Chapter 13 Evolve

The patient presents to the emergency department after having crushing chest pain for the past 5 hours. The ECG and laboratory work confirm suspicions of an acute myocardial infarction (AMI). Which findings would be the most conclusive that the patient is having an AMI? (Select all that apply.) A. ECG changes with ST-elevation B. Elevated CK-MB isoenzymes C. Elevated serum troponin levels D. Elevated urinary myoglobin level

A, B, C

An adult patient suffered an anterior wall myocardial infarction (MI) 4 days ago. Today the patient is experiencing dyspnea and sitting straight up in bed. The nurse's assessment includes bibasilar crackles, an S3 heart sound with a heart rate of 125 beats/min. What condition are these signs and symptoms consistent with? A. Heart failure B. Papillary muscle rupture C. Pericarditis D. Pulmonary embolism

A

The initial drug recommended at the onset of acute myocardial infarction (AMI) to reduce platelet aggregation is: A. aspirin. B. lidocaine. C. nitroglycerin. D. oxygen.

A

The patient presents to the emergency department with severe substernal chest discomfort. Cardiac enzymes are elevated and his ECG shows ST-segment depression in V2 and V3. This patient is most likely experiencing: A. non-Q-wave myocardial infarction (MI). B. pulmonary embolism. C. Q-wave myocardial infarction (MI). D. right ventricular infarction.

A

Which statements related to the management of unstable angina are true? (Select all that apply.) A. Aspirin is given at the onset of each chest pain episode. B. Calcium channel blockers help to reduce symptoms. C. Early revascularization (e.g., angioplasty) may be helpful. D. It is best treated with rest and nitroglycerin.

A, B, C

Angiotensin-converting enzymes inhibitors (ACE inhibitors) should be started within 24 hours of acute myocardial infarction (AMI) to reduce the incidence of: A. hibernating myocardium. B. myocardial remodeling. C. myocardial stunning. D. tachycardia.

B

A 67-year-old female is admitted to the emergency department complaining of mid-back pain and shortness of breath for the preceding 2 hours. She also complains of nausea and states that she vomited twice before coming to the hospital. She denies any chest discomfort or arm pain. The presenting symptoms suggest that this patient may be: A. exhibiting flu symptoms. B. having an anxiety attack. C. having a myocardial infarction (MI). D. suffering from osteoporosis.

C

The patient, who is being treated for hypercholesterolemia, complains of hot flashes and a metallic taste in the mouth. These are common side effects of: A. bile acid resins. B. clopidogrel. C. nicotinic acid. D. statins.

C

A patient is complaining of midsternal chest discomfort radiating down the right arm. The discomfort has been present for about 5 minutes. The patient is also asthmatic and allergic to calcium channel blockers. The medication of choice for this patient at this time is: A. isoptin. B. metoprolol. C. nifedipine. D. nitroglycerin sublingual.

D

The most sensitive cardiac enzyme to assess myocardial necrosis is: A. CK. B. CK-MB. C. potassium. D. troponin I.

D