Adult Nursing Coronary Care Case Study: Acute Myocardial Infarction (AMI),
Chest Pain Assessment, ST-Segment Elevation, Sinus Tachycardia with PVCs,
Cardiac Telemetry, Cardiac Marker Interpretation (Troponin T), Risk Factor
Assessment (Hypertension, Smoking History, Obesity, Family History, High-Fat
Diet), Oxygen Therapy, Vital Signs Monitoring, UAP and LPN/LVN Delegation,
Intravenous Medication Administration (Amiodarone, Morphine Sulfate,
Atenolol), Percutaneous Coronary Intervention (PCI) and Cardiac
Catheterization, Post-PCI Care, Dual Antiplatelet Therapy (DAT), Beta-Blocker
Safety, Thrombolytic Timing, Electrolyte Monitoring, Intake and Output, Cardiac
Rehabilitation Phase 1, Patient Education, Psychosocial Support, Documentation
Standards Exam Questions Verified and Provided with Complete A+ Graded
Rationales Latest Updated 2026
Ms. S is a 58-year-old African-American woman who is admitted to the coronary care unit (CCU)
from the emergency department (ED) with reports of chest pressure and indigestion associated
with nausea. She started feeling ill about 10 hours before she called her daughter, who brought
her to the ED for admission. She told the nurse that she tried drinking water and took some
bismuth subsalicylate that was in her bathroom medicine cabinet. She also tried lying down to
rest, but none of these actions helped. She states, "It just gets worse and worse." Ms. S has
been under a health care provider's (HCP's) care for the past 12 years for management of
hypertension and swelling in her ankles. She was a smoker for 43 years but quit 1 year ago.
In the ED, admission laboratory tests, including levels of cardiac markers, were performed, and a
12-lead electrocardiogram (ECG) was taken.
Ms. S's CCU vital sign values on admission are as follows:
-Blood pressure: 174/92 mm Hg
-Heart rate: 120 to 130 beats/min, irregular
, -O2 saturation: 94% on room air
-Respiratory rate: 30 to 34 breaths/min
-Temperature: 99.8° F (37.7° C) (oral)
Which risk factors from Ms. S's history would suggest a possible cardiac problem to the nurse?
Select all that apply.
•Hypertension for 12 years
•Smoked for 43 years; quit smoking 1 year ago
•Surgery for gallbladder removal 1 year ago
•Ms. S's father died at age 42 years from a heart attack
•Client's weight is 278 lb (126 kg)
•Diet includes fast foods three to five times a week
•Hypertension for 12 years
•Smoked for 43 years; quit smoking 1 year ago
•Ms. S's father died at age 42 years from a heart attack
•Client's weight is 278 lb (126 kg)
•Diet includes fast foods three to five times a week
•Risk factors for cardiac problems include hypertension, family history, obesity, and high-fat
diets (which may cause elevation of cholesterol). Gallbladder surgery would not be a risk factor.
Quitting smoking would be a risk factor, and the years that the client smoked would be a strong
risk factor.
Which action is best for the nurse to delegate to a new unlicensed assistive personnel (UAP)
orienting to the CCU when caring for Ms. S?
Chest Pain Assessment, ST-Segment Elevation, Sinus Tachycardia with PVCs,
Cardiac Telemetry, Cardiac Marker Interpretation (Troponin T), Risk Factor
Assessment (Hypertension, Smoking History, Obesity, Family History, High-Fat
Diet), Oxygen Therapy, Vital Signs Monitoring, UAP and LPN/LVN Delegation,
Intravenous Medication Administration (Amiodarone, Morphine Sulfate,
Atenolol), Percutaneous Coronary Intervention (PCI) and Cardiac
Catheterization, Post-PCI Care, Dual Antiplatelet Therapy (DAT), Beta-Blocker
Safety, Thrombolytic Timing, Electrolyte Monitoring, Intake and Output, Cardiac
Rehabilitation Phase 1, Patient Education, Psychosocial Support, Documentation
Standards Exam Questions Verified and Provided with Complete A+ Graded
Rationales Latest Updated 2026
Ms. S is a 58-year-old African-American woman who is admitted to the coronary care unit (CCU)
from the emergency department (ED) with reports of chest pressure and indigestion associated
with nausea. She started feeling ill about 10 hours before she called her daughter, who brought
her to the ED for admission. She told the nurse that she tried drinking water and took some
bismuth subsalicylate that was in her bathroom medicine cabinet. She also tried lying down to
rest, but none of these actions helped. She states, "It just gets worse and worse." Ms. S has
been under a health care provider's (HCP's) care for the past 12 years for management of
hypertension and swelling in her ankles. She was a smoker for 43 years but quit 1 year ago.
In the ED, admission laboratory tests, including levels of cardiac markers, were performed, and a
12-lead electrocardiogram (ECG) was taken.
Ms. S's CCU vital sign values on admission are as follows:
-Blood pressure: 174/92 mm Hg
-Heart rate: 120 to 130 beats/min, irregular
, -O2 saturation: 94% on room air
-Respiratory rate: 30 to 34 breaths/min
-Temperature: 99.8° F (37.7° C) (oral)
Which risk factors from Ms. S's history would suggest a possible cardiac problem to the nurse?
Select all that apply.
•Hypertension for 12 years
•Smoked for 43 years; quit smoking 1 year ago
•Surgery for gallbladder removal 1 year ago
•Ms. S's father died at age 42 years from a heart attack
•Client's weight is 278 lb (126 kg)
•Diet includes fast foods three to five times a week
•Hypertension for 12 years
•Smoked for 43 years; quit smoking 1 year ago
•Ms. S's father died at age 42 years from a heart attack
•Client's weight is 278 lb (126 kg)
•Diet includes fast foods three to five times a week
•Risk factors for cardiac problems include hypertension, family history, obesity, and high-fat
diets (which may cause elevation of cholesterol). Gallbladder surgery would not be a risk factor.
Quitting smoking would be a risk factor, and the years that the client smoked would be a strong
risk factor.
Which action is best for the nurse to delegate to a new unlicensed assistive personnel (UAP)
orienting to the CCU when caring for Ms. S?
