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The nurse teaches a student nurse about diagnostic studies used for acute coronary syndrome. Which statement made by the student nurse indicates effective learning?
"Serum cardiac markers are proteins that are released from necrotic heart muscle."
The nurse provides information about thrombolytic therapy to a group of student nurses. Which statement made by a student nurse indicates the need for further teaching?
"Significant facial trauma within the past 3 months is a relative contraindication."
The nurse teaches a student nurse about acute pericarditis. Which statement made by the student nurse indicates effective learning?
"The patient's chest pain can be relieved by sitting in the forward position."
A patient experiences prolonged chest pain that is not immediately reversible. The patient's health care provider explains that the cause of the pain is that a once-stable atherosclerotic plaque has ruptured, causing platelet aggregation and thrombus formation. The nurse recognizes this meets the definition of what diagnosis?
ACS
The nurse provides education to a patient that receives a prescription for sublingual nitroglycerin for treatment of angina. Which statement made by the patient indicates the need for further teaching
After the bottle is open, the tablets lose potency and should be replaced every 12 months."
A patient reports heaviness and burning sensation in the substernal and retrosternal region. Assessment findings include a fasting blood glucose of 190 mg/dL and blood pressure of 145/90 mm Hg. The nurse recognizes that which other finding indicates sympathetic nervous system stimulation?
Ashen, clammy, and cool skin
The nurse is providing postoperative care to a patient that underwent coronary artery bypass graft (CABG) surgery. The nurse should monitor the patient for what common complication?
Atrial dysrhythmias
Diagnostic results of a patient indicate three-vessel coronary artery disease and the presence of cardiac-specific troponin I (cTnI) and cardiac-specific troponin T (cTnT) markers. The nurse identifies that which intervention will benefit the patient?
Coronary revascularization with coronary artery bypass graft (CABG) surgery
The nurse is providing teaching to a patient recovering from a myocardial infarction (MI). How should resumption of sexual activity be discussed?
Discussed along with other physical activities
During the 48 hours after a myocardial infarction (MI), a nurse should assign the highest priority to monitoring the patient for what complication?
Dysrhythmias
The nurse reviews a patient's laboratory results and recognizes that which result is most indicative of myocardial infarction?
Increased creatine kinase-MB
The nurse recalls that which artery is most commonly used for bypass graft?
Internal mammary artery
A patient with acute coronary syndrome (ACS) is scheduled for an off-pump coronary artery bypass (OPCAB) surgery. The nurse reviews the patient's history and notes the presence of multiple co-morbidities. The nurse identifies that the OPCAB procedure is used for this type of patient for what reason?
It is associated with less blood loss and less renal dysfunction
The nurse is preparing an initial care plan for a patient that presents with chest pain. What is the priority nursing intervention?
Monitoring the patient's ECG
The nurse assesses a patient with papillary muscle dysfunction. Which observation supports the patient's diagnosis?
Murmur at the cardiac apex
The nurse recognizes indications of unstable angina if a patient experiences what symptoms?
Nausea, indigestion, and shortness of breath
The nurse recognizes that which medication(s) may relieve spasms associated with radial artery coronary artery bypass surgery? Select all that apply.
Nicardipine Verapamil
The nurse is examining the ECG of a patient who has just been admitted with a suspected myocardial infarction (MI). Which ECG change is most indicative of prolonged or complete coronary occlusion?
Pathologic Q wave
A patient experiences mild chest pain during inspiration, while coughing, and while performing daily activities. Sitting in a forward position relieves the pain. The nurse identifies that the patient is experiencing what complication of myocardial infarction?
Pericarditis
The nurse recalls that coronary revascularization with coronary artery bypass graft (CABG) surgery is recommended for which patients? Select all that apply.
Patients who fail medical management Patients with left main coronary artery or three-vessel disease Patients who are not candidates for percutaneous coronary intervention (PCI) Patients who have failed percutaneous coronary intervention (PCI) and continue to have chest pain
Diagnostic tests confirm that a patient has experienced a ST-segment-elevation myocardial infarction (STEMI). The nurse should prepare the patient for what first line of treatment?
Percutaneous coronary intervention (PCI)
A patient is scheduled for a coronary artery bypass graft (CABG) surgery. The nurse reviews the surgical plan and notes that the type of graft that will be used is prone to future stenosis and graft occlusion. Therefore the nurse anticipates postoperative use of antiplatelet and statin therapy to improve graft patency. Which type of graft will be used for the surgery?
Saphenous vein graft
A patient tells the nurse, "I had severe chest pain six days ago." The nurse identifies that which cardiac biomarker will be most helpful in determining whether the patient had a myocardial infarction at the time the patient experienced chest pain?
Troponin
The nurse recognizes that which type of medication may be prescribed for a patient with an ejection fraction of 25%?
ace inhibitor
A patient that is being discharged from the hospital after acute coronary syndrome will be participating in cardiac rehabilitation. What information should the nurse provide about the early recovery phase of rehabilitation?
Activity level is increased gradually with supervision by the rehabilitation team and with ECG monitoring.
A patient reports chest pain. The nurse should assess for which clinical manifestations associated with a myocardial infarction (MI)? Select all that apply.
Ashen skin Diaphoresis Nausea and vomiting S 3 or S 4 heart sounds
A patient receives morphine sulfate to relieve chest pain. The nurse should monitor this patient for which complications associated with the medication? Select all that apply.
Bradypnea, Hypotension
The nurse provides a list of health-promoting regular physical activity examples to a patient with coronary artery disease (CAD). Which activity is appropriate to be included on the list?
Brisk walking (3 to 4 miles per hour)
The nurse is caring for a patient 24 hours after the patient was diagnosed with ST segment elevation myocardial infarction (STEMI). The nurse should monitor the patient for what complication of myocardial infarction (MI)?
Cardiac dysrhythmias
The nurse monitors a patient for complications of myocardial infarction. The nurse auscultates a new murmur at the cardiac apex. Which treatment strategies are appropriate for inclusion in the patient's care plan? Select all that apply.
Cardiac surgery with mitral valve repair Intraaortic balloon pump (IABP) therapy
A patient is admitted to the intensive care unit with a diagnosis of myocardial infarction. The patient is in stable condition. The nurse recognizes what common medications that are used to treat this condition? Select all that apply.
Dual antiplatelet therapy Intravenous (IV) nitroglycerin Low molecular weight heparin (LMWH)
The nurse is caring for a patient who survived sudden cardiac death (SCD) that was caused by a lethal ventricular dysrhythmia. The nurse anticipates that which tests will be prescribed to monitor the effectiveness of drug treatment? Select all that apply.
Exercise stress testing 24-hour Holter monitoring Signal-averaged electrocardiogram (ECG) Electrophysiologic study (EPS) under fluoroscopy
The nurse assesses a patient who has been administered the tissue-type plasminogen activator alteplase for an acute myocardial infarction. Which assessment finding is the highest priority and should be reported to the primary health care provider immediately?
Hematuria
In caring for the patient with angina the patient states, "I walked to the bathroom. While I was having a bowel movement, I started having the worst chest pain ever. It was similar to the pain I had at home. The pain went away rather quickly." What further assessment data should the nurse obtain from the patient?
In what areas did you feel this pain?
The nurse recognizes that which type of myocardial infarction (MI) may occur due to blockage of the right coronary artery?
Inferior wall MI
The nurse assesses a patient with diabetes who reports shortness of breath, neck pain, and hypoglycemic symptoms. The patient's blood pressure is 130/86 mm Hg, heart rate is 102 beats/minute, respiratory rate is 24 breaths/minute, and the fingerstick blood glucose is 136 mg/dL. The nurse recognizes that the patient is experiencing what?
MI
A patient with a diagnosis of unstable angina is admitted to the intensive care unit. The nurse anticipates that which drug therapies will be prescribed? Select all that apply.
Nitrates Antiplatelet therapy Anticoagulant therapy
A patient with a history of unstable angina reports a sudden onset of retrosternal chest heaviness and tightness, fatigue, shortness of breath, and nausea. What actions should the nurse take? Select all that apply
Obtain a 12-lead ECG. Administer sublingual nitroglycerin
The nurse is caring for a patient two days after the patient experienced a myocardial infarction. The nurse should monitor the patient for what complications? Select all that apply.
Pericarditis Heart failure Dysrhythmia cardiogenic shock
A patient with ventricular dysfunction receives a prescription for an angiotensin-converting enzyme (ACE) inhibitor. The nurse should monitor the patient for what indication of intolerance of this type of medication?
Persistent cough
The nurse provides basic physical activity guidelines for a patient that is being discharged following acute coronary syndrome (ACS). The nurse recommends following the FITT formula, which includes which guidelines?
Physical activity that is regular, rhythmic, and repetitive
A patient phones a health care provider's office and states, "I am having severe chest tightness that won't go away even when I lie down." In addition to contacting emergency responders, what instruction should the nurse provide to the patient?
Take chewable aspirin. The total dose should be 325 mg."
For which problem is percutaneous coronary intervention (PCI) most clearly indicated?
acute MI
The nurse is caring for a patient with a myocardial infarction. The health care provider prescribes an intravenous infusion of alteplase. What is the priority nursing intervention during the administration of this medication?
neuro status
The nurse is caring for a patient one month after the patient's cardiac surgery. The patient is hospitalized with a three-day history of chest pain, joint pain, and a body temperature of 101°F. The patient's lab results include a white blood cell count of 15,000/mcL and an erythrocyte sedimentation rate of 30 mm/hr. Which condition does the nurse suspect?
Dressler syndrome
A patient is recovering from an uncomplicated myocardial infarction (MI). Which instructions will the nurse include when discussing physical activity?
Physical activity should be regular, rhythmic, and repetitive.
A patient asks the nurse about resuming sexual activity after acute coronary syndrome (ACS). What should the nurse include in the patient's teaching plan?
Taking a prophylactic nitrate may decrease chest pain during sexual activity
The nurse reviews the medical records of four patients with chest pain. The nurse identifies that which patient will benefit from nitroprusside and intraaortic balloon pump (IABP) therapy?
patient c (dyspnea)
After being identified as high risk for traditional bypass surgery, a patient is scheduled for a minimally invasive direct coronary artery bypass (MIDCAB). The nurse recognizes that which steps are involved in the procedure? Select all that apply.
Small incisions are made between the ribs. A mechanical stabilizer is placed to immobilize the operative site. A thoracoscope or robotic assistance is used to dissect the internal mammary artery from the chest
A patient with acute coronary syndrome (ACS) receives a prescription for niacin to treat hyperlipidemia. The nurse observes another care provider giving information about the medication to the patient. The nurse should question which item that was included in the education?
Take the drug on an empty stomach.
