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Carl Shapiro. Coronary Artery Disease Questions and Answers 2024
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Carl Shapiro. Coronary Artery Disease
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Carl Shapiro. Coronary Artery DiseaseThe nurse understands that aspirin is administered to a client with a suspected
myocardial infarction (MI) for which of the following reasons? - answer To prevent
platelet aggregation
Rationale: The client with a suspected MI should receive aspirin immediately, unless
allergic to it, to help prevent platelet aggregation.
The nurse knows that which factors may increase the client's risk of developing
coronary artery disease? (Select all that apply.)
Metabolic syndrome
Cigarette smoking
Female less than age 55
Activity limited to walking
Family history - answer Metabolic syndrome , Cigarette smoking , Family history
Rationale: Non-modifiable risk factors for coronary artery disease include family history
and increasing age (more than 55 years for women). Cigarette smoking and metabolic
syndrome are modifiable risk factors for coronary artery disease. A diagnosis of
metabolic syndrome includes three of the following conditions: insulin resistance, central
obesity, dyslipidemia, blood pressure persistently greater than 130/85 mmHg, high
levels of C-reactive protein, and high fibrinogen level. Any activity based on client's
capability is encouraged.
When a client is experiencing angina, the nurse administers nitroglycerin sublingually at
what frequency?
Once only, then administer morphine
Every 3 minutes, 5 doses maximum
Every 15 minutes, 3 doses maximum
Every 5 minutes, maximum 3 doses - answerEvery 5 minutes, maximum 3 doses
Rationale:When a client is experiencing acute angina, it is recommended that the client
allow one sublingual tablet to dissolve under the tongue (or spray nitroglycerin under the
tongue) and repeat every 5 minutes for a maximum of three doses.
Which of the following are cardiac markers assessed in the client experiencing angina
to determine potential myocardial injury? (Select all that apply.)
Creatinine
CK-MM
CK-MB
Hemoglobin
, Troponin - answerCK-MB , Troponin
Rationale:Cardiac enzymes and biomarkers, which include troponin, creatine kinase
(CK), and myoglobin, are used to diagnose an acute MI. Of the three CK isoenzymes,
CK-myocardial bound (MB) is specific to the heart muscle. CK-MM is specific to skeletal
muscle and is not an indicator of MI. Hemoglobin is used to determine the amount of
oxygen in the blood. Creatinine is elevated in renal failure, not in myocardial injury.
When administering medication to the client with suspected myocardial infarction, the
nurse understands that morphine has which of the following beneficial effects? (Select
all that apply.)
Decreases anxiety
Decreases afterload
Decreases respiratory rate
Decreases pain
Decreases preload - answerDecreases anxiety , Decreases afterload , Decreases pain ,
Decreases preload
Rationale:Morphine is the drug of choice to reduce pain, thereby reducing anxiety. It
also reduces preload and afterload, decreasing the work of the heart. The client must be
monitored closely for the side effects of hypotension and respiratory depression.
Which of the following does the nurse recognize as typical signs and symptoms
exhibited by a client experiencing angina? (Select all that apply.)
Substernal chest pain
Pain on inspiration
Tenderness over apical area
Shortness of breath
Diaphoresis - answerSubsternal chest pain , Shortness of breath , Diaphoresis
Rationale:Typical signs and symptoms of angina can include substernal chest pain or
heaviness that may radiate, shortness of breath, dusky or pallor skin, diaphoresis,
weakness, nausea and vomiting, and denial by the client. Pain on inspiration and
tenderness over the apical area are symptoms associated with other disease processes
such as pericarditis or pleurisy.
The nurse recognizes that ST elevation on the 12-lead ECG typically indicates which of
the following?
Hyperkalemia
This is a normal finding
Mitral valve prolapse
Myocardial injury - answerMyocardial injury
Rationale:Myocardial injury causes ST-segment and T-wave changes on an ECG.
Hyperkalemia causes tall peaked T-waves on the ECG. There are no specific ST
changes on the ECG associated with mitral valve prolapse.
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