Med Surg 2 Exam 2 Practice Questions Med Surg exam 2 practice questions on chapter 33 to 53.1. The nurse is developing a teaching plan for a 64-year-old patient with coronary artery disease
(CAD). Which factor should the nurse focus on during the teaching sessionx?
a. Family history of coronary ...
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Chapter 33: Coronary Artery Disease and Acute Coronary Syndrome
1. The nurse is developing a teaching plan for a 64-year-old patient with coronary artery disease
(CAD). Which factor should the nurse focus on during the teaching sessionx?
a. Family history of coronary artery disease
b. Elevated low-density lipoprotein (LDL) level
c. Greater risk associated with the patient’s gender
d. Increased risk of cardiovascular disease with aging
ANS: B RN should focus on the pt’s LDL level. ↓ LDL will help ↓ the pt’s risk for developing CAD.
2. Which nursing intervention is likely to be most effective when assisting the pt w/ CAD to make
appropriate dietary ∆?
a. Inform the patient about a diet containing no saturated fat and minimal salt.
b. Emphasize the increased cardiac risk unless the patient makes dietary changes.
c. Help the patient modify favorite high-fat recipes by using monounsaturated oils.
d. Give the patient a list of low-sodium, low-cholesterol foods to include in the diet.
ANS: C Lifestyle changes are more likely to be successful when consideration is given to the patient’s
values and preferences. The highest percentage of calories from fat should come from monounsaturated
or polyunsaturated fats.
3. The nurse is admitting a patient who has chest pain. Which assessment data suggest that the
pain is from an acute MI?
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.
ANS: B
4. Which info from a pt helps the nurse confirm the previous dx of chronic stable angina?
a. “The pain wakes me up at night.”
b. “The pain is level 3 to 5 (0 to 10 scale).”
c. “The pain has gotten worse over the last week.”
d. “The pain goes away after a nitroglycerin tablet.”
ANS: D Chronic stable angina is typically relieved by rest or nitroglycerin
5. Which pt statement indicates that the RN’s teaching about subling nitroglycerin (Nitrostat) has
been effective?
a. “I can expect nausea as a side effect of nitroglycerin.”
b. “I should only take nitroglycerin when I have chest pain.”
c. “Nitroglycerin helps prevent a clot from forming and blocking blood flow to my heart.”
d. “I will call an ambulance if I have pain after taking 3 nitroglycerin 5 minutes apart.”
ANS: D
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6. Which statement made by a pt w/ CAD after the nurse has completed teaching about the thx
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.”
ANS: D
7. Which pt statement indicates that the nurse’s teaching about carvedilol (Coreg) for preventing
anginal episodes has been effective?
a. “Carvedilol will help my heart muscle work harder.”
b. “It is important not to suddenly stop taking the carvedilol.”
c. “I can expect to feel short of breath when taking carvedilol.”
d. “Carvedilol will increase the blood flow to my heart muscle.”
ANS: B Can develop intense and frequent angina if the medication is suddenly DC’d
8. A pt who has had chest pain for several hours is admitted with a diagnosis of rule out AMI.
Which laboratory test is most specific for the nurse to monitor in determining whether the
patient has had an AMI?
a. Myoglobin
b. Homocysteine
c. C-reactive protein
d. Cardiac-specific troponin
ANS: D Troponin levels ↑about 4-6 hrs after the onset of myocardial infarction (MI) and are highly
specific indicators for MI. Myoglobin is released within 2 hours of MI, but it lacks specificity and its use is
limited. The other laboratory data are useful in determining the patient’s risk for developing coronary
artery disease but are not helpful in determining whether an acute MI is in progress.
9. Diltiazem (Cardizem) is Rx for a pt w/ newly dx Prinzmetal’s (variant) angina. Which action of
diltiazem is accurate for the nurse to include in the teaching plan?
a. Reduces heart palpitations.
b. Prevents coronary artery plaque.
c. Decreases coronary artery spasms.
d. Increases contractile force of the heart.
ANS: C Prinzmetal’s angina is caused by coronary artery spasm. Calcium channel blockers (e.g., diltiazem,
amlodipine [Norvasc]) are a first-line therapy for this type of angina.
Lipid-lowering drugs help ↓ atherosclerosis (plaque formation)
and -adrenergic blockers ↓ sympathetic stimulation of <3 (palpitations).
10. Which data indicates to the nurse that the pt w/ stable angina is experiencing SE of metoprolol ?
a. Patient is restless and agitated.
b. Patient reports feeling anxious.
c. Blood pressure is 90/54 mm Hg.
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d. Heart monitor shows normal sinus rhythm.
ANS: C
11. Nadolol (Corgard) Rx for a patient with chronic stable angina and left ventricular dysfunction.
What data would indicate to the nurse that the drug is effective?
a. Decreased blood pressure and heart rate
b. Improvement in the strength of the distal pulses
c. Fewer complaints of having cold hands and feet
d. Participation in daily activities without chest pain
e. ANS: D
12. Heparin is ordered for a pt with a non–ST-segment-elevation myocardial infarction (NSTEMI).
How should the nurse explain the purpose of the heparin to the patient?
a. “Heparin enhances platelet aggregation at the plaque site.”
b. “Heparin decreases the size of the coronary artery plaque.”
c. “Heparin prevents the development of new clots in the coronary arteries.”
d. “Heparin dissolves clots that are blocking blood flow in the coronary arteries.”
ANS:
13. Which action will nurse take to evaluate the effectiveness of IV nitroglycerin for a pt w/ MI?
a. Monitor heart rate.
b. Ask about chest pain.
c. Check blood pressure.
d. Observe for dysrhythmias.
ANS: B
14. A patient with ST-segment elevation in 3 contiguous ECG leads is admitted to ED & dx as having
ST-segment-elevation MI (STEMI). Which q should the nurse ask to determine whether the pt is a
candidate for thrombolytic therapy?
a. “Do you have any allergies?”
b. “Do you take aspirin daily?”
c. “What time did your pain begin?”
d. “Can you rate the pain on a 0 to 10 scale?”
ANS: C Thrombolytic therapy should be started within 6 hours of the onset of MIDIF: Cognitive Level:
Apply (application)
15. A pt who has recently had an acute MI (AMI) ambulates in the hospital hallway. Which data
would indicate to the nurse that the patient should stop and rest?
a. O2 saturation drops from 99% to 95%.
b. Heart rate increases from 66 to 98 beats/min.
c. Respiratory rate goes from 14 to 20 breaths/min.
d. Blood pressure (BP) changes from 118/60 to 126/68 mm Hg.
ANS: B
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