Ineffective Tissue Perfusion: Myocardial Infarction Flashcards
What are the primary causes of myocardial infarction?
A) Hypertension and electrolyte imbalances
B) Atherosclerosis, thrombus formation, and vasospasm
C) Viral infections and autoimmune conditions
D) Valvular disorders and arrhythmias
B) Atherosclerosis, thrombus formation, and vasospasm
Rationale: Atherosclerosis (plaque buildup), thrombosis (clot formation), and vasospasm (sudden narrowing of arteries) can block coronary blood flow, causing MI.
Which electrocardiogram (EKG) changes are commonly seen in myocardial infarction?
A) Prolonged PR interval
B) ST elevation or depression, T-wave inversion, or Q waves
C) Widened QRS complex
D) Decreased heart rate variability
B) ST elevation or depression, T-wave inversion, or Q waves
Rationale: MI causes ischemic changes that can lead to ST elevation (STEMI), ST depression (NSTEMI), or pathological Q waves
A 65-year-old male with a history of hypertension and smoking presents with chest pain that does not improve with rest. What is the most likely diagnosis?
A) Stable angina
B) Myocardial infarction (MI)
C) Pericarditis
D) Aortic aneurysm
B) Myocardial infarction (MI)
Rationale: Chest pain that is unrelieved by rest is a hallmark sign of MI, distinguishing it from stable angina.
Which cardiac biomarkers are used to diagnose an MI?
A) BNP and CK-MM
B) Troponin, CK-MB, and myoglobin
C) D-dimer and lactate dehydrogenase
D) Albumin and sodium
B) Troponin, CK-MB, and myoglobin
Rationale: Troponin (most specific), CK-MB, and myoglobin indicate cardiac muscle damage, confirming an MI diagnosis.
Which of the following is a classic symptom of myocardial infarction?
A) Sharp, localized chest pain that worsens with deep breaths
B) Chest pressure or pain radiating to the arm, jaw, or back
C) Pain that improves with movement
D) Pulsatile abdominal mass
B) Chest pressure or pain radiating to the arm, jaw, or back
Rationale: MI pain is typically described as pressure, tightness, or squeezing, often radiating to the left arm, jaw, or back.
A patient presents with nausea, diaphoresis, shortness of breath, and dizziness, but no chest pain. What should the nurse suspect?
A) Acid reflux
B) Silent myocardial infarction
C) Anxiety attack
D) Pulmonary embolism
B) Silent myocardial infarction
Rationale: Some MI patients, especially women, diabetics, and elderly individuals, may experience atypical symptoms like nausea, sweating, and dizziness instead of chest pain.
What is the recommended treatment window for MI intervention?
A) Within 3 hours
B) Within 90 minutes
C) Within 6 hours
D) Within 24 hours
B) Within 90 minutes
Rationale: Immediate intervention (PCI or thrombolytics) within 90 minutes significantly reduces myocardial damage and improves survival.
What are the common dysrhythmias that occur after an MI?
A) Sinus bradycardia and atrial flutter
B) Ventricular tachycardia and ventricular fibrillation
C) First-degree AV block and sinus tachycardia
D) Premature atrial contractions
B) Ventricular tachycardia and ventricular fibrillation
Rationale: Post-MI patients are at high risk for life-threatening arrhythmias like VT and VF, which require immediate intervention.
A patient experiencing an MI is given nitroglycerin. What is the expected effect?
A) Decreased pain and improved coronary perfusion
B) Increased heart rate and cardiac workload
C) Constriction of coronary arteries
D) Prevention of arrhythmias
A) Decreased pain and improved coronary perfusion
Rationale: Nitroglycerin dilates coronary arteries, improving blood flow and reducing chest pain.
What surgical interventions are used to treat MI?
A) Coronary angioplasty with stent and coronary artery bypass graft (CABG)
B) Heart transplant and valve replacement
C) Pacemaker implantation and balloon valvuloplasty
D) Radiofrequency ablation and carotid endarterectomy
A) Coronary angioplasty with stent and coronary artery bypass graft (CABG)
Rationale: PCI (angioplasty with stent) and CABG are used to restore blood flow in blocked coronary arteries.
A post-MI patient is being discharged. Which lifestyle modification is MOST important?
A) Drinking 8 cups of coffee daily
B) Maintaining a high-fat diet
C) Smoking cessation and regular exercise
D) Avoiding all physical activity
C) Smoking cessation and regular exercise
Rationale: Smoking cessation, a heart-healthy diet, and regular exercise reduce the risk of future MIs.
What medications are commonly prescribed after an MI?
A) Beta-blockers, antiplatelets, and statins
B) NSAIDs, diuretics, and antibiotics
C) Opioids, benzodiazepines, and anticonvulsants
D) Antifungals, steroids, and insulin
A) Beta-blockers, antiplatelets, and statins
Rationale: Post-MI patients require beta-blockers (reduce workload), antiplatelets (prevent clots), and statins (lower cholesterol).
A patient with a history of MI is experiencing sudden shortness of breath, crackles in the lungs, and pink frothy sputum. What complication should the nurse suspect?
A) Pulmonary embolism
B) Heart failure
C) Pleural effusion
D) Asthma exacerbation
B) Heart failure
Rationale: Post-MI patients are at risk for heart failure, leading to fluid overload, pulmonary congestion, and respiratory distress.
What is the gold standard diagnostic test for confirming an MI?
A) Chest X-ray
B) Troponin levels
C) Complete blood count (CBC)
D) CT scan
B) Troponin levels
Rationale: Troponins are cardiac-specific biomarkers that indicate myocardial damage, making them the most reliable MI diagnostic tool.
