

Accepted Answer

Hypertension,diabetes mellitus,and increased iron and homocysteine levels can be modified.A.D.Ethnic group and hereditary health problems cannot be modified.

Question 15

A patient reports that chest pain started at 2 pm.The nurse realizes that for thrombolytic treatment to be most effective in dissolving a blood clot,it should be given by:

Accepted Answer

For thrombolytic treatment to be most effective in dissolving a blood clot,it should be given within 6 hours of the onset of symptoms or for this patient,by 8 pm.B.C.D.Medication given at these times would not be the most effective to dissolve the clot.

Question 16

The nurse determines that a patient recovering from an acute MI is experiencing activity intolerance.What findings did the nurse use to come to this conclusion? (Select all that apply.)

Accepted Answer

Abnormal responses to activity include heart rate over 120 bpm or 20 beats over resting rate,systolic BP increased over 20 mm Hg during activity,chest pain,dizziness,skin color changes,diaphoresis,dyspnea,dysrhythmias,excessive fatigue,and ST-segment changes on ECG.C.Nausea and vomiting are not manifestations of activity intolerance.

Question 17

The nurse is reinforcing teaching provided to a patient with Buerger's disease on the most important modifiable risk factor.Which risk factor should the patient state that indicates teaching has been effective?

Accepted Answer

Heavy cigarette smoking is a major contributing factor to Buerger's disease.Some studies indicate an autoimmune response to tobacco products as a possible cause.A.C.D.The most important modifiable risk factor for this disease is not diet,sedentary lifestyle,or exposure to cold temperatures.

Question 18

The nurse is caring for a patient who has long-standing asthma and stable angina.Which medication can the nurse safely provide to the patient?

Accepted Answer

With asthma or chronic obstructive pulmonary disease,nonselective beta-adrenergic blockers are avoided due to bronchoconstriction.Metoprolol and Atenolol are more cardioselective and are used with asthma.A.B.D.The nurse should question before administering these medications.

Question 19

The nurse is preparing to apply a nitroglycerin patch to a patient with stable angina.What actions should the nurse take when providing this medication? (Select all that apply.)

Accepted Answer

When applying transdermal nitroglycerin,the nurse should wear gloves to protect against hypotension from touching the ointment or patch medication.Always remove the prior ointment or patch before applying a new one to prevent overdose.A.The patch does not need to be applied before breakfast.C.The patient does not need to rest for 1 hour after applying the new patch.E.The new patch is not to be applied 30 minutes before removing the old patch.

Quiz 24: Nursing Care of Patients With Occlusive Cardiovascular Disorders