ACS HESI Questions
A client is admitted to the cardiac care unit with an anterior lateral myocardial infarction. The healthcare provider prescribes 500 mL of D5W with 50 mg of nitroglycerin to be administered intravenously to relieve pain. The nurse should assess for which most common side effect of this medication? 1 Nausea 2 Syncope 3 Bradycardia 4 Hypotension
ANS 4
A client is admitted with chest pain unrelieved by nitroglycerin, an elevated temperature, decreased blood pressure, and diaphoresis. A myocardial infarction is diagnosed. Which should the nurse consider as a valid reason for one of this client's physiologic responses? 1 Parasympathetic reflexes from the infarcted myocardium cause diaphoresis. 2 Inflammation in the myocardium causes a rise in the systemic body temperature. 3 Catecholamines released at the site of the infarction cause intermittent localized pain. 4 Constriction of central and peripheral blood vessels causes a decrease in blood pressure.
ANS 2
A nurse is preparing to teach a client to apply a nitroglycerin patch as prophylaxis for angina. Which instruction should the nurse include in the teaching plan? 1 Apply the patch on a distal extremity. 2 Remove a previous patch before applying the next one. 3 Massage the area gently after applying the patch to the skin. 4 Apply a warm compress to the site before attaching the patch.
ANS 2
A client is admitted to the hospital with the diagnosis of myocardial infarction. The nurse should monitor this client for which signs and symptoms associated with heart failure? Select all that apply. 1 Weight loss 2 Unusual fatigue 3 Dependent edema 4 Nocturnal dyspnea 5 Increased urinary output
ANS 234
What are the clinical manifestations of myocardial infarction in women? Select all that apply. 1 Anoxia 2 Indigestion 3 Unusual fatigue 4 Sleep disturbances 5 Tightness of the chest
ANS 234
A client admitted to the hospital for chest pain is diagnosed with stable angina. Which information should the nurse include in the teaching session? 1 It is relieved by rest. 2 It is precipitated by light activity. 3 It is described as sharp or knifelike. 4 It is unaffected by the administration of vasodilators.
ANS 1
A client is admitted to the emergency department with crushing chest pain. A diagnosis of acute coronary syndrome is suspected. The nurse expects that the client's initial treatment will include which medication? 1 Aspirin 2 Midazolam 3 Gabapentin 4 Alprazolam
ANS 1
A client is admitted to the hospital with chest pain and a diagnosis of myocardial infarction. How would the nurse expect the client to describe the chest pain? 1 Severe, intense 2 Burning and of short duration 3 Mild, radiating toward the abdomen 4 Squeezing, relieved by nitroglycerin
ANS 1
A client is scheduled to have a coronary artery bypass graft (CABG). The client's spouse asks what the benefit of the surgery is. How should the nurse respond? 1 "This surgery significantly decreases symptoms in most clients." 2 "This procedure will enable your spouse to return to work after healing occurs." 3 "Studies have consistently shown that this surgery increases an individual's life span." 4 "Evidence substantiates that surgery can prevent progression of coronary artery disease."
ANS 1
A client with a history of coronary artery disease is admitted with pneumonia. The healthcare provider prescribes atenolol. What should the nurse monitor to determine the therapeutic effect of atenolol? 1 Heart rate 2 Respirations 3 Temperature 4 Pulse oximetry
ANS 1
A client with a history of heart disease has been receiving a calcium channel blocker and morphine sulfate for pain from abdominal surgery. When getting the client out of bed, the nurse first should have the client sit on the edge of the bed with feet on the floor. What untoward client response can be prevented by this nursing action? 1 Abdominal pain 2 Respiratory distress 3 Sudden hemorrhage 4 Postural hypotension
ANS 4
When a client has a myocardial infarction, one of the major manifestations is a decrease in the conductive energy provided to the heart. When assessing this client, the nurse is aware that the existing action potential is in direct relationship to what? 1 Heart rate 2 Refractory period 3 Pulmonary pressure 4 Strength of contraction
ANS 4
A healthcare provider prescribes morphine for a client being treated for myocardial infarction. What physiologic response will occur if the client experiences the intended therapeutic effect of morphine? 1 Increased respiratory rate 2 Decreased workload of the heart 3 Reduced size of the clot blocking the coronary artery 4 Diminished metabolites within the ischemic heart muscle
ANS 2
A client who had a myocardial infarction receives a prescription for a nitroglycerin patch. What does the nurse identify as the purpose of the nitroglycerin patch? 1 Decreased heart rate lowers cardiac output. 2 Increased cardiac output increases oxygen demand. 3 Decreased cardiac preload reduces cardiac workload. 4 Peripheral venous and arterial constriction increases peripheral resistance
ANS 3
A client who has had an uncomplicated myocardial infarction asks the nurse about the resumption of sexual activity. Which physical parameters should the nurse consider to determine the safe resumption of sexual activity? 1 When the client and partner are not fearful of sexual intimacy 2 When the client feels emotionally ready to resume sexual activity 3 The point at which two flights of stairs can be climbed without dyspnea 4 Laboratory data showing that enzyme results have returned to preinfarction levels
ANS 3
A client with a coronary occlusion is experiencing chest pain and distress. Why does the nurse administer oxygen? 1 To prevent dyspnea 2 To prevent cyanosis 3 To increase oxygen concentration to heart cells 4 To increase oxygen tension in the circulating blood
ANS 3
A client with an inferior myocardial infarction has a heart rate of 120 beats per minute. Which goal achievements are priority? 1 Increase left ventricular filling and improve cardiac output 2 Decrease oxygen needs of the vital organs and prevent cardiac dysrhythmias 3 Decrease the workload on the heart and promote maximum coronary artery filling 4 Increase venous return to the right atrium and increase pulmonary arterial blood flow
ANS 3
The nurse provides discharge teaching to a client with a history of angina. The nurse instructs the client to call for emergency services immediately if the client's pain exhibits which characteristic? 1 Causes mild perspiration 2 Occurs after moderate exercise 3 Continues after rest and nitroglycerin 4 Precipitates discomfort in the arms and jaw
ANS 3
A nurse is teaching a health class about heart disease to older adult women. The nurse discusses the most common prodromal symptom reported by women with acute coronary heart disease that usually is not experienced by men. Which response indicates a woman in the group understands the teaching? 1 Unusual fatigue 2 Shortness of breath 3 Crushing pain in the chest 4 Substernal pressure radiating to the neck
ANS 1
Serum cardiac marker studies are prescribed for a client after a myocardial infarction. Which laboratory test is most important for the nurse to monitor? 1 Troponin 2 Myoglobin 3 Homocysteine 4 Creatine kinase (CK)
ANS 1
While instructing a community group regarding risk factors for coronary artery disease, the nurse provides a list of risk factors that cannot be modified. What should be included on the list? 1 Heredity 2 Hypertension 3 Cigarette smoking 4 Diabetes mellitus
ANS 1
A client admitted with a myocardial infarction is prescribed docusate and morphine and takes digoxin and fluoxetine at home. Which drug should the nurse recognize as a risk factor for straining due to constipation? 1 Digoxin 2 Morphine 3 Docusate 4 Fluoxetine
ANS 2
A client arrives at the emergency room complaining of chest pain and dizziness. The client has a history of angina. The primary healthcare provider prescribes an electrocardiogram (ECG) and lab tests. A change in which component of the ECG tracing should the nurse recognize as the client actively having a myocardial infarction (MI)? 1 QRS complex 2 S-T segment 3 P wave 4 R wave
ANS 2
A client presents to the emergency department with symptoms of acute myocardial infarction (MI). Which results will the nurse expect to find upon assessment? 1 Decreased breath sounds 2 Elevated serum troponin I 3 Decreased creatine kinase-MB (CK-MB) 4 Elevated brain natriuretic peptide (BNP) level
ANS 2