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What are the risk factors for coronary artery disease? Select all…
What are the risk factors for coronary artery disease? Select all that apply.
Select 3 correct answer(s)
Question 1 options:
Tobacco use
Elevated serum lipid levels
Body mass index < 24
Hypotension
Increasing age
Question 2
The nurse understands that atherosclerosis is a leading cause of coronary artery disease. List in order the pathophysiological development of atherosclerosis.
Question 2 options:
1 2 3 4 5 6 The lipoproteins become oxidized and engulfed by macrophages producing foam cells,
1 2 3 4 5 6 Foam cells combine with additional lipids to form fatty streaks
1 2 3 4 5 6 The plaques accumulate platelet caps which can occlude the artery.
1 2 3 4 5 6 An injury to the intima lining of an arterial blood vessel
1 2 3 4 5 6 The fatty streaks gradually harden over time to form fibrous plaques
1 2 3 4 5 6 Low-density lipoproteins filter into the lining of the blood vessel and become trapped.
Question 3
What health promoting behaviors should the nurse include in Mrs. Jones teaching plan. Select all that apply.
Select 3 correct answer(s)
Question 3 options:
Have your blood pressure checked regularly
Check blood glucose levels daily
Drink a glass of red wine with each evening meal
Engage in a regular exercise program
Eat a diet high in fruits, vegetables and fiber
Question 4
The patient is newly diagnosed with hyperlipidemia. What medication does the nurse anticipate will be prescribed for her?
Question 4 options:
metoprolol
simvastatin
lisinopril
amlodipine
Coronary artery disease (CAD) is a progressive disease. Mrs. Jones has been diagnosed with coronary artery disease for almost a year now. Today, she comes to the ER after participating in a walk program with complaints of chest pain. Mrs. Jones describes the chest pain as "pressure", rating it 7/10. She is triaged, moved to a treatment room and is placed in a gown.
Question 5
What order will the emergency room (ER) nurse implement first?
Question 5 options:
Insert an IV access and infuse fluids
Apply supplement oxygen at 2L NC
Place the patient on a heart monitor
Draw lab for cardiac enzymes
Question 6
What is happening on a cellular level in the heart when the patient is initially experiencing angina?
Question 6 options:
Apoptosis of cardiac cells begins
Coronary arteries become vasodilated
Myocardial cells experience hypoxia
Sinoatrial node fails to fire regularly
Question 7 (1 point)
What medication does the nurse anticipate will be administered immediately to this patient for their acute angina?
Question 7 options:
Isosorbide mononitrate po
Alteplase IV
Digoxin po
Nitroglycerin SL
Question 8
If Mrs. Jones angina is not resolved quickly (within a few minutes) what pathophysiological process begins in the heart?
Question 8 options:
Anerobic metabolism begins, and lactic acid is produced
Development of pulmonary hypertension and edema
The AV node takes over as the primary pacemaker
The mitral and aortic valves will begin to stenosis
Mrs. Jones's chest pain continues to worsen. She now describes the pain as 10/10 and "like someone is squeezing my chest". The patient is also diaphoretic. The nurse suspects the patient is experiencing a myocardial infarction.
Question 9
What statement best describes pathophysiological process of a myocardial infarction?
Question 9 options:
There is retrograde blood flow into the left ventricle
A thrombus occludes a coronary artery
A thickening in the muscle wall which decreases cardiac output
Inflammation occurs in the myocardial layer of the heart
Question 10
What interventions and orders will the nurse implement now? Select all that apply.
Select 4 correct answer(s)
Question 10 options:
Administer morphine sulfate for pain
Insert an IV access and infuse Normal Saline
Provide a full liquid diet
Obtain frequent vital signs
Obtain a 12-lead electrocardiogram (ECG)
Question 11
The patient's lab has returned. Which lab value best supports the diagnosis of myocardial infarction?
Question 11 options:
Decreased beta natriuretic peptide levels
Elevated Troponin I levels
Decreased lactic acid levels
Elevated homocysteine levels
The ER physician consults a cardiologist who give orders for the patient to have an emergency percutaneous coronary intervention (PCI).
Question 12
As the nurse is preparing the patient for the procedure, the patient says, "Can you explain this procedure to me, I did not understand what the doctor said?" What is the nurse's best response?
Question 12 options:
A fibrinolytic medication is administered and the clot which is occluding the artery in your heart will be dissolved.
A catheter will be placed and guided into the artery in your heart and a balloon on the end of the catheter will expand, opening the artery
A technician will use a specialized probe will take ultrasound pictures of your heart to look at its structures and ability to pump
Surgery which will place a graft on your heart, routing blood around the blocked artery improving the circulation on your
The patient is transferred to special procedures and the cardiologist successfully performs the percutaneous coronary intervention. The patient is immediately transferred to the coronary care unit. You are the nurse receiving the patient.
Question 13
The nurse has just received the patient from the special procedure lab. What intervention will the nurse do first?
Question 13 options:
Apply compression stockings
Look at the IV insertion site
Examine the dressing site
Palpate peripheral pulses
Question 14
Immediately following the procedure, what interventions and orders will the nurse now include in the patient's plan of care? Select all that apply.
Select 3 correct answer(s)
Question 14 options:
Assess the dressing for bleeding frequently
Administer aspirin for pain management
Place on complete bed rest for 6-8 hours
Place the patient on heart monitor
Keep the patient NPO for 24 hours
Question 15
Seventy-two (72) hours after the procedure, the patient has fully recovered. The nurse is preparing his discharge teaching.
What will the nurse include in the patient's teaching plan? Select all that apply.
Select 4 correct answer(s)
Question 15 options:
Encourage your family and friends to take CPR certification classes
Take your cholesterol lowering medication in the evening
Begin a diet low in saturated fats and high in fiber
If you experience chest pain, take your nitroglycerin tab under your tongue
Begin a moderate to high impact exercise program quickly
Intermittent bleeding from your procedure site is expected for a few more days