Chapter 23: Management of Patients with Coronary Vascular Disorders

Which is the most important postoperative assessment parameter for a client recovering from cardiac surgery? Blood glucose concentration Mental alertness Activity intolerance Inadequate tissue perfusion

Inadequate tissue perfusion

The nurse notes that the post cardiac surgery client demonstrates low urine output (< 25 mL/hr) with high specific gravity (> 1.025). What will the nurse anticipate the health care provider will order? Prepare the client for dialysis Increase intravenous fluids Decrease intravenous fluids Irrigate the urinary catheter

Increase intravenous fluids

A nurse is reevaluating a client receiving IV fibrinolytic therapy. Which finding requires immediate intervention by the nurse? Altered level of consciousness Minimal oozing of blood from the IV site Chest pain 2 of 10 (on a 1-to-10 pain scale) Presence of reperfusion dysrhythmias

Altered level of consciousness

Which method to induce hemostasis after sheath removal after percutaneous transluminal coronary angioplasty (PTCA) is most effective? Direct manual pressure Application of a vascular closure device such as Angio-Seal or VasoSeal Application of a sandbag to the area Application of a pneumatic compression device (e.g., FemoStop)

Application of a vascular closure device such as Angio-Seal or VasoSeal

A nurse is caring for a client who is recovering from a myocardial infarction (MI). The cardiologist refers the client to cardiac rehabilitation. Which statement by the client indicates an understanding of cardiac rehabilitation? "When I finish the rehabilitation program I'll never have to worry about heart trouble again." "I'll get rest during these rehabilitation classes. All I have to do is sit and listen to the instructor." "Rehabilitation will help me function as well as I physically can.

"Rehabilitation will help me function as well as I physically can."

A client with angina pectoris must learn how to reduce risk factors that exacerbate this condition. When developing the client's care plan, which expected outcome should a nurse include? "Client will verbalize the intention to avoid exercise." "Client will verbalize an understanding of the need to restrict dietary fat, fiber, and cholesterol." "Client will verbalize an understanding of the need to call the physician if acute pain lasts more than 2 hours." "Client will verbalize the intention

"Client will verbalize the intention to stop smoking."

A client is ordered a nitroglycerine transdermal patch for treatment of CAD and asks the nurse why the patch is removed at bedtime. Which is the best response by the nurse? "Removing the patch at night prevents drug tolerance while keeping the benefits." "Contact dermatitis and skin irritations are common when the patch remains on all day." "You do not need the effects of nitroglycerine while you sleep." "Nitroglycerine causes headaches, but removing the patch decreases the inc

"Removing the patch at night prevents drug tolerance while keeping the benefits."

When providing discharge instructions for a client who has been prescribed sublingual nitroglycerin for angina, the nurse should plan to include which instructions? "Only take one nitroglycerin tablet for each episode of angina." "Place the nitroglycerin tablet between cheek and gum." "See if rest relieves the chest pain before using the nitroglycerin." "Call 911 if you develop a headache following nitroglycerin use."

"See if rest relieves the chest pain before using the nitroglycerin."

When assessing a client who reports recent chest pain, the nurse obtains a thorough history. Which client statement most strongly suggests angina pectoris? "The pain got worse when I took a deep breath." "The pain lasted about 45 minutes." "The pain occurred while I was mowing the lawn." "The pain resolved after I ate a sandwich."

"The pain occurred while I was mowing the lawn."

A client is prescribed a nitroglycerin transdermal patch to treat angina. Which statement doesthe nurse include when reinforcing medication teaching to the client prior to discharge? "The patch should be worn for 12 hours and then removed for 12 hours." "Skin irritation is common when the patch is worn for more than 12 hours." "The medication patch causes headaches so you should remove it daily." "You do not need the effects of nitroglycerine while you sleep."

"The patch should be worn for 12 hours and then removed for 12 hours."

A client had a percutaneous transluminal coronary angioplasty (PTCA). What medication will the nurse administer to prevent thrombus formation in the stent? Diltiazem Isosorbide mononitrate Metoprolol Clopidogrel

Clopidogrel

A client has just arrived in the ER with a possible myocardial infarction (MI). The electrocardiogram (ECG) should be obtained within which time frame of arrival to the ER? 5 minutes 10 minutes 20 minutes 15 minutes

10 minutes

A client presents to the emergency department reporting chest pain. Which order should the nurse complete first? Monitor intake and output 12-lead ECG Aspirin 325 mg orally Troponin level

12-lead ECG

The nurse is reviewing the results of a total cholesterol level for a client who has been taking simvastatin. What results display the effectiveness of the medication? 160-190 mg/dL 280-300 mg/dL 250-275 mg/dL 210-240 mg/dL

160-190 mg/dL

A client asks the nurse how long to wait after taking nitroglycerin before experiencing pain relief. What is the best answer by the nurse? 60 minutes 5 minutes 15 minutes 30 minutes

5 minutes

Following a percutaneous transluminal coronary angioplasty, a client is monitored in the postprocedure unit. The client's heparin infusion was stopped 2 hours earlier. There is no evidence of bleeding or hematoma at the insertion site, and the pressure device is removed. With regards to partial thromboplastin time (PTT), when should the nurse plan to remove the femoral sheath? 125 seconds or less. 50 seconds or less. 75 seconds or less. 100 seconds or less.

50 seconds or less.

The nurse provides care to a menopausal client, who states, "I read a news article that says I am at risk for coronary vascular disease due to inflammation." Which method should the nurse suggest to the client to aid in the prevention of inflammation that can lead to atherosclerosis? Drinking at least 2 liters of water a day Avoiding use of caffeine Taking a daily multivitamin Addressing obesity

Addressing obesity

A client in the emergency department reports squeezing substernal pain that radiates to the left shoulder and jaw. The client also reports nausea, diaphoresis, and shortness of breath. What is the nurse's priority action? Complete the client's registration information, perform an electrocardiogram, gain I.V. access, and take vital signs. Gain I.V. access, give sublingual nitroglycerin, and alert the cardiac catheterization team. Administer oxygen, attach a cardiac monitor, and notify the heal

Administer oxygen, attach a cardiac monitor, take vital signs, and alert the cardiac catheterization team

After percutaneous transluminal coronary angioplasty (PTCA), the nurse confirms that a client is experiencing bleeding from the femoral site. What will be the nurse's initial action? Review the results of the latest blood cell count, especially the hemoglobin and hematocrit. Apply manual pressure at the site of the insertion of the sheath. Notify the health care provider. Decrease anticoagulant or antiplatelet therapy.

Apply manual pressure at the site of the insertion of the sheath.

The client asks the nurse to explain the difference between arteriosclerosis and atherosclerosis. Which is the best explanation the nurse can give to the client? "Arteriosclerosis is when the vessels become dilated and weakened, whereas atherosclerosis is the deposit of fatty substances in the vessel lining." "Both terms refer to the same disorder and can be used interchangeably." "Arteriosclerosis is a loss of elasticity of the arteries that accompanies the aging process, whereas athe

Arteriosclerosis is a loss of elasticity of the arteries that accompanies the aging process, whereas atherosclerosis is a condition in which the arteries fill with plaque."

An older adult is postoperative day one, following a coronary artery bypass graft (CABG). The client's family members express concern to the nurse that the client is uncharacteristically confused. After reporting this change in status to the health care provider, what additional action should the nurse take? Assess for factors that may be causing the client's delirium. Educate the family about how confusion is expected in older adults postoperatively. Document the early signs of dementia and e

Assess for factors that may be causing the client's delirium.

Which medication is given to clients who are diagnosed with angina but are allergic to aspirin? Clopidogrel Diltiazem Amlodipine Felodipine

Clopidogrel

A client has recently undergone a coronary artery bypass graft (CABG). The nurse should be alert to which respiratory complication? Hyperkalemia Urinary tract infection (UTI) Atelectasis Elevated blood glucose level

Atelectasis

A client is receiving nitroglycerin ointment to treat angina pectoris. The nurse evaluates the therapeutic effectiveness of this drug by assessing the client's response and checking for adverse effects. Which vital sign is most likely to reflect an adverse effect of nitroglycerin? Respiration 26 breaths/minute Pulse rate of 84 beats/minute Temperature of 100.2° F (37.9° C) Blood pressure 84/52 mm Hg

Blood pressure 84/52 mm Hg

Which is a diagnostic marker for inflammation of vascular endothelium? Triglyceride High-density lipoprotein (HDL) Low-density lipoprotein (LDL) C-reactive protein (CRP)

C-reactive protein (CRP)

A patient has had cardiac surgery and is being monitored in the intensive care unit (ICU). What complication should the nurse monitor for that is associated with an alteration in preload? Hypertension Cardiac tamponade Elevated central venous pressure Hypothermia

Cardiac tamponade

Which complication of cardiac surgery occurs when fluid and clots accumulate in the pericardial sac, which compresses the heart, preventing blood from filling the ventricles? Cardiac tamponade Hypertension Fluid overload Hypothermia

Cardiac tamponade

A client with chest pain arrives in the emergency department and receives nitroglycerin, morphine, oxygen, and aspirin. The health care provider diagnoses acute coronary syndrome. When the client arrives on the unit, vital signs are stable and the client does not report any pain. In addition to the medications already given, which medication does the nurse expect the health care provider to order? Digoxin Carvedilol Furosemide Nitroprusside

Carvedilol

The nurse is assisting with a bronchoscopy at the bedside in a critical care unit. The client experiences a vasovagal response. What should the nurse do next? Check blood pressure. Suction the airway. Prepare to administer intravenous fluids. Assess pupils for reactiveness.

Check blood pressure.

A middle-aged client presents to the ED reporting severe chest discomfort. Which finding is most indicative of a possible myocardial infarction (MI)? Cool, clammy skin and a diaphoretic, pale appearance Anxiousness, restlessness, and lightheadedness Intermittent nausea and emesis for 3 days Chest discomfort not relieved by rest or nitroglycerin

Chest discomfort not relieved by rest or nitroglycerin

A client is admitted for treatment of Prinzmetal angina. When developing this client's care plan, the nurse should keep in mind that this type of angina is a result of what trigger? Coronary artery spasm. The same type of activity that caused previous angina episodes. An unpredictable amount of activity. Activities that increase myocardial oxygen demand.

Coronary artery spasm.

The nurse is to administer morphine sulfate to a client with chest pain. What initial nursing action is required prior to administration? Count the respiratory rate for bradypnea. Check the radial pulse for dysrhythmias. Measure the blood pressure for hypertension. Measure urinary output for dehydration

Count the respiratory rate for bradypnea.

A nurse is caring for a client who experienced an MI. The client is ordered to receive metoprolol. The nurse understands that this medication has which therapeutic effect? Increases cardiac output Decreases cholesterol level Decreases resting heart rate Decreases platelet aggregation

Decreases resting heart rate

The nurse is administering a calcium channel blocker to a patient who has symptomatic sinus tachycardia at a rate of 132 bpm. What is the anticipated action of the drug for this patient? Decreases the sinoatrial node automaticity Creates a positive inotropic effect Increases the heart rate Increases the atrioventricular node conduction

Decreases the sinoatrial node automaticity

A client comes to the emergency department reporting chest pain. An electrocardiogram (ECG) reveals myocardial ischemia and an anterior-wall myocardial infarction (MI). Which ECG characteristic does the nurse expect to see? Prolonged PR interval Widened QRS complex Elevated ST segment Absent Q wave

Elevated ST segment

A nurse teaches a client with angina pectoris that he or she needs to take up to three sublingual nitroglycerin tablets at 5-minute intervals and immediately notify the health care provider if chest pain doesn't subside within 15 minutes. What symptoms may the client experience after taking the nitroglycerin? Nausea, vomiting, depression, fatigue, and impotence. Headache, hypotension, dizziness, and flushing. Sedation, nausea, vomiting, constipation, and respiratory depression. Flushing, dizz

Headache, hypotension, dizziness, and flushing.

The nurse is administering oral metoprolol. Where are the receptor sites mainly located? Uterus Heart Blood vessels Bronchi

Heart

The nurse is discussing risk factors for developing CAD with a patient in the clinic. Which results would indicate that the patient is not at significant risk for the development of CAD? High-density lipoprotein (HDL), 80 mg/dL A ratio of LDL to HDL, 4.5 to 1.0 Cholesterol, 280 mg/dL Low density lipoprotein (LDL), 160 mg/dL

High-density lipoprotein (HDL), 80 mg/dL

When the postcardiac surgical patient demonstrates vasodilation, hypotension, hyporeflexia, slow gastrointestinal motility (hypoactive bowel sounds), lethargy, and respiratory depression, the nurse suspects which electrolyte imbalance? Hypokalemia Hyperkalemia Hypermagnesemia Hypomagnesemia

Hypermagnesemia

Understanding atherosclerosis, the nurse identifies which of the following to be both a risk factor for the development of the disorder and an outcome? Hyperlipidemia Glucose intolerance Hypertension Obesity

Hypertension

A new surgical patient who has undergone a coronary artery bypass graft (CABG) is receiving opioids for pain control. The nurse must be alert to adverse effects of opioids. Which of the following effects would be important for the nurse to document? Hypotension Hyperactive bowel sounds Urinary incontinence Hypertension

Hypotension

Which of the following is inconsistent as a condition related to metabolic syndrome? Insulin resistance Abdominal obesity Dyslipidemia Hypotension

Hypotension

A client, who has undergone a percutaneous transluminal coronary angioplasty (PTCA), has received discharge instructions. Which statement by the client would indicate the need for further teaching by the nurse? "I should expect bruising at the catheter site for up to 3 weeks." "I should avoid taking a tub bath until my catheter site heals." "I should expect a low-grade fever and swelling at the site for the next week." "I should avoid prolonged sitting."

I should expect a low-grade fever and swelling at the site for the next week."

A client admitted to the coronary care unit (CCU) diagnosed with a STEMI is anxious and fearful. Which medication will the nurse administer to relieve the client's anxiety and decrease cardiac workload? IV nitroglycerin Atenolol Amlodipine IV morphine

IV morphine

A client with venous insufficiency is instructed to exercise, apply elastic stockings, and elevate the extremities. Which is the primary benefit for this nursing management regime? Improve arterial flow Strengthen venous valves Improve venous return Increase venous congestion

Improve venous return

When the nurse notes that, after cardiac surgery, the client demonstrates low urine output (less than 25 mL/h) with high specific gravity (greater than 1.025), the nurse suspects which condition? Overhydration Normal glomerular filtration Inadequate fluid volume Anuria

Inadequate fluid volume

A client has been recently placed on nitroglycerin. Which instruction by the nurse should be included in the client's teaching plan? Instruct the client not to crush the tablet. Instruct the client on side effects of flushing, throbbing headache, and tachycardia. Instruct the client to renew the nitroglycerin supply every 3 months. Instruct the client to place nitroglycerin tablets in a plastic pill box.

Instruct the client on side effects of flushing, throbbing headache, and tachycardia.

Which discharge instruction for self-care should the nurse provide to a client who has undergone a percutaneous transluminal coronary angioplasty (PTCA) procedure? Refrain from sexual activity for 1 month Normal activities of daily living can be resumed the first day after surgery Monitor the site for bleeding or hematoma. Cleanse the site with disinfectants and dress the wound appropriately

Monitor the site for bleeding or hematoma.

Severe chest pain is reported by a client during an acute myocardial infarction. Which of the following is the most appropriate drug for the nurse to administer? Meperidine hydrochloride (Demerol) Morphine sulfate (Morphine) Nitroglycerin transdermal patch Isosorbide mononitrate (Isordil)

Morphine sulfate (Morphine)

A female patient is being seen in the ER complaining of fatigue and shoulder blade discomfort. She is also short of breath. Based on these symptoms, what will the nurse suspect? Intracerebral hemorrhage Myocardial infarction (MI) Deep vein thrombosis (DVT) Stroke

Myocardial infarction (MI)

A nurse reviews a client's medication history before administering a cholinergic blocking agent. Adverse effects of a cholinergic blocking agent may delay absorption of what medication? Digoxin Diphenhydramine Amantadine Nitroglycerin

Nitroglycerin

A nurse reviews a client's medication history before administering a cholinergic blocking agent. Adverse effects of a cholinergic blocking agent may delay absorption of what medication? Nitroglycerin Digoxin Amantadine Diphenhydramine

Nitroglycerin

A client presents to the ED reporting anxiety and chest pain after shoveling heavy snow that morning. The client says that nitroglycerin has not been taken for months but upon experiencing this chest pain did take three nitroglycerin tablets. Although the pain has lessened, the client states, "They did not work all that well." The client shows the nurse the nitroglycerin bottle; the prescription was filled 12 months ago. The nurse anticipates which order by the physician? Chest x-ray Serum ele

Nitroglycerin SL

The nurse is caring for a client following a coronary artery bypass graft (CABG). The nurse notes persistent oozing of bloody drainage from various puncture sites. The nurse anticipates that the physician will order which medication to neutralize the unfractionated heparin the client received? Aspirin Alteplase Protamine sulfate Clopidogrel

Protamine sulfate

The nurse is teaching a client diagnosed with coronary artery disease about nitroglycerin. What is the cardiac premise behind administration of nitrates? It increases myocardial oxygen consumption. It functions as a vasoconstrictor. More blood returns to the heart. Preload is reduced.

Preload is reduced.

Following cardiac surgery, the nurse assesses the client for any common complication of hypovolemia. What significant indication of a complication should the nurse monitor? Blood pressure reading of 130/95 mm Hg Central venous pressure (CVP) reading of 8 mm Hg Pulmonary artery wedge pressure (PAWP) of 6 mm Hg Heart rate of 60 bpm

Pulmonary artery wedge pressure (PAWP) of 6 mm Hg

A client diagnosed with a myocardial infarction (MI) has begun a cardiac rehabilitation program. The nurse recognizes which overall goal as a focus of rehabilitation for a client who has had an MI? Reduce risk through education, support, and physical activity. Eliminate the effects of atherosclerosis and lower blood pressure. Return to work and the lifestyle experienced before the illness. Increase low-density lipoprotein (LDL) and reduce high-density lipoprotein (HDL).

Reduce risk through education, support, and physical activity.

A triage team is assessing a client to determine if reported chest pain is a manifestation of angina pectoris or an MI. The nurse knows that a primary distinction of angina pain is? Described as crushing and substernal Relieved by rest and nitroglycerin Accompanied by diaphoresis and dyspnea Associated with nausea and vomiting

Relieved by rest and nitroglycerin

The nurse is caring for a client presenting to the emergency department (ED) reporting chest pain. Which electrocardiographic (ECG) finding would be most concerning to the nurse? Sinus tachycardia Frequent premature atrial contractions (PACs) ST elevation Isolated premature ventricular contractions (PVCs)

ST elevation

A nurse is assigned to care for a recently admitted client who has been diagnosed with refractory angina. What symptom will the nurse expect the client to exhibit? Pain that may occur at rest, but the threshold for pain is lower than expected Severe, incapacitating chest pain Predictable and consistent pain that occurs on exertion and is relieved by rest Pain that occurs more frequently and lasts longer than the pain usually seen with stable angina

Severe, incapacitating chest pain

A client reports chest pain and palpitations during and after jogging in the mornings. The client's family history reveals a history of coronary artery disease (CAD). What should the nurse recommend to minimize cardiac risk? Protein-rich diet Liquid diet Smoking cessation Mild meals

Smoking cessation

A client reports chest pain that occurs when playing tennis but resolves when sitting down. The nurse knows these symptoms are common for which type of angina? Unstable Intractable Stable Variant

Stable

The client is prescribed nadolol for hypertension. What is the reason the nurse will teach the client not to stop taking the medication abruptly? The abrupt stop will precipitate internal bleeding. The abrupt stop can lead to formation of blood clots. The abrupt stop can trigger a migraine headache. The abrupt stop can cause a myocardial infarction.

The abrupt stop can cause a myocardial infarction.

A nurse is evaluating a client who had a myocardial infarction (MI) 7 days earlier. Which outcome indicates that the client is responding favorably to therapy? The client demonstrates ability to tolerate more activity without chest pain. The client verbalizes the intention of making all necessary lifestyle changes except for stopping smoking. The client exhibits a heart rate above 100 beats/minute. The client states that sublingual nitroglycerin usually relieves his chest pain.

The client demonstrates ability to tolerate more activity without chest pain.

In the treatment of coronary artery disease (CAD), medications are often ordered to control blood pressure in the client. Which of the following is a primary purpose of using beta-adrenergic blockers in the nursing management of CAD? To decrease homocysteine levels To dilate coronary arteries To decrease workload of the heart To prevent angiotensin II conversion

To decrease workload of the heart

The client has had biomarkers tested after reporting chest pain. Which diagnostic marker of myocardial infarction remains elevated for as long as 2 weeks? Myoglobin CK-MB Total creatine kinase Troponin

Troponin

When a client who has been diagnosed with angina pectoris reports experiencing chest pain more frequently, even at rest, that the period of pain is longer, and that it takes less stress for the pain to occur, the nurse recognizes that the client is describing which type of angina? Refractory Intractable Variant Unstable

Unstable

Which term refers to preinfarction angina? Stable angina Unstable angina Variant angina Silent ischemia

Unstable angina

The nurse is reevaluating a client 2 hours after a percutaneous transluminal coronary angioplasty (PTCA) procedure. Which assessment finding may indicate the client is experiencing a complication of the procedure? Dried blood at the puncture site Heart rate of 100 bpm Potassium level of 4.0 mEq/L Urine output of 40 mL

Urine output of 40 mL

nurse is teaching a client about maintaining a healthy heart. What information will the nurse include with the teaching? Use alcohol in moderation. Smoke in moderation. Exercise one or two times per week. Consume a diet high in saturated fats.

Use alcohol in moderation.

The nurse knows that women and older adult are at greater risk for a fatal myocardial event. Which factor is the primary contributor of this cause? Gender bias Decreased sensation to pain Vague symptoms Chest pain is typical

Vague symptoms

Which nursing actions would be of greatest importance in the management of a client preparing for angioplasty? Remove hair from skin insertion sites. Assess distal pulses. Withhold anticoagulant therapy. Inform client of diagnostic tests.

Withhold anticoagulant therapy.

The nurse is explaining the cause of angina pain to a client. What will the nurse say most directly caused the pain? a destroyed part of the heart muscle incomplete blockage of a major coronary artery complete closure of an artery a lack of oxygen in the heart muscle cells

a lack of oxygen in the heart muscle cells

The laboratory values for a client diagnosed with coronary artery disease (CAD) have just come back from the lab. The client's low-density lipoprotein (LDL) level is 112 mg/dL. The nurse recognizes that this value is · above the optimal range. · extremely high. · within the optimal range. · below the optimal range.

above the optimal range.

A client reports midsternal chest pain radiating down his left arm. The nurse notes that the client is restless and slightly diaphoretic, and measures a temperature of 99.6 °F (37.6 °C); a heart rate of 102 beats/minute; regular, slightly labored respirations at 26 breaths/minute; and a blood pressure of 150/90 mm Hg. What assessment is the nurse's highest priority? cardiac output body temperature acute pain anxiety

acute pain

A client has had a 12-lead ECG completed as part of an annual physical examination. The nurse notes an abnormal Q wave on an otherwise unremarkable ECG. The nurse recognizes that this finding indicates a cardiac dysrhythmia. an old MI. variant angina. an evolving MI.

an old MI.

A client with a myocardial infarction (MI) develops pulmonary crackles and dyspnea. A chest X-ray shows evidence of pulmonary edema. What type of MI did this client have? inferior. lateral. posterior. anterior.

anterior.

A client with chronic arterial occlusive disease undergoes percutaneous transluminal coronary angioplasty (PTCA) for mechanical dilation of the right femoral artery. After the procedure, the client will be prescribed long-term administration of which drug? aspirin or acetaminophen. pentoxifylline or acetaminophen. penicillin V or erythromycin. aspirin or clopidogrel.

aspirin or clopidogrel.

The nurse is caring for a client diagnosed with coronary artery disease (CAD). What condition most commonly results in CAD? renal failure diabetes mellitus myocardial infarction atherosclerosis

atherosclerosis

The nurse is removing a client's femoral sheath after cardiac catheterization. What medication will the nurse have available? adenosine atropine sulfate protamine sulfate heparin

atropine sulfate

A client is beginning to have more breathlessness with aortic stenosis. What is the treatment does the nurse anticipate for the client? balloon angioplasty cardiac graft procedure balloon valvuloplasty cardiac catheterization

balloon valvuloplasty

A client with CAD thinks diltiazem (Cardizem) has been causing nausea. Diltiazem (Cardizem) is categorized as which type of drug? diuretic beta-adrenergic blocker nitrate calcium-channel blocker

calcium-channel blocker

A client who has been diagnosed with Prinzmetal's angina will present with which symptom? radiating chest pain that lasts 15 minutes or less prolonged chest pain that accompanies exercise chest pain of increased frequency, severity, and duration chest pain that occurs at rest and usually in the middle of the night

chest pain that occurs at rest and usually in the middle of the night

A client returns for a follow-up visit to the cardiologist 4 days after a trip to the ED for sudden shortness of breath and abdominal pain. The nurse realizes the client had a myocardial infarction because the results from the blood work drawn in the hospital shows: decreased LDH levels. increased C-reactive protein levels. decreased myoglobin levels. elevated troponin levels.

elevated troponin levels.

The nurse is caring for a client with coronary artery disease. What is the nurse's priority goal for the client? decrease anxiety educate the client about his symptoms administer sublingual nitroglycerin enhance myocardial oxygenation

enhance myocardial oxygenation

A client's lipid profile reveals an LDL level of 122 mg/dL. This is considered a: high LDL level. normal LDL level. fasting LDL level. low LDL level.

high LDL level.

The nurse is reviewing the laboratory results for a client diagnosed with coronary artery disease (CAD). The client's low-density lipoprotein (LDL) level is 115 mg/dL. The nurse interprets this value as critically high. high. within normal limits. low.

high.

A client's elevated cholesterol levels are being managed with atorvastatin daily. What is a common side effect the nurse will teach the client that will require monitoring? hyperglycemia increased liver enzymes hyperuricemia severe muscle pain

increased liver enzymes

The nurse is caring for a client who is having chest pain associated with a myocardial infarction (MI). What medication will the nurse administer intravenously to reduce pain and anxiety? hydromorphone hydrochloride fentanyl morphine sulfate codeine sulfate

morphine sulfate

The nurse is admitting a client with an elevated creatine kinase-MB isoenzyme (CK-MB). What is the cause for the elevated isoenzyme? skeletal muscle damage due to a recent fall cerebral bleeding I.M. injection myocardial necrosis

myocardial necrosis

The nurse recognizes that the treatment for a non-ST-elevation myocardial infarction (NSTEMI) differs from that for a STEMI, in that a STEMI is more frequently treated with IV nitroglycerin. IV heparin. percutaneous coronary intervention (PCI). thrombolytics.

percutaneous coronary intervention (PCI).

The nurse is assessing a client with suspected post-pericardiotomy syndrome after cardiac surgery. What manifestation will alert the nurse to this syndrome? pericardial friction rub decreased white blood cell (WBC) count hypothermia decreased erythrocyte sedimentation rate (ESR)

pericardial friction rub

The nurse is caring for a client after cardiac surgery. What is the most immediate concern for the nurse? potassium level of 6 mEq/L bilateral rales and rhonchi serum glucose of 124 mg/dL weight gain of 6 ounces

potassium level of 6 mEq/L

A client presents to the ED with a myocardial infarction. Prior to administering a prescribed thrombolytic agent, the nurse must determine whether the client has which absolute contraindication to thrombolytic therapy? use of heparin recent consumption of a meal prior intracranial hemorrhage shellfish allergy

prior intracranial hemorrhage

A client with a family history of coronary artery disease reports experiencing chest pain and palpitations during and after morning jogs. What would reduce the client's cardiac risk? antioxidant supplements exercise avoidance a protein-rich diet smoking cessation

smoking cessation

A client who is resting quietly reports chest pain to the nurse. The cardiac monitor indicates the presence of reversible ST-segment elevation. What type of angina is the client experiencing? silent angina variant angina intractable angina stable angina

variant angina

A client was chopping firewood and experienced a heaviness in the chest and dyspnea. The client arrives in the emergency department four hours after the heaviness and the health care provider diagnoses an anterior myocardial infarction (MI). What orders will the nurse anticipate? serial liver enzyme testing, telemetry, and a lidocaine infusion sublingual nitroglycerin, tissue plasminogen activator (tPA), and telemetry morphine administration, stress testing, and admission to the cardiac care u

sublingual nitroglycerin, tissue plasminogen activator (tPA), and telemetry

A client has a blockage in the proximal portion of a coronary artery and decides to undergo percutaneous transluminal coronary angioplasty (PTCA). What medication will the nurse expect to administer during the procedure? ceftriaxone hydrochlorothiazide ticagrelor metoprolol

ticagrelor

The nurse is assessing a client with severe angina pectoris and electrocardiogram changes in the emergency room. What is the most important cardiac marker for the client? troponin creatine kinase lactate dehydrogenase myoglobin

troponin