NURS 3100 MyLab Chapter 28
Which lifestyle behaviors should the nurse discuss with a client to help reduce their risk of coronary artery disease? Select all that apply. A. Abstinence from smoking B. Decrease stress C. Limit alcohol consumption D. Maintain optimal weight E. Limit sodium intake
A. Abstinence from smoking C. Limit alcohol consumption E. Limit sodium intake
Which prescriptions does the nurse anticipate to be included in the goal to reduce the post-MI mortality of a client? Select all that apply. A. Aspirin B. Beta blockers C. Narcotic analgesics D. ACE inhibitors E. Antidysrhythmics
A. Aspirin B. Beta blockers D. ACE inhibitors
Which should the nurse assess a client for prior to administering atenolol (Tenormin)? A. Blood pressure B. Pulse C. Respirations D. Oxygen saturation E. Temperature
A. Blood pressure
The nurse is preparing to administer nitroglycerine via the intravenous route. Which should the nurse do prior to the administration of the prescription? A. Cover the intravenous (IV) bottle to decrease light exposure. B. Use gloves to prevent self-administration. C. Darken the room to decrease light exposure. D. Instruct the client to avoid moving the arm in which the prescription is infusing.
A. Cover the intravenous (IV) bottle to decrease light exposure.
For which conditions should the nurse instruct a client to hold the application of nitroglycerin ointment and contact the healthcare provider? Select all that apply. A. Dyspnea B. Productive cough C. Headache D. Fever E. Confusion
A. Dyspnea B. Productive cough E. Confusion
Which adverse effect is common for clients prescribed topical nitroglycerin paste? A. Headache B. Ventricular tachycardia C. Rash D. Shortness of breath
A. Headache
Which information should the nurse include when educating a client about coronary artery disease? Select all that apply. A. Plaque causes narrowing of the artery B. Plaque begins to accrue early in life C. Plaque causes narrowing of the veins D. Plaque affects the elasticity of the artery E. Plaque builds up in the myocardial tissue
A. Plaque causes narrowing of the artery B. Plaque begins to accrue early in life D. Plaque affects the elasticity of the artery
Which statements by the client are specifically associated with unstable angina? Select all that apply. A. "My chest has started hurting even if I am just watching television." B. "My chest starts hurting if I climb one set of stairs." C. "My attacks of chest pain are coming more frequently now." D. "The pain occurs most often after I eat a meal." E. "The pain is worse than it used to be."
A. "My chest has started hurting even if I am just watching television." C. "My attacks of chest pain are coming more frequently now." E. "The pain is worse than it used to be."
The nurse is reviewing the myocardial blood supply for a client with coronary artery disease (CAD). Which statements made by the client indicate an understanding of the information? Select all that apply. A. "The heart has right and left arteries that arise from the aorta." B. "The coronary arteries carry blood away from the heart to the right atrium." C. "The heart receives its oxygen through the blood that fills it." D. "Coronary arteries primarily carry blood to the left ventricle." E. "The right and left arteries have smaller branches that go around the heart."
A. "The heart has right and left arteries that arise from the aorta." E. "The right and left arteries have smaller branches that go around the heart."
Which prescription is indicated for the prevention of blood clots? A. Reteplase (Retavase) B. Abciximab (ReoPro) C. Morphine D. Captopril (Capoten)
B. Abciximab (ReoPro)
A client experiencing bradycardia is suspected of overdosing on diltiazem (Cardizem). Which treatment should the nurse anticipate prescribed? A. Narcan B. Atropine C. Dopamine D. Calcium chloride
B. Atropine
Which mechanism of action does beta-adrenergic agonists have on the cardiovascular system? A. Increase cardiac output B. Dilate arterial smooth muscle C. Dilate venous system D. Decrease the contractility of the heart
B. Dilate arterial smooth muscle
Which conditions is the use of thrombolytic therapy contraindicated in? Select all that apply. A. Venous emboli B. History of intracranial hemorrhage C. Hemophilia D. Liver disease E. Peptic ulcer disease
B. History of intracranial hemorrhage C. Hemophilia D. Liver disease E. Peptic ulcer disease
Which is the primary pharmacologic goal in the treatment of a client experiencing stable angina? A. Eliminate blockages by using thrombolytics. B. Increase cardiac oxygen supply and reduce cardiac oxygen demand. C. Establish a regular exercise program and diet plan. D. Increase venous blood flow to the right atrium.
B. Increase cardiac oxygen supply and reduce cardiac oxygen demand.
Which information should the nurse include in the education for a client prescribed a transdermal nitroglycerin patch? Select all that apply. A. Place the patch on the upper arm or leg. B. Rotate sites of application. C. Remove the patch for an hour each day. D. Cleanse the skin under the patch after removal. E. Triple wrap the patch in plastic wrap for disposal.
B. Rotate sites of application. D. Cleanse the skin under the patch after removal.
Which information should the nurse include in the education for a client prescribed antianginal therapy? Select all that apply. A. The prescriptions increase the heart rate. B. The prescriptions dilate the veins so that the heart receives less blood. C. The prescriptions cause the heart to contract with less force. D. The prescriptions increase blood pressure. E. The prescriptions increase the ability of the body to produce red blood cells.
B. The prescriptions dilate the veins so that the heart receives less blood. C. The prescriptions cause the heart to contract with less force.
A client asks the nurse if angina is the same thing as having a heart attack. Which response should the nurse provide? A. "They are basically the same." B. "Angina means heart muscle is not getting enough oxygen, while heart attack, or myocardial infarction, means part of your heart has died." C. "Actually, it depends on what type of angina you mean; there are several types." D. "They have some things in common, for example, severe emotional distress and panic can accompany both angina and myocardial infarction."
B. "Angina means heart muscle is not getting enough oxygen, while heart attack, or myocardial infarction, means part of your heart has died."
A client receiving diltiazem (Cardizem) asks the nurse why they get a headache after taking the prescription. Which response should the nurse provide the client? A. "Diltiazem (Cardizem) causes the blood vessels in your brain to narrow, giving you the headache." B. "Diltiazem (Cardizem) causes the blood vessels in your brain to widen, giving you the headache." C. "Diltiazem (Cardizem) increases prostaglandin synthesis, giving you the headache." D. "Diltiazem (Cardizem) releases Substance P, activating pain receptors in your brain and giving you the headache."
B. "Diltiazem (Cardizem) causes the blood vessels in your brain to widen, giving you the headache."
A client post-acute myocardial infarction asks the nurse why they are prescribed reteplase (Retavase) intravenously (IV). Which response should the nurse provide the client? A. "The prescription dilates the arteries in the heart so it can get more oxygen." B. "The prescription is dissolving the clot that has caused your heart attack." C. "The prescription thins your blood so more clots will not develop." D. "The prescription will increase the strength of the muscles in the heart during each beat."
B. "The prescription is dissolving the clot that has caused your heart attack."
Which prescriptions reduce the heart's demand for oxygen by lowering heart rate? A. Organic nitrates and calcium channel blockers B. Beta-adrenergic blockers and calcium channel blockers C. Calcium channel blockers and anticoagulants D. Anticoagulants and beta-adrenergic blockers
B. Beta-adrenergic blockers and calcium channel blockers
Which is a priority assessment for the client receiving reteplase (Retavase) intravenously? A. Fluid balance B. Respiratory rate C. Abnormal bleeding D. Blood glucose
C. Abnormal bleeding
Which symptom is most likely to be related to angina as opposed to a myocardial infarction? A. Chest pain accompanied by shortness of breath B. Chest pain that occurred while the patient was eating breakfast C. Chest pain relieved by one sublingual nitroglycerin D. Chest pain that radiates to the patient's back
C. Chest pain relieved by one sublingual nitroglycerin
A client asks which conditions will cause the heart to need more oxygen. Which information should the nurse be prepared to discuss? A. Hyperthyroidism B. Hepatitis B C. Sleep apnea D. Asthma
C. Sleep apnea
Which is the most sensitive and effective biomarker of a myocardial infarction? A. White blood cells B. Myoglobin C. Troponin D. Creatine kinase
C. Troponin
The nurse has completed the education for a client with angina prescribed nitroglycerine (Nitrostat). Which statement made by the client indicates further teaching is required? A. "If my pain is not reduced 5 minutes after taking one tablet I should call EMS." B. "I can take three tablets, one every 5 minutes." C. "I can take up to 5 tablets to resolve the chest pain." D. "I should take a tablet as soon as chest pain occurs."
C. "I can take up to 5 tablets to resolve the chest pain."
Which information about the primary therapeutic action of an antianginal prescription should the nurse include in client teaching? A. "This prescription increases the oxygen to your heart by increasing nitric oxide production." B. "This prescription will thin your blood so your heart receives more oxygen." C. "The prescription decreases how much oxygen your heart needs." D. "This prescription increases the amount of oxygen your heart receives."
C. "The prescription decreases how much oxygen your heart needs."
Which client should the nurse anticipate a prescription for reteplase (Retavase) therapy post myocardial infarction? A. A 45-year-old female with a 2-week-old cranial artery repair B. A 62-year-old with a recent hemorrhagic stroke C. A 70-year-old male with active GI bleed D. A 54-year-old female with type 2 diabetes
D. A 54-year-old female with type 2 diabetes
Which are the goals of antianginal therapy? Select all that apply. A. Decreased oxygen consumption of the brain. B. Increased myocardial contractility. C. Increased blood flow to the peripheral blood vessels. D. Increased blood flow to the myocardium. E. Decreased myocardial oxygen demand.
D. Increased blood flow to the myocardium. E. Decreased myocardial oxygen demand.
Which is the primary desired outcome for a client that has experienced several episodes of angina? A. The client will experience relief of chest pain with anticoagulant therapy. B. The client will experience relief of chest pain with aspirin therapy. C. The client will experience relief of chest pain with therapeutic lifestyle changes. D. The client will experience relief of chest pain with nitrate therapy.
D. The client will experience relief of chest pain with nitrate therapy.
Which statement by the client receiving nitroglycerine (Nitrostat) should the nurse be concerned about? A. "My angina has been a little more frequent I would like something to take for the pain." B. "I really don't like taking those little pills, I would like to use a patch." C. "I'm going water skiing tomorrow; I hope my angina isn't a problem." D. "I'm getting married tomorrow; I hope my erectile dysfunction isn't a problem."
D. "I'm getting married tomorrow; I hope my erectile dysfunction isn't a problem."