The nurse is caring for a patient 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

A

A patient presents to the walk-in clinic complaining of intermittent chest pain on exertion, which is eventually attributed to angina. The nurse should inform the patient 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

D

The nurse is caring for an adult patient 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

C

The triage nurse in the ED assesses a 66-year-old male patient who presents to the ED with complaints of midsternal chest pain that has lasted for the last 5 hours. If the patient’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 he 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

A

Family members bring a patient 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.

C

6.

An OR nurse is preparing to assist with a coronary artery bypass graft (CABG). The OR nurse knows that the vessel most commonly used as source for a CABG is what?

A)

Brachial artery

B)

Brachial vein

C)

Femoral artery

D)

Greater saphenous vein

D

A patient with an occluded coronary artery is admitted and has an emergency percutaneous transluminal coronary angioplasty (PTCA). The patient is admitted to the cardiac critical care unit after the PTCA. For what complication should the nurse most closely monitor the patient?

A)

Hyperlipidemia

B)

Bleeding at insertion site

C)

Left ventricular hypertrophy

D)

Congestive heart failure

B

The nurse is caring for a patient who is scheduled for cardiac surgery. What should the nurse include in preoperative care?

A)

With the patient, clarify the surgical procedure that will be performed.

B)

Withhold the patient’s scheduled medications for at least 12 hours preoperatively.

C)

Inform the patient that health teaching will begin as soon as possible after surgery.

D)

Avoid discussing the patient’s fears as not to exacerbate them.

A

The OR nurse is explaining to a patient that cardiac surgery requires the absence of blood from the surgical field. At the same time, it is imperative to maintain perfusion of body organs and tissues. What technique for achieving these simultaneous goals should the nurse describe?

A)

Coronary artery bypass graft (CABG)

B)

Percutaneous transluminal coronary angioplasty (PTCA)

C)

Atherectomy

D)

Cardiopulmonary bypass

D

The nurse has just admitted a 66-year-old patient for cardiac surgery. The patient tearfully admits to the nurse that she is afraid of dying while undergoing the surgery. What is the nurse’s best response?

A)

Explore the factors underlying the patient’s anxiety.

B)

Teach the patient guided imagery techniques.

C)

Obtain an order for a PRN benzodiazepine.

D)

Describe the procedure in greater detail.

A

A patient with angina has been prescribed nitroglycerin. Before administering the drug, the nurse should inform the patient about what potential adverse effects?

A)

Nervousness or paresthesia

B)

Throbbing headache or dizziness

C)

Drowsiness or blurred vision

D)

Tinnitus or diplopia

B

The nurse is providing an educational workshop about coronary artery disease (CAD) and its risk factors. The nurse explains to participants that CAD has many risk factors, some that can be controlled and some that cannot. What risk factors would the nurse list that can be controlled or modified?

A)

Gender, obesity, family history, and smoking

B)

Inactivity, stress, gender, and smoking

C)

Obesity, inactivity, diet, and smoking

D)

Stress, family history, and obesity

C

A 48-year-old man presents to the ED complaining of severe substernal chest pain radiating down his left arm. He is admitted to the coronary care unit (CCU) with a diagnosis of myocardial infarction (MI). What nursing assessment activity is a priority on admission to the CCU?

A)

Begin ECG monitoring.

B)

Obtain information about family history of heart disease.

C)

Auscultate lung fields.

D)

Determine if the patient smokes.

A