ACUTE CORONARY SYNDROME NCLEX EXAM
PRACTICE QUESTIONS WITH VERIFIED
SOLUTIONS
Which of the following atypical symptoms may be present in the female client
experiencing myocardial infarction (MI)? Select all that apply.
Sharp, inspiratory chest pain
Dyspnea
Dizziness
Extreme fatigue
Anorexia --ANSWER--Dyspnea, Dizziness, Extreme fatigue
To validate that the client has had a myocardial infarction (MI), the nurse
assesses for positive findings on which tests?
1. Creatine kinase-MB fraction (CK-MB) and alkaline phosphatase
2. Homocysteine and C-reactive protein
3. Total cholesterol, low-density lipoprotein (LDL) and high-density lipoprotein
(HDL) cholesterols
4. Myoglobin and troponin --ANSWER--4. Myoglobin, troponin, and CK-MB
are the cardiac markers used to determine whether MI has occurred.
Homocysteine and C-reactive protein are markers of inflammation, which may
represent risk for MI, but they are not diagnostic for MI.
Page | 1
,When caring for a client with acute myocardial infarction, the nurse recognizes
that prompt pain management is essential for which reason?
1.The discomfort will increase client anxiety and reduce coping.
2. Pain relief improves the oxygen supply and decreases oxygen demand.
3. Relief of pain indicates that the myocardial infarction is resolving.
4. Pain medication should not be used until a definitive diagnosis has been
established. --ANSWER--2. The focus of pain relief is on reducing myocardial
oxygen demand. Chest discomfort will increase anxiety, but it may not affect
coping. The major purpose of pain relief is to reduce myocardial oxygen
demand. Relief of pain is secondary to the use of opiates or indicates that the
tissue infarction is complete.
When planning care for a client in the emergency department, the nurse
recognizes that which interventions are needed in the acute phase? Select all
that apply.
Morphine sulfate
Oxygen
Nitroglycerin
Naloxone
Acetaminophen
Verapamil (Calan, Isoptin) --ANSWER--Morphine: Morphine is needed to
reduce oxygen demand, preload, pain, and anxiety.
Oxygen: will increase available oxygen for the ischemic myocardium.
Nitroglycerin is used to reduce preload and chest pain.
Page | 2
, The client is given aspirin to chew; acetaminophen may be used for headache
related to nitroglycerin. Owing to negative inotropic action, calcium channel
blockers are used for angina, not for myocardial infarction (MI).
After thrombolytic therapy, the nurse working in the cardiac catheterization
laboratory would be alarmed to notice which sign?
1. 1 inch backup of blood in the IV tubing
2. Facial drooping
3. Partial thromboplastin time (PTT) 68 seconds
4. Report of chest pressure during dye injection --ANSWER--2. During and
after thrombolytic administration, the nurse observes for any indications of
bleeding, including changes in neurologic status, which may indicate
intracranial bleeding.
The client with unstable angina has received education about the acute coronary
syndrome. Which of the following indicates that he understood the teaching?
1. "This is a big warning, I must modify my lifestyle or risk having a heart
attack in the next year."
2. "Angina is just a temporary interruption of blood flow to my heart."
3. "I need to tell my wife I've had a heart attack."
4. "Because this was temporary, I will not need to take any medications for my
heart." --ANSWER--1. Among people who have unstable angina, 10% to 30%
have a myocardial infarction (MI) within 1 year. Although angina pain is
Page | 3
PRACTICE QUESTIONS WITH VERIFIED
SOLUTIONS
Which of the following atypical symptoms may be present in the female client
experiencing myocardial infarction (MI)? Select all that apply.
Sharp, inspiratory chest pain
Dyspnea
Dizziness
Extreme fatigue
Anorexia --ANSWER--Dyspnea, Dizziness, Extreme fatigue
To validate that the client has had a myocardial infarction (MI), the nurse
assesses for positive findings on which tests?
1. Creatine kinase-MB fraction (CK-MB) and alkaline phosphatase
2. Homocysteine and C-reactive protein
3. Total cholesterol, low-density lipoprotein (LDL) and high-density lipoprotein
(HDL) cholesterols
4. Myoglobin and troponin --ANSWER--4. Myoglobin, troponin, and CK-MB
are the cardiac markers used to determine whether MI has occurred.
Homocysteine and C-reactive protein are markers of inflammation, which may
represent risk for MI, but they are not diagnostic for MI.
Page | 1
,When caring for a client with acute myocardial infarction, the nurse recognizes
that prompt pain management is essential for which reason?
1.The discomfort will increase client anxiety and reduce coping.
2. Pain relief improves the oxygen supply and decreases oxygen demand.
3. Relief of pain indicates that the myocardial infarction is resolving.
4. Pain medication should not be used until a definitive diagnosis has been
established. --ANSWER--2. The focus of pain relief is on reducing myocardial
oxygen demand. Chest discomfort will increase anxiety, but it may not affect
coping. The major purpose of pain relief is to reduce myocardial oxygen
demand. Relief of pain is secondary to the use of opiates or indicates that the
tissue infarction is complete.
When planning care for a client in the emergency department, the nurse
recognizes that which interventions are needed in the acute phase? Select all
that apply.
Morphine sulfate
Oxygen
Nitroglycerin
Naloxone
Acetaminophen
Verapamil (Calan, Isoptin) --ANSWER--Morphine: Morphine is needed to
reduce oxygen demand, preload, pain, and anxiety.
Oxygen: will increase available oxygen for the ischemic myocardium.
Nitroglycerin is used to reduce preload and chest pain.
Page | 2
, The client is given aspirin to chew; acetaminophen may be used for headache
related to nitroglycerin. Owing to negative inotropic action, calcium channel
blockers are used for angina, not for myocardial infarction (MI).
After thrombolytic therapy, the nurse working in the cardiac catheterization
laboratory would be alarmed to notice which sign?
1. 1 inch backup of blood in the IV tubing
2. Facial drooping
3. Partial thromboplastin time (PTT) 68 seconds
4. Report of chest pressure during dye injection --ANSWER--2. During and
after thrombolytic administration, the nurse observes for any indications of
bleeding, including changes in neurologic status, which may indicate
intracranial bleeding.
The client with unstable angina has received education about the acute coronary
syndrome. Which of the following indicates that he understood the teaching?
1. "This is a big warning, I must modify my lifestyle or risk having a heart
attack in the next year."
2. "Angina is just a temporary interruption of blood flow to my heart."
3. "I need to tell my wife I've had a heart attack."
4. "Because this was temporary, I will not need to take any medications for my
heart." --ANSWER--1. Among people who have unstable angina, 10% to 30%
have a myocardial infarction (MI) within 1 year. Although angina pain is
Page | 3
