Myocardial Infarction & Heart Failure

Which of the following classes of medications protects the ischemic myocardium by blocking catecholamines & sympathetic nerve stimulation? A. Beta-adrenergic blockers B. Calcium channel blockers C. Narcotics D. Nitrates

A. Beta-adrenergic blockers Beta-adrenergic blockers work by blocking beta receptors in the myocardium, reducing the response of catecholamines & sympathetic nerve stimulation. They protect the myocardium, helping to reduce the risk of another infarction by decreasing myocardial oxygen demand.

Which of the following symptoms is most commonly associated with left-sided heart failure? A. Crackles B. Arrhythmias C. Hepatic engorgement D. Hypotension

A. Crackles Crackles in the lungs are a classic sign of left-sided heart failure. These sounds are caused by fluid backing up into the pulmonary system.

Toxicity from which of the following medications may cause a client to see a green-yellow halo around lights? A. Digoxin B. Furosemide (Lasix) C. Metoprolol (Lopressor) D. Enalapril (Vasotec)

A. Digoxin One of the most common signs of digoxin toxicity is the visual disturbance known as the "green-yellow halo sign"

After an anterior wall myocardial infarction, which of the following problems is indicated by auscultation of crackles in the lungs? A. Left-sided heart failure B. Pulmonic valve malfunction C. Right-sided heart failure D. Tricuspid valve malfunction

A. Left-sided heart failure The left ventricle is responsible for most of the cardiac output. An anterior wall myocardial infarction may result in a decrease in left ventricular function.

What is the first intervention for a client experiencing MI? A. Administer morphine B. Administer oxygen C. Administer sublingual nitroglycerin D. Obtain an ECG

B. Administer oxygen Administering supplemental oxygen to the client is the first priority of care. The myocardium is deprived of oxygen during an infarction, so additional oxygen is administered to assist in oxygenation & prevent further damage.

Which of the following actions is first priority of care for a client exhibiting signs & symptoms of coronary artery disease? A. Decrease anxiety B. Enhance myocardial oxygenation C. Administer sublingual nitroglycerin D. Educate the client about his symptoms

B. Enhance myocardial oxygenation Enhancing myocardial oxygenation is always the first priority when a client exhibits signs or symptoms of cardiac compromise. Without adequate oxygenation, the myocardium suffers damage.

Which of the following conditions is associated with a predictable level of pain that occurs as a result of physical or emotional stress? A. Anxiety B. Stable angina C. Unstable angina D. Variant angina

B. Stable angina The pain of stable angina is predictable in nature, builds gradually, & quickly reaches maximum intensity.

What is the most common complication of an MI? A. Cardiogenic shock B. Heart failure C. Arrhythmias D. Pericarditis

C. Arrhythmias Arrhythmias, caused by oxygen deprivation to the myocardium, are the most common complication of an MI.

Which of the following symptoms might a client with right sided heart failure exhibit? A. Adequate urine output B. Polyuria C. Oliguria D. Polydipsia

C. Oliguria Inadequate deactivation of aldosterone by the liver after right sided heart failure leads to fluid retention, which causes oliguria.

Medical treatment of coronary artery disease includes which of the following procedures? A. Cardiac catheterization B. Coronary artery bypass surgery C. Oral medication therapy D. Percutaneous transluminal coronary angioplasty

C. Oral medication therapy Oral medication administration is a noninvasive, medical treatment for coronary artery disease. Cardiac catheterization is not a treatment, but a diagnostic tool.

Which of the following blood tests is most indicative of cardiac damage? A. Lactate dehydrogenase B. Complete blood count (CBC) C. Troponin I D. Creatine kinase (CK)

C. Troponin I Troponin I levels rise rapidly & are detectable within 1 hr of myocardial injury. Troponin I levels aren't detectable in people without cardiac injury.

Which of the following tests is used most often to diagnose angina? A. Chest x-ray B. Echocardiogram C. Cardiac catheterization D. 12-lead electrocardiogram (ECG)

D. 12-lead electrocardiogram (ECG) The 12-lead ECG will indicate ischemia, showing T-wave inversion.

Which of the following conditions is predominant cause of angina? A. Increased preload B. Decreased afterload C. Coronary artery spasm D. Inadequate oxygen supply to the myocardium

D. Inadequate oxygen supply to the myocardium Inadequate oxygen supply to the myocardium is responsible for the pain accompanying angina.

Which of the following classes of medications maximizes cardiac performance in clients with HF by increasing ventricular contractility? A. Beta-adrenergic blockers B. Calcium channel blockers C. Diuretics D. Inotropic agents

D. Inotropic agents Inotropic agents are administered to increase the force of the heart's contractions, thereby increasing ventricular contractility & ultimately increasing cardiac output.

Which of the following symptoms is the most likely origin of pain the client described as knifelike chest pain that increases in intensity with inspiration? A. Cardiac B. Gastrointestinal C. Musculoskeletal D. Pulmonary

D. Pulmonary Pulmonary pain is generally described by these symptoms.

Which of the following conditions is most closely associated with weight gain, nausea, & a decrease in urine output? A. Angina pectoris B. Cardiomyopathy C. Left sided heart failure D. Right sided heart failure

D. Right sided heart failure Weight gain, nausea, & a decrease in urine output are secondary effects of right sided heart failure. Cardiomyopathy is usually identified as a symptom of left sided heart failure. Left sided heart failure causes primarily pulmonary symptoms rather than systemic ones.

In which of the following disorders would the nurse expect to assess sacral edema in a bedridden client? A. Diabetes B. Pulmonary emboli C. Renal failure D. Right sided heart failure

D. Right sided heart failure The most accurate area on the body to assess dependent edema in a bedridden client is the sacral area.

What is the primary reason for administering morphine to a client with an MI? A. To sedate the client B. To decrease the client's pain C. To decrease the client's anxiety D. To decrease oxygen demand on the client's heart

D. To decrease oxygen demand on the client's heart Morphine is administered because it decreases myocardial oxygen demand.

Which of the following types of angina is most closely related with an impending MI? A. Angina decubitus B. Chronic stable angina C. Nocturnal angina D. Unstable angina

D. Unstable angina Unstable angina progressively increases in frequency, intensity, & duration & is related to an increased risk of MI within 3-18 months.