Management of Patients With Coronary Vascular Disorders
35.) A nurse is working with a patient who has been scheduled for a percutaneous coronary intervention (PCI) later in the week. What anticipatory guidance should the nurse provide to the patient?
- A sheath will be placed over the insertion site after the procedure is finished
38.) The nurse providing care for a patient post PTCA knows to monitor the patient closely For what complications should the nurse monitor the patient? Select all that apply.
- Abrupt closure of the coronary artery - Bleeding at the insertion site - Retroperitoneal bleeding - Arterial occlusion
30.) The nurse is creating a plan of care for a patient with acute coronary syndrome. What nursing action should be included in the patients care plan?
- Administer supplementary oxygen, as needed
25.) You are writing a care plan for a patient who has been diagnosed with angina pectoris. The patient describes herself as being distressed and shocked by her new diagnosis. What nursing diagnosis is most clearly suggested by the woman statement?
- Anxiety related to cardiac symptoms
31.) The nurse is participating in the care conference for a patient with ACS. What goal should guide the care teams selection of assessments, interventions, and treatments?
- Balancing myocardial oxygen supply with demand
13.) A 48-year0old man presents to the ED complaining of severe substernal chest pain radiating down his left arm. He is admitted to the coronary care unit (CCU) with a diagnosis of myocardial infarction (MI). What nursing assessment activity is a priority on admission to the CCU?
- Begin ECG monitoring
7.) A patient with an occluded coronary artery is admitted and has an emergency percutaneous transluminal coronary angioplasty (PTCA). The patient is admitted to the cardiac critical care unit after the PTCA. For what complication should the nurse most closely monitor the patient?
- Bleeding at the insertion site
37.) A patient in the cardiac step-down unit has begun bleeding from the percutaneous coronary intervention (PCI) access site in her femoral region. What is the nurses most appropriate action?
- Call for help and apply pressure to the access site
9.) The OR nurse is explaining to the patient that cardiac surgery requires the absence of blood from the surgical field. At the sad time, it is imperative to maintain perfusion of body organs and tissues. What technique for achieving these simultaneous goals should the nurse describe?
- Cardiopulmonary bypass
34.) A nurse has taken on the care of a patient who had a coronary artery stent placed yesterday. When reviewing the patients daily mediations administration record, the nurse should anticipate administering what drug?
- Clopidogrel
39.) A patient who is postoperative day 1 following a CABG has produced 20 mL urine in the past 3 hours and he nurse has confirmed the potency of the urinary catheter. What is the nurses most appropriate action?
- Contact the patients physician and suggest assessment of fluid balance and renal function
2.) A patient presents to the walk-in clinic complaining of intermittent chest pain on exertion, which is eventually attributed to angina. The nurse should inform the patient that angina is most often attributable to what cause?
- Coronary arteriosclerosis
14.) The public health nurse is participating in a health fir and interviews a patient with a history of hypertension, who is currently smoking one pack of cigarettes per day. She denies any of the most common manifestations of CAD. Based on these data, the nurse would expect the focuses of CAD treatment most likely to be which of the following?
- Diet therapy and smoking cessation
32.) The nurse working on the coronary care unit is caring for a patient with ACS. How can the nurse best meet the patients psychosocial needs?
- Directly address the patients anxieties and fears
29.) The nurse is assessing a patient with acute coronary syndrome (ACS). The nurse includes a careful history in the assessment, especially with regard to signs and symptoms. What signs and symptoms are suggestive of ACS? Select all that apply.
- Dyspnea - Unusual Fatigue - Syncope
18.) When discussing angina pectoris secondary to atherosclerotic disease with a patient, the patient asks why he tends to experience chest pain when he exerts himself. The nurse should describe which of the following phenomena?
- Exercise increases the heart oxygen demands
10.) The nurse has just admitted a 66-year-old patient for cardiac surgery. The patient tearfully admits to the nurse that she is afraid of dying while undergoing the surgery. What is the nurse best response?
- Explore the factors underlying that patients anxiety
6.) A OR nurse is preparing to assist with a coronary artery bypass graft (CABG). The OR nurse knows that the vessel most commonly used as source for a CABG is what?
- Greater saphenous vein
22.) In preparation for cardiac surgery, a patient was taught about measures to prevent venous thromboembolism. What statement indicates that the patient clearly understood this education?
- I'll make sure that I don't cross my legs when I'm resting in bed
33.) The nurse is caring for a patient who has undergone percutaneous trans luminal coronary angioplasty (PTCA). What is the major indicator of success for this procedure?
- Increase in the size of the arteries lumen
3.) The nurse is caring for an adult patient who had symptoms of unstable angina upon admission to the hospital. What nursing diagnosis underlies the discomfort associated with angina?
- Ineffective cardiopulmonary tissue perfusion related to coronary artery disease
21.) The nurse is assessing a patient who was admitted to the critical care unit 3 hours ago following cardiac surgery. The nurses most recent assessment reveals that the patients left pedal pulses are not palpable and that the right pedal pulses are rated +2. What is the nurses best response?
- Inform the patients physician of this assessment finding
36.) Preoperative education is an important part of the nursing care of patients having coronary artery revascularization. When explaining the pre- and postoperative regimens, the nurse would be sure to include education about which subject?
- Intubation and mechanical ventilation
4.) The triage nurse in the ED assesses a 66-year-old male patient who presents to the ED with complaints of midsternal chest pain that has lasted for 5 hours. If the patients symptoms are due to an MI, what will have happened to the myocardium?
- It my have developed an increased area of infarction during the time without treatment.
1.) The nurse is caring for a patient who has been diagnosed with an elevated cholesterol level. The nurse is aware that plaque on the inner lumen or arteries is composed chiefly of what?
- Lipids and fibrous tissues
17.) The nurse is providing are for a patient with high cholesterol and triglyceride values. In teaching the patient about therapeutic lifestyle changes such as diet and exercise, the nurse realize that the desired goal for cholesterol levels is which of the following?
- Low LDL values and high HDL values
28.) The ED nurse is caring for a patient with a suspected MI. What drug should the nurse anticipate administering to this patient?
- Morphine
20.) An adult patient is admitted to the ED with chest pain. The patient states that he had developed unrelieved chest pain that was present for approximately 20 minutes before coming to the hospital. To minimize cardiac damage, the nurse should expect to administer which of the following interventions?
- Morphine sulphate, oxygen, and bed rest
23.) An ED nurse is assessing an adult woman for suspected MI. When planning the assessment, the nurse should be cognizant of what signs and symptoms of MI that are particularly common in female patients?
- Numbness - Weakness
12.) The nurse is providing an educational workshop about coronary artery disease (CAD) and its risk factors. The nurse explains to participants that CAD has many risk factors, some that can be controlled and some that can not. What risk factors would the nurse list that can be controlled or modified?
- Obesity, inactivity, diet, and smoking
40.) A patient is recovering in the hospital from cardiac surgery. The nurse has identified the diagnosis of risk for ineffective airway clearance related to pulmonary secretions. What interventions best addresses this risk?
- Patients consistent performance of deep breathing and coughing exercises
26.) The nurse is caring for patient who tells the nurse that he has an angina attack beginning. What is the nurses most appropriate initial action?
- Place the patient on the bed rest in the semi-Fowler's portion
27.) A patient presents to the ED in distress and complaining of crashing chest pin. What is the nurses priority for assessment?
- Prompt initiation of an ECG
16.) A patient with cardiovascular disease is being treated with amlodipine (Norvasc), a calcium channel blocking agent. The therapeutic effects of calcium channel blockers include which of the following?
- Reducing the hearts workload by decreasing heart rate and myocardial contraction
19.) The nurse is acting for a patient who is believed to have just experienced an MI. The nurse notes changes in the ECG of the patient. What change on an ECG most strongly suggests to the nurse that ischemia is occurring?
- T wave inversion
15.) The nurse is working with a patient who had an MI and is now active in rehabilitation. The nurse should teach this patient to cease activity if which of the following occurs?
- The patient experiences chest pain, palpitations, or dyspnea
24.) When assessing a patient diagnosed with angina pectoris it is most important for the nurse to gather what information?
- The patients symptoms and the activities that precipitate attacks
5.) Family members bring a patient to the ED with pale cool skin, sudden midsternal chest pain unrelieved with rest, and a history of CAD. How should the nurse best interpret these initial data?
- The symptoms indicate an acute coronary episode and should be treated as such
11.) A patient with angina has been prescribed nitroglycerin. Before administering the drug, the nurse should inform the patient about what potential adverse effects?
- throbbing headache and dizziness
8.) The nurse is caring for a patient who is scheduled for cardiac surgery. What should the nurse include in preoperative care?
- with the patient, clarify the surgical procedure that will be preformed
