Chapter 33 questions
a patient who has had chest pain for several hours is admitted with a diagnosis of rule out acute myocardial infarction (AMI). which lab test is most specific for the nurse to monitor in determining whether the patient has had an AMI?
cardiac-specific troponin
the nurse is administering a thrombolytic agent to a patient with an acute myocardial infarction. what patient data indicates that the nurse should stop the drug infusion?
decreased level of consciousness
diltiazem (Cardizem) is prescribed for a patient with newly diagnosed Prinzmetals (variant) angina. which action of diltiazem is accurate for the nurse to include in the teaching plan?
decreases coronary artery spasms
to improve the physical activity level for a mildly obese 68 year old patient, which action should the nurse plan to take?
determine what kind of physical activities the patient usually enjoys
a patient who has chest pain is admitted to the ED and all of the following items are prescribed. which one should the nurse arrange to be completed first?
electrocardiogram (ECG)
the nurse is developing a teaching plan for a 64 year old patient with coronary artery disease. which factor should the nurse focus on during the teaching session?
elevated low-density lipoprotein (LDL) level
a patient who has recently started taking pravastatin (Pravachol) and niacin reports several symptoms to the nurse. which info is most important to communicate to the health care provider?
generalized muscle aches and pains
a patient with hyperlipidemia has a new order for colesevelam (Welchol). which nursing action is appropriate when scheduling this medication?
give the patients other medications 2 hours after colesevelam
the nurse is caring for a patient who has just arrived on the tele unit after having cardiac catherization. what task should the nurse delegate to a liscensed practial/vocational nurse (LPN/VN)
give the scheduled aspirin and lipid-lowering medication
a patient who has recently had an acute myocardial infarction (AMI) ambulates in the hospital hallway. which data would indicate to the nurse that the patient should stop and rest?
heart rate increases from 66 to 98 beats/min
which nursing intervention is likely to be most effective when assisting the patient with coronary artery disease to make appropriate dietary changes?
help the patient modify favorite high-fat recepies by using monounsaturated oils
Heparin is ordered for a patient with a non-ST-segment-elevation myocardial infarction (NSTEMI). What is the purpose of the heparin?
heparin prevents the development of new clots in the coronary arteries
which patient statement indicates that the nurses teaching about sublingual nitroglycerin has been effective?
i will call an ambulance if i have pain after taking 3 nitroglycerin 5 minutes apart
which statement made by a patient with coronary artery disease after the nurse has completed teaching about the therapeutic lifestyle changes (TLC) diet indicates that further teaching is needed?
i will miss being able to eat peanut butter sandwiches
which patient statement indicates that the nurse's teaching about carvedilol (Coreg) for preventing anginal episodes has been effective?
it is important not to suddenly stop taking carvedilol
which info about a patient recieving thrombolytic therapy for an acute myocardial infarction is most important for the nurse to communicate to the health care provider?
no change in patients reported level of chest pain
which assessment finding in a patient who has had coronary artery bypass grafting using a right radial artery graft is most important for the nurse to communicate to the health care provider?
pallor and weakness of the right hand
Nadolol (Corgard) is prescribed for a patient with chronic stable angina and left ventricular dysfunction. what data would indicate to the nurse that the drug is effective
participation in daily activities without chest pain
Which patient at the cardiovascular clinic requires the most immediate action by the nurse?
patient with stable angina whose chest pain has recently increased in frequency
a patient with diabetes mellitus and chronic stable angina has a new order for captopril. what should the nurse teach this patient about the primary purpose of captopril?
prevents changes in heart muscles
A patient had a non-ST-segment-elevation myocardial infarction (NSTEMI) 3 days ago. Which nursing intervention included in the plan of care is appropriate for the registered nurse (RN) to delegate to an experienced licensed practical/vocational nurse (LPN/LVN)?
reinforcement of teaching about the prescribed medications
a patient with acute coronary syndrome has returned to the coronary care unit after having angioplasty with stent placement. which assessment data indicates the need for immediate action by the nurse?
report of chest pain
a patient who is recovering from an acute myocardial infarction (AMI) asks the nurse about safely resuming sexual intercourse. which response by the nurse is best?
sexual activity uses about as much energy as climbing two flights of stairs
a patient admitted to the coronary care unity (CCU) with an ST-segment elevation myocardial infarction (STEMI) is restless and anxious. the BP is 86/40 mmHg, and HR is 132 beats/min. based on this info, which patient problem is the priority?
stress management
which info from a patient helps the nurse confirm the previous diagnosis of chronic stable angina?
the pain goes away after a nitroglycerin tablet
the nurse is admitting a patient who has chest pain. which assessment data suggests that the pain is from an acute Myocardial infarction
the pain has lasted longer than 30 minutes
a patient with ST-segment elevation in three contiguous electrocardiographic leads is admitted to the ED and diagnosed with having an ST-segment-elevation myocardial infarction (STEMI). which question should the nurse ask to determine whether the patient is a candidate for thrombolytic therapy
what time did your pain begin
the nurse is caring for a patient who was admitted to the coronary care unit following an acute myocardial infarction (AMI) and percutaneous coronary intervention the previous day. what should teaching for this patient include today?
when cardiac rehabilitation will begin
the nurse is evaluating the effectiveness of preoperative teaching with a patient scheduled for coronary artery bypass graft (CABG) surgery using the internal mammary artery. which patient statement indicates that additional teaching is needed?
"I will have incisions in my leg where they will remove the vein"
in preparation for discharge, the nurse teaches a patient with chronic stable angina how to use the prescribed short-acting and long-acting nitrates. which patient statement indicates that the teaching has been effective?
"i will sit down before I put the nitroglycerin under my tongue"
After having a myocardial infarction (MI) and successful percutaneous coronary intervention, the patient states, "It was just a little chest pain. As soon as I get out of here, I'm going for my vacation as planned." Which reply would be most appropriate for the nurse to make?
"what do you think caused your chest pain?"
which data indicates to the nurse that the patient with stable angina is experiencing a side effect of metoprolol (Lopressor)?
BP is 90/54 mmHg
which electrocardiographic (ECG) change by a patient with chest pain is most important for the nurse to report rapidly to the HCP?
ST-segment elevation
a patient who is being admitted to the ED with intermittent chest pain gives the following list of daily medications to the nurse. which meds has the most immediate implications for the patients care?
Tadalafil (Cialas)
after recieving change of shift report about the following four patients on the cardiac care unit, which patient should the nurse assess first?
a 59 year old patient with unstable angina who has just returned after a percutaneous coronary intervention (PCI)
the nurse is caring for a patient who is recovering from a sudden cardiac death (SCD) event and has no evidence of an acute myocardial infarction (AMI). what should the nurse anticipate teaching the patient?
additional diagnostic testing will be required
which action will the nurse take to evaluate the effectiveness of IV nitroglycerin for a patient with a myocardial infarction (MI)?
ask about chest pain
when admitting a patient with a non-ST segment elevation myocardial infarction (NSTEMI) to the intensive care unit, which action should the nurse perform first?
attach the heart monitor
a patient recovering from a myocardial infarction (MI) develops chest pain on day 3 that increases when taking a deep breath and is relieved by leaning forward. which action should the nurse take as focused follow-up on this symptom?
auscultate for a pericardial friction rub
the nurse obtains the following data when assessing a patient who experienced an ST-segment elevation myocaridal infarction (STEMI) 2 days previously. which info is most important to report to the HCP?
bilateral crackles in the mid-lower lobes
