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Myocardial Infarction - ML8 Questions With Complete Solutions
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Myocardial Infarction - ML8 Questions With Complete Solutions
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Myocardial Infarction - ML8 Questions With CompleteSolutions
A 40-year-old client has been admitted to the cardiac intensive
care unit after having an anterior wall myocardial infarction
(MI). The nurse is reviewing modifiable risk factors with the
client to avoid the redevelopment of thromboembolic
complications, possibly leading to a second MI. Which of the
following increases this risk?
Oral contraceptives
Caffeine intake
Hypoglycemic states
Factor V Leiden mutation Correct Answer Oral contraceptives
The best answer is oral contraceptives. Modifiable risk factors
for the development of thrombosis include oral contraceptives,
prolonged bed rest, smoking, and obesity. Nonmodifiable risk
factors include Factor V Leiden mutation, myocardial infarction,
coronary artery disease, and cancer.
A 45-year-old adult male patient is admitted to emergency after
he developed unrelieved chest pain that was present for
approximately 20 minutes before he presented to the emergency
department. The patient has been subsequently diagnosed with a
myocardial infarction (MI). To minimize cardiac damage, what
health care provider's order will the nurse expect to see for this
patient?
Thrombolytics, oxygen administration, and bed rest
Morphine sulfate, oxygen administration, and bed rest
,Oxygen administration, anticoagulants, and bed rest
Bed rest, albuterol nebulizer treatments, and oxygen
administration Correct Answer Morphine sulfate, oxygen
administration, and bed rest
Morphine sulfate reduces preload and decreases workload of the
heart, along with increased oxygen from oxygen therapy and bed
rest. With decreased cardiac demand, this provides the best
chance of decreasing cardiac damage. Thrombolytics and
anticoagulants are contraindicated in patients who are bleeding
or have a bleeding disorder. Albuterol is a medication used to
manage asthma and respiratory conditions and will increase the
heart rate.
A 52-year-old client who experienced a myocardial infarction
has an order for discharge. Part of the discharge teaching
includes prior administration of nitroglycerin for chest pain.
Which statement by the client indicates understanding of the
teaching provided?
"I will take two nitroglycerin tablets 15 minutes apart, and if I
do not have any relief I will contact my health care provider."
"I will take three nitroglycerin tablets 5 minutes apart, and if I
do not have any relief I will seek emergency care immediately."
"I will take three tables every 5 minutes until the chest pain
subsides."
"I will take one tablet and lay down for an hour." Correct
Answer "I will take three nitroglycerin tablets 5 minutes apart,
and if I do not have any relief I will seek emergency care
immediately."
,The client with stable or unstable angina will be prescribed
sublingual nitroglycerin to relieve chest pain symptoms. The
client may take up to three tablets of sublingual nitroglycerin 5
minutes apart. If the chest pain is unrelieved, the client needs to
seek emergency medical care immediately.
A 61-year-old man is prescribed alteplase for an acute
myocardial infarction. A priority nursing intervention will be to
monitor for what during and after drug therapy?
Gastrointestinal distress
Liver failure
A drop in blood pressure
Arrhythmias Correct Answer Arrhythmias
A patient who is on alteplase therapy to treat a myocardial
infarction should be monitored for arrhythmias using a cardiac
monitor. Reperfusion arrhythmias are common when blood flow
to the heart has been reestablished. The patient's blood pressure
should also be monitored but would not be the priority
intervention. Gastrointestinal distress and liver failure are not
associated with alteplase therapy.
A 65-year-old man who just had a heart attack is placed on
aspirin, 81 mg daily. The nurse is explaining the purpose of this
medication to the client and his wife. What would be the nurses
bestexplanation?
The aspirin is being prescribed because it reduces the
prostaglandins in your body.
The aspirin is being prescribed because it will protect your heart.
, The aspirin is being prescribed because it reduces your risk of a
second heart attack.
The aspirin is being prescribed to relieve the pain from the heart
attack. Correct Answer The aspirin is being prescribed because
it reduces your risk of a second heart attack.
Because of its antiplatelet and anti-inflammatory effects, low-
dose aspirin (81 mg daily) is useful in preventing or reducing the
risk of transient ischemic attacks (TIAs), MI, and ischemic
cerebral vascular accident (stroke). It is also indicated for clients
with a previous MI, chronic or unstable angina, and those
undergoing angioplasty or other revascularization procedures.
A client comes to the emergency department complaining of
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
absent Q wave
elevated ST segment
widened QRS complex Correct Answer elevated ST segment
Ischemic myocardial tissue changes cause elevation of the ST
segment, an inverted T wave, and a pathological Q wave. A
prolonged PR interval occurs with first-degree heart block, the
least dangerous atrioventricular heart block; this disorder may
arise in healthy people but sometimes results from drug toxicity,
electrolyte or metabolic disturbances, rheumatic fever, or
chronic degenerative disease of the conduction system. An
absent Q wave is normal; an MI may cause a significant Q
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