The nurse is caring for a client who has been diagnosed with an elevated
cholesterol level. The nurse is aware that plaque on the inner lumen of arteries
is composed chiefly of what?
A. Lipids and fibrous tissue
B. White blood cells
C. Lipoproteins
D. High-density cholesterol Answer - A. Lipids and fibrous tissue
Rationale: As T-lymphocytes and monocytes infiltrate to ingest lipids on the
arterial wall and then die, a fibrous tissue develops. This causes plaques to
form on the inner lumen of arterial walls. These plaques do not consist of
white cells, lipoproteins, or high-density cholesterol.
A client presents to the clinic reporting intermittent chest pain on exertion,
which is eventually attributed to angina. The nurse should inform the client
that angina is most often attributable to what cause?
A. Decreased cardiac output
,B. Decreased cardiac contractility
C. Infarction of the myocardium
D. Coronary arteriosclerosis Answer - D. Coronary arteriosclerosis
Rationale: In most cases, angina pectoris is due to arteriosclerosis. The disease
is not a result of impaired cardiac output or contractility. Infarction may result
from untreated angina, but it is not a cause of the disease.
The nurse is caring for an adult client who had symptoms of unstable angina
upon admission to the hospital. What nursing diagnosis underlies the
discomfort associated with angina?
A. Ineffective breathing pattern related to decreased cardiac output
B. Anxiety related to fear of death
C. Ineffective cardiopulmonary tissue perfusion related to coronary artery
disease (CAD)
D. Impaired skin integrity related to CAD Answer - C. Ineffective
cardiopulmonary tissue perfusion related to coronary artery disease (CAD)
Rationale: Ineffective cardiopulmonary tissue perfusion directly results in the
symptoms of discomfort associated with angina. Anxiety and ineffective
breathing may result from angina chest pain, but they are not the causes. Skin
integrity is not impaired by the effects of angina.
The triage nurse in the ED assesses an adult client who presents with reports of
midsternal chest pain that has lasted for the last 5 hours. If the client's
symptoms are due to an MI, what will have happened to the myocardium?
A. It may have developed an increased area of infarction during the time
without treatment.
, B. It will probably not have more damage than if the client came in
immediately.
C. It may be responsive to restoration of the area of dead cells with proper
treatment.
D. It has been irreparably damaged, so immediate treatment is no longer
necessary. Answer - A. It may have developed an increased area of infarction
during the time without treatment.
Rationale: When the client experiences lack of oxygen to myocardium cells
during an MI, the sooner treatment is initiated, the more likely the treatment
will prevent or minimize myocardial tissue necrosis. Delays in treatment equate
with increased myocardial damage. Despite the length of time the symptoms
have been present, treatment needs to be initiated immediately to minimize
further damage. Dead cells cannot be restored by any means.
Family members bring a client to the ED with pale cool skin, sudden midsternal
chest pain unrelieved with rest, and a history of CAD. How should the nurse
best interpret these initial data?
A. The symptoms indicate angina and should be treated as such.
B. The symptoms indicate a pulmonary etiology rather than a cardiac etiology.
C. The symptoms indicate an acute coronary episode and should be treated as
such.
D. Treatment should be determined pending the results of an exercise stress
test. Answer - C. The symptoms indicate an acute coronary episode and should
be treated as such.
Rationale: Angina and MI have similar symptoms and are considered the same
process but are on different points along a continuum. That the client's
symptoms are unrelieved by rest suggests an acute coronary episode rather
than angina. Pale, cool skin and sudden onset are inconsistent with a
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