Level 2 - RNSG 1443
In teaching a patient about coronary artery disease, the nurse explains that the changes that occur in this disorder include (select all that apply)
a. diffuse involvement of plaque formation in coronary veins.
b. abnormal levels of cholesterol, especially low-density lip...
Level 2 - RNSG 1443
In teaching a patient about coronary artery disease, the nurse explains that the
changes that occur in this disorder include (select all that apply)
a. diffuse involvement of plaque formation in coronary veins.
b. abnormal levels of cholesterol, especially low-density lipoproteins.
c. accumulation of lipid and fibrous tissue within the coronary arteries.
d. development of angina due to a decreased blood supply to the heart muscle.
e. chronic vasoconstriction of coronary arteries leading to permanent vasospasm. -
Answer- B, C, D
b. abnormal levels of cholesterol, especially low-density lipoproteins.
c. accumulation of lipid and fibrous tissue within the coronary arteries.
d. development of angina due to a decreased blood supply to the heart muscle.
.
After teaching about ways to decrease risk factors for CAD, the nurse recognizes
that additional instruction is needed when the patient says
a. "I would like to add weight lifting to my exercise program."
b. "I can only keep my blood pressure normal with medication."
c. "I can change my diet to decrease my intake of saturated fats."
d. "I will change my lifestyle to reduce activities that increase my stress." - Answer- A
"I would like to add weight lifting to my exercise program."
A hospitalized patient with a history of chronic stable angina tells the nurse that she
is having chest pain. The nurse bases his actions on the knowledge that ischemia
a. will always progress to myocardial infarction.
b. will be relieved by rest, nitroglycerin, or both.
c. indicates that irreversible myocardial damage is occurring.
d. is frequently associated with vomiting and extreme fatigue. - Answer- B
will be relieved by rest, nitroglycerin, or both.
The nurse is caring for a patient who is 2 days post MI. The patient reports that she
is experiencing chest pain. She states, "It hurts when I take a deep breath." Which
action would be a priority?
a. Notify the physician STAT and obtain a 12-lead ECG.
b. Obtain vital signs and auscultate for a pericardial friction rub.
c. Apply high-flow O2 by face mask and auscultate breath sounds.
d. Medicate the patient with PRN analgesic and reevaluate in 30 minutes. - Answer-
B
,Obtain vital signs and auscultate for a pericardial friction rub.
A patient is admitted to the ICU with a diagnosis of unstable angina. Which drugs(s)
would the nurse expect the patient to receive (select all that apply)?
a. ACE inhibitor
b. Antiplatelet therapy
c. Thrombolytic therapy
d. Prophylactic antibiotics
e. IV nitroglycerin - Answer- A, B, E
a. ACE inhibitor
b. Antiplatelet therapy
e. IV nitroglycerin
.
A patient is recovering from an uncomplicated MI. Which rehabilitation guideline is a
priority to include in the teaching plan?
a. Refrain from sexual activity for a minimum of 3 weeks.
b. Plan a diet program that aims for a 1- to 2-pound weight loss per week.
c. Begin an exercise program that aims for at least five 30-minute sessions per
week.
d. Consider the use of erectile agents and prophylactic NTG before engaging in
sexual activity. - Answer- C
Begin an exercise program that aims for at least five 30-minute sessions per week.
.
The most common finding in individuals at risk for sudden cardiac death is
a. aortic valve disease.
b. mitral valve disease.
c. left ventricular dysfunction.
d. atherosclerotic heart disease.
. - Answer- C
left ventricular dysfunction.
.
When developing a teaching plan for a 61-year-old man with the following risk
factors for coronary artery disease (CAD), the nurse should focus on the
a. family history of coronary artery disease.
b. increased risk associated with the patients gender.
c. increased risk of cardiovascular disease as people age.
,d. elevation of the patients low-density lipoprotein (LDL) level. - Answer- D. elevation
of the patients low-density lipoprotein (LDL) level.
Because family history, gender, and age are non-modifiable risk factors, the nurse
should focus on the patients LDL level. Decreases in LDL will help reduce the
patients risk for developing CAD.
.
.
Which nursing intervention will be most effective when assisting the patient with
coronary artery disease (CAD) to make appropriate dietary changes?
a. Give the patient a list of low-sodium, low-cholesterol foods that should be included
in the diet.
b. Emphasize the increased risk for heart problems unless the patient makes the
dietary changes.
c. Help the patient modify favorite high-fat recipes by using monosaturated oils when
possible.
d. Inform the patient that a diet containing no saturated fat and minimal salt will be
necessary. - Answer- C
Lifestyle changes are more likely to be successful when consideration is given to the
patients values and preferences. The highest percentage of calories from fat should
come from monosaturated fats.
Although low- sodium and low-cholesterol foods are appropriate, providing the
patient with a list alone is not likely to be successful in making dietary changes.
Completely removing saturated fat from the diet is not a realistic expectation. Up to
7% of calories in the therapeutic lifestyle changes (TLC) diet can come from
saturated fat. Telling the patient about the increased risk without assisting further
with strategies for dietary change is unlikely to be successful.
Which assessment data collected by the nurse who is admitting a patient with chest
pain suggest that the pain is caused by an acute myocardial infarction (AMI)?
a. The pain increases with deep breathing.
b. The pain has lasted longer than 30 minutes.
c. The pain is relieved after the patient takes nitroglycerin.
d. The pain is reproducible when the patient raises the arms. - Answer- B
Chest pain that lasts for 20 minutes or more is characteristic of AMI.
Changes in pain that occur with raising the arms or with deep breathing are more
typical of musculoskeletal pain or pericarditis. Stable angina is usually relieved when
the patient takes nitroglycerin.
.
, Which information given by a patient admitted with chronic stable angina will help the
nurse confirm this diagnosis?
a. The patient states that the pain wakes me up at night.
b. The patient rates the pain at a level 3 to 5 (0 to 10 scale).
c. The patient states that the pain has increased in frequency over the last week.
d. The patient states that the pain goes away with one sublingual nitroglycerin tablet.
. - Answer- D
Chronic stable angina is typically relieved by rest or nitroglycerin administration.
The level of pain is not a consistent indicator of the type of angina. Pain occurring at
rest or with increased frequency is typical of unstable angina.
.
After the nurse has finished teaching a patient about the use of sublingual
nitroglycerin (Nitrostat), which patient statement indicates that the teaching has been
effective?
a. I can expect some nausea as a side effect of nitroglycerin.
b. I should only take the nitroglycerin if I start to have chest pain.
c. I will call an ambulance if I still have pain after taking 3 nitroglycerin 5 minutes
apart.
d. Nitroglycerin helps prevent a clot from forming and blocking blood flow to my
heart. - Answer- C
The emergency medical services (EMS) system should be activated when chest pain
or other symptoms are not completely relieved after 3 sublingual nitroglycerin tablets
taken 5 minutes apart.
Nitroglycerin can be taken to prevent chest pain or other symptoms from developing
(e.g., before intercourse). Gastric upset (e.g., nausea) is not an expected side effect
of nitroglycerin. Nitroglycerin does not impact the underlying pathophysiology of
coronary artery atherosclerosis.
Which statement made by a patient with coronary artery disease after the nurse has
completed teaching about therapeutic lifestyle changes (TLC) diet indicates that
further teaching is needed?
a. I will switch from whole milk to 1% milk.
b. I like salmon and I will plan to eat it more often.
c. I can have a glass of wine with dinner if I want one.
d. I will miss being able to eat peanut butter sandwiches. - Answer- D
Although only 30% of the daily calories should come from fats, most of the fat in the
TLC diet should come from monosaturated fats such as are found in nuts, olive oil,
and canola oil. The patient can include peanut butter sandwiches as part of the TLC
diet.
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