quiz 3 Flashcards
A 50-year-old received trauma to the chest that caused severe impairment of the primary pacemaker cells of the heart. Which of the following areas received the greatest damage?
A. SA node
B. Ventricles
C. AV node
D. Bundle of HIS
SA node
- A 51-year-old male presents with recurrent chest pain on exertion and is diagnosed with angina pectoris. The pain occurs when:
A. the vagus nerve is stimulated
B. myocardial stretch has exceeded the upper limits
C. the myocardial oxygen supply has fallen below demand
D. cardiac output has fallen below normal levels
C. the myocardial oxygen supply has fallen below demand
- A 53-year-old male patient has been admitted for evaluation of chest pain. He has been diagnosed with angina and prescribed sublingual nitroglycerin tablets. What important instructions for using this medication should the nurse give the patient?
A. if the chest pain is not relieved, go to hospital immediately
B. if the tablet does not dissolve quickly, chew the tablet for maximal effect
C. take up to five doses at 15 minute intervals after an anginal attack
D. sit or lie down when taking a tablet; change positions slowly to avoid falling or fainting
D. sit or lie down when taking a tablet; change positions slowly to avoid falling or fainting
- A 55-year-old male died of a myocardial infarction. What would autopsy most likely reveal?
A. embolization of plaque from the aorta
B. decreased ventricular diastolic filling time
C. indications of myocardial ischemia and necrosis
D. smooth muscle dysplasia in the coronary artery
C. indications of myocardial ischemia and necrosis maybe
- A 60-year-old female has survived a myocardial infarction. The nurse is providing care for impaired ventricular function because:
A. the cells become hypertrophic
B. the resulting ischemia leads to hypoxic injury and myocardial cell death
C. there is a temporary alteration in electrolyte balance
D. there is too much stress on the heart
B. the resulting ischemia leads to hypoxic injury and myocardial cell death
- A 68-year-old male presents to the ER reporting chest pain. He has a history of stable angina that now appears to be unstable. What does he most likely have?
A. decreased myocardial oxygen demand
B. impending MI
C. electrical conduction problems in the heart
D. mild to moderate atherosclerosis
B. impending MI
- A 75-year-old male has severe chest pain and dials 911. Based upon the laboratory findings indicating a patient has elevated levels of cardiac troponins I and T, the nurse suspects which of the following has occurred?
A. angina
B. Raynaud disease
C. MI
D. Orthostatic hypotension
MI
- A client with ST segment elevation in several electrocardiographic (ECG) leads is admitted to the emergency department (ED) and diagnosed as having an ST-segment-elevation myocardial infarction (STEMI). Which of the following questions should the nurse ask to determine whether the client is a candidate for fibrinolytic therapy?
A. “Do you take Aspirin on a daily basis?”
B. “What time did you chest pain begin?”
C. “ Is there any family hx of heart disease?”
D. “Can you describe the quality of your chest pain?”
B. “What time did you chest pain begin?”
- A female patient has been prescribed warfarin (Coumadin®) in addition to a heparin infusion. What is the reason for her receiving two anticoagulants?
A. the oral and injection forms work synergistically
B. oral anticoagulants are used to reach an adequate level of anticoagulation when heparin alone is enable to do so
C. when oral anticoagulants are prescribed, heparin is often used to initiate therapy until laboratory tests indicate an adequate therapeutic response
D. the combination of heparin and an oral anticoagulant results in fewer adverse effects than heparin used alone
C. when oral anticoagulants are prescribed, heparin is often used to initiate therapy until laboratory tests indicate an adequate therapeutic response
- A male patient will be receiving streptokinase as part of the treatment of acute myocardial infarction. He asks why he is being prescribed this drug. The nurse’s best response is to tell him that the drug is being prescribed to
A. prevent further clot formation
B. dissolve the clot in his coronary artery
C. control bleeding in the coronary microcirculation
D. relieve chest pain
B. dissolve the clot in his coronary artery
- A patient has started on anticoagulant drugs. What is the primary goal of this therapy?
A. to prevent thrombus formation
B. to prevent the thrombus from becoming an embolus
C. to dissolve an existing thrombus
D. to stabilize an existing thrombus
to prevent thrombus formation
- The nurse is admitting a client who has chest pain is to the emergency department and all the following diagnostic tests are prescribed. Which of the following tests should the nurse arrange to be completed first?
A. CT scan
B. ECG
C. troponin level
D. chest x-ray
ECG
- The nurse is caring for a client who has a normal cardiac rhythm and a heart rate of 72 beats/minute, except that the P-R interval is 0.24 seconds. Which of the following actions should the nurse implement?
A. prepare the client for temporary pacemaker insertion
B. document the finding and continue to monitor the client
C. notify the client’s HCP immediately
D. administer atropine per agency bradycardia protocol
B. document the finding and continue to monitor the client
- The nurse is caring for a client who has survived a sudden cardiac death (SCD) event and has no evidence of an acute myocardial infarction. Which of the following information should the nurse teach the client?
A. how to self administer low molecular weight heparin
B. to limit activities after discharge to prevent future events
C. about the purpose of outpatient Holter monitoring
D. that sudden cardiac death events rarely reoccur
C. about the purpose of outpatient Holter monitoring
- The nurse is caring for a client whose cardiac monitor shows sinus tachycardia, rate 102, and is apneic with no pulses are palpable by the nurse. Which of the following actions should the nurse do first?
A. start CPR
B. defibrillate
C. give 100% oxygen per nonrebreather mask
D. administer atropine per hospital protocol
start cpr
