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Three days after experiencing a myocardial infarction (MI) ,a patient who is scheduled for discharge asks for assistance with hygiene activities,saying,"I am too nervous to take care of myself." Based on this information,which nursing diagnosis is appropriate?


A) Ineffective coping related to anxiety
B) Activity intolerance related to weakness
C) Denial related to lack of acceptance of the MI
D) Disturbed personal identity related to understanding of illness

Correct Answer

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Nadolol (Corgard) is prescribed for a patient with chronic stable angina and left ventricular dysfunction.To determine whether the drug is effective,the nurse will monitor for


A) decreased blood pressure and heart rate.
B) fewer complaints of having cold hands and feet.
C) improvement in the strength of the distal pulses.
D) the ability to do daily activities without chest pain.

Correct Answer

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The nurse will suspect that the patient with stable angina is experiencing a side effect of the prescribed metoprolol (Lopressor) if the


A) patient is restless and agitated.
B) blood pressure is 90/54 mm Hg.
C) patient complains about feeling anxious.
D) cardiac monitor shows a heart rate of 61 beats/minute.

Correct Answer

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In preparation for discharge,the nurse teaches a patient with chronic stable angina how to use the prescribed short-acting and long-acting nitrates.Which patient statement indicates that the teaching has been effective?


A) "I will check my pulse rate before I take any nitroglycerin tablets."
B) "I will put the nitroglycerin patch on as soon as I get any chest pain."
C) "I will stop what I am doing and sit down before I put the nitroglycerin under my tongue."
D) "I will be sure to remove the nitroglycerin patch before taking any sublingual nitroglycerin."

Correct Answer

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A patient with ST-segment elevation in three contiguous electrocardiographic (ECG) leads is admitted to the emergency department (ED) and diagnosed as having an ST-segment-elevation myocardial infarction (STEMI) .Which question should the nurse ask to determine whether the patient is a candidate for thrombolytic therapy?


A) "Do you have any allergies?"
B) "Do you take aspirin on a daily basis?"
C) "What time did your chest pain begin?"
D) "Can you rate your chest pain using a 0 to 10 scale?"

Correct Answer

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Diltiazem (Cardizem) is ordered for a patient with newly diagnosed Prinzmetal's (variant) angina.When teaching the patient,the nurse will include the information that diltiazem will


A) reduce heart palpitations.
B) decrease spasm of the coronary arteries.
C) increase the force of the heart contractions.
D) help prevent plaque from forming in the coronary arteries.

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A patient who is recovering from an acute myocardial infarction (AMI) asks the nurse about when sexual intercourse can be resumed.Which response by the nurse is best?


A) "Most patients are able to enjoy intercourse without any complications."
B) "Sexual activity uses about as much energy as climbing two flights of stairs."
C) "The doctor will provide sexual guidelines when your heart is strong enough."
D) "Holding and cuddling are good ways to maintain intimacy after a heart attack."

Correct Answer

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Which information about a patient who has been receiving thrombolytic therapy for an acute myocardial infarction (AMI) is most important for the nurse to communicate to the health care provider?


A) No change in the patient's chest pain
B) An increase in troponin levels from baseline
C) A large bruise at the patient's IV insertion site
D) A decrease in ST-segment elevation on the electrocardiogram

Correct Answer

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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.

Correct Answer

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A patient who has chest pain is admitted to the emergency department (ED) and all of the following are ordered.Which one should the nurse arrange to be completed first?


A) Chest x-ray
B) Troponin level
C) Electrocardiogram (ECG)
D) Insertion of a peripheral IV

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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."

Correct Answer

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A patient with hyperlipidemia has a new order for colesevelam (Welchol) .Which nursing action is most appropriate when giving the medication?


A) Have the patient take this medication with an aspirin.
B) Administer the medication at the patient's usual bedtime.
C) Have the patient take the colesevelam with a sip of water.
D) Give the patient's other medications 2 hours after the colesevelam.

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Heparin is ordered for a patient with a non-ST-segment-elevation myocardial infarction (NSTEMI) .What is the purpose of the heparin?


A) Heparin enhances platelet aggregation.
B) Heparin decreases coronary artery plaque size.
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.

Correct Answer

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The nurse obtains the following data when assessing a patient who experienced an ST-segment-elevation myocardial infarction (STEMI) 2 days previously.Which information is most important to report to the health care provider?


A) The troponin level is elevated.
B) The patient denies ever having a heart attack.
C) Bilateral crackles are auscultated in the mid-lower lobes.
D) The patient has occasional premature atrial contractions (PACs) .

Correct Answer

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When caring for a patient who is recovering from a sudden cardiac death (SCD) event and has no evidence of an acute myocardial infarction (AMI) ,the nurse will anticipate teaching the patient that


A) sudden cardiac death events rarely reoccur.
B) additional diagnostic testing will be required.
C) long-term anticoagulation therapy will be needed.
D) limited physical activity after discharge will be needed to prevent future events.

Correct Answer

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Which patient at the cardiovascular clinic requires the most immediate action by the nurse?


A) Patient with type 2 diabetes whose current blood glucose level is 145 mg/dL
B) Patient with stable angina whose chest pain has recently increased in frequency
C) Patient with familial hypercholesterolemia and a total cholesterol of 465 mg/dL
D) Patient with chronic hypertension whose blood pressure today is 172/98 mm Hg

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A patient admitted to the coronary care unit (CCU) with an ST-segment-elevation myocardial infarction (STEMI) is restless and anxious.The blood pressure is 86/40 and heart rate is 123.Based on this information,which nursing diagnosis is a priority for the patient?


A) Acute pain related to myocardial infarction
B) Anxiety related to perceived threat of death
C) Stress overload related to acute change in health
D) Decreased cardiac output related to cardiogenic shock

Correct Answer

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During the administration of the thrombolytic agent to a patient with an acute myocardial infarction (AMI) ,the nurse should stop the drug infusion if the patient experiences


A) bleeding from the gums.
B) increase in blood pressure.
C) a decrease in level of consciousness.
D) a nonsustained episode of ventricular tachycardia.

Correct Answer

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Which electrocardiographic (ECG) change is most important for the nurse to report to the health care provider when caring for a patient with chest pain?


A) Inverted P wave
B) Sinus tachycardia
C) ST-segment elevation
D) First-degree atrioventricular block

Correct Answer

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To improve the physical activity level for a mildly obese 71-year-old patient,which action should the nurse plan to take?


A) Stress that weight loss is a major benefit of increased exercise.
B) Determine what kind of physical activities the patient usually enjoys.
C) Tell the patient that older adults should exercise for no more than 20 minutes at a time.
D) Teach the patient to include a short warm-up period at the beginning of physical activity.

Correct Answer

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