ATI MED SURG: Acute Coronary Syndrome LEWIS Top
quality Exam Review guide Questions and Answers
2025/2026
The nurse is reviewing a patient's lipid profile results. Which level increases the patient's
risk of coronary artery disease (CAD)?
1. Decreased triglycerides
2. Elevated low-density lipoproteins (LDL)
3. Elevated high-density lipoproteins (HDL)
4. Decreased very-low-density lipoproteins (VLDL)
2. Elevated low-density lipoproteins (LDL)
(Elevated LDLs contain more cholesterol than any of the other lipoproteins and have an
affinity for arterial walls. Elevated LDL levels correlate most closely with an increased
incidence of atherosclerosis and CAD. Elevated HDL, decreased triglycerides, and
VLDL are all negative risk factors for CAD).
The nurse recalls that which artery is most commonly used for bypass graft?
1. Radial artery
2. Gastroepiploic artery
3. Inferior epigastric artery
4. Internal mammary artery
4. Internal mammary artery
(Bypass graft surgery involves the replacement of blood vessels that transport blood
between the aorta and the blocked coronary artery. The internal mammary artery (IMA)
is the most common artery used for bypass graft. The long-term patency rate for an IMA
graft is greater than 90 percent after 10 years. Procedures involving the radial,
gastroepiploic, or inferior epigastric artery have a comparatively short-term patency
rate.)
What instruction should the nurse give to the patient who is predisposed to coronary
artery disease (CAD)? Select all that apply.
,1. "Avoid consuming tofu."
2. "Drink whole or 2% milk."
3. "Limit concentrated fruit juice."
4. "Decrease intake of beans."
5. "Choose foods such as buckwheat and oats."
3. "Limit concentrated fruit juice."
5. "Choose foods such as buckwheat and oats."
(Concentrated fruit juices are high in added sugar and should be limited. Buckwheat
and oats are made whole grain and are recommended. Beans are a good source of
fiber and are recommended. The AHA recommends eating tofu because it contains
alpha-linolenic acid, which becomes omega-3 fatty acid in the body. Patients should
select fat free or low fat dairy products.)
The nurse is providing care to a patient with chronic stable angina that is scheduled for
a cardiac catheterization. What finding associated with myocardial ischemia could be
obtained by this diagnostic procedure?
1. ST segment depression
2. Cardiac enlargement
3. Abnormal cardiac wall motion
4. 70% block in right coronary artery
4. 70% block in right coronary artery
(Cardiac catheterization is an invasive diagnostic procedure to find out the location and
severity of blockages in the coronary circulation. ST segment depression is an important
diagnostic finding for the presence of myocardial ischemia, which is obtained by
electrocardiography (ECG). Cardiac enlargement is a sign of heart failure that can be
seen on an x-ray. Echocardiography is used to detect the presence of abnormal wall
motion due to myocardial ischemia.)
A patient experiences mild chest pain during inspiration, while coughing, and while
performing daily activities. Sitting in a forward position relieves the pain. The nurse
identifies that the patient is experiencing what complication of myocardial infarction?
,1. Pericarditis
2. Left-sided heart failure
3. Ventricular aneurysm
4. Papillary muscle dysfunction
1. Pericarditis
(Chest pains experienced during inspiration, coughing, and performing activities that
goes away upon sitting forward indicate acute pericarditis in the patient. Left-sided heart
failure occurs initially with subtle signs such as mild dyspnea, restlessness, agitation, or
slight tachycardia. A ventricular aneurysm may result from thinning of the infarcted
myocardial walls. Papillary muscle dysfunction occurs when the infarcted area includes
the papillary muscle that attaches to the mitral valve.) p. 721
A patient experienced sudden cardiac death (SCD) while hospitalized and survived. The
nurse expects that what preventive treatment will be prescribed?
1. External pacemaker
2. An electrophysiologic study (EPS)
3. Medications to prevent dysrhythmias
4. Implantable cardioverter-defibrillator (ICD)
4. Implantable cardioverter-defibrillator (ICD)
(An ICD is the most common approach to preventing recurrence of SCD. An external
pacemaker may be used in the hospital, but will not be used for the patient living daily
life at home. An EPS may be done to determine if a recurrence is likely and determine
the most effective medication treatment. Medications to prevent dysrhythmias are used,
but are not best for prevention of SCD.) p. 730
**The most common approach to preventing a recurrence is the use of an ICD. It has
been shown that an ICD improves survival compared with drug therapy alone. Drug
therapy and a PCI will not prevent a recurrence of SCD. A CABG is not necessary.
The nurse provides basic physical activity guidelines for a patient that is being
discharged following acute coronary syndrome (ACS). The nurse recommends following
the FITT formula, which includes which guidelines?
, 1. Physical activity that is regular, rhythmic, and repetitive
2. An increase in heart rate of 25 beats/minute over the resting heart rate
3. Physical activity sessions that begin at 5 to 10 minutes and build up to 45 minutes.
4. Mild weightlifting for 10 minutes to allow stretching of muscles before exercising
1. Physical activity that is regular, rhythmic, and repetitive
(The FITT formula includes physical activities that are regular, rhythmic, and repetitive,
using large muscles to build up endurance. The increase in heart rate (HR) should not
exceed 20 beats/min over the resting HR. The physical activity session should build up
to 30 minutes. There is no weightlifting included in the formula.)
Upon taking a lipid-lowering medication for hyperlipidemia, a patient reports muscle
pain. The nurse notes the patient has elevated liver enzymes and creatine kinase
levels. It is most likely that the patient takes which lipid-lowering medication?
1. Niacin
2. Colestipol
3. Simvastatin
4. Gemfibrozil
3. Simvastatin
(Muscle pain and elevated creatine kinase levels are manifestations of rhabdomyolysis.
Elevated liver enzymes and rhabdomyolysis are adverse effects of statin drugs such as
simvastatin. Side effects of niacin include pruritus and flushing. High doses of this drug
may cause decreased liver function. Gemfibrozil is a fibric acid derivative that can cause
rhabdomyolysis when given with a statin drug. Colestipol is a bile-acid sequestrant drug.
This drug does not have any major adverse effects except that it lowers the absorption
of drugs such as warfarin, digoxin, and thiazide diuretics. Colestipol is not related to
rhabdomyolysis.)
A patient with acute coronary syndrome (ACS) receives a prescription for niacin to treat
hyperlipidemia. The nurse observes another care provider giving information about the
medication to the patient. The nurse should question which item that was included in the
education?
1. "Most side effects subside with time."
quality Exam Review guide Questions and Answers
2025/2026
The nurse is reviewing a patient's lipid profile results. Which level increases the patient's
risk of coronary artery disease (CAD)?
1. Decreased triglycerides
2. Elevated low-density lipoproteins (LDL)
3. Elevated high-density lipoproteins (HDL)
4. Decreased very-low-density lipoproteins (VLDL)
2. Elevated low-density lipoproteins (LDL)
(Elevated LDLs contain more cholesterol than any of the other lipoproteins and have an
affinity for arterial walls. Elevated LDL levels correlate most closely with an increased
incidence of atherosclerosis and CAD. Elevated HDL, decreased triglycerides, and
VLDL are all negative risk factors for CAD).
The nurse recalls that which artery is most commonly used for bypass graft?
1. Radial artery
2. Gastroepiploic artery
3. Inferior epigastric artery
4. Internal mammary artery
4. Internal mammary artery
(Bypass graft surgery involves the replacement of blood vessels that transport blood
between the aorta and the blocked coronary artery. The internal mammary artery (IMA)
is the most common artery used for bypass graft. The long-term patency rate for an IMA
graft is greater than 90 percent after 10 years. Procedures involving the radial,
gastroepiploic, or inferior epigastric artery have a comparatively short-term patency
rate.)
What instruction should the nurse give to the patient who is predisposed to coronary
artery disease (CAD)? Select all that apply.
,1. "Avoid consuming tofu."
2. "Drink whole or 2% milk."
3. "Limit concentrated fruit juice."
4. "Decrease intake of beans."
5. "Choose foods such as buckwheat and oats."
3. "Limit concentrated fruit juice."
5. "Choose foods such as buckwheat and oats."
(Concentrated fruit juices are high in added sugar and should be limited. Buckwheat
and oats are made whole grain and are recommended. Beans are a good source of
fiber and are recommended. The AHA recommends eating tofu because it contains
alpha-linolenic acid, which becomes omega-3 fatty acid in the body. Patients should
select fat free or low fat dairy products.)
The nurse is providing care to a patient with chronic stable angina that is scheduled for
a cardiac catheterization. What finding associated with myocardial ischemia could be
obtained by this diagnostic procedure?
1. ST segment depression
2. Cardiac enlargement
3. Abnormal cardiac wall motion
4. 70% block in right coronary artery
4. 70% block in right coronary artery
(Cardiac catheterization is an invasive diagnostic procedure to find out the location and
severity of blockages in the coronary circulation. ST segment depression is an important
diagnostic finding for the presence of myocardial ischemia, which is obtained by
electrocardiography (ECG). Cardiac enlargement is a sign of heart failure that can be
seen on an x-ray. Echocardiography is used to detect the presence of abnormal wall
motion due to myocardial ischemia.)
A patient experiences mild chest pain during inspiration, while coughing, and while
performing daily activities. Sitting in a forward position relieves the pain. The nurse
identifies that the patient is experiencing what complication of myocardial infarction?
,1. Pericarditis
2. Left-sided heart failure
3. Ventricular aneurysm
4. Papillary muscle dysfunction
1. Pericarditis
(Chest pains experienced during inspiration, coughing, and performing activities that
goes away upon sitting forward indicate acute pericarditis in the patient. Left-sided heart
failure occurs initially with subtle signs such as mild dyspnea, restlessness, agitation, or
slight tachycardia. A ventricular aneurysm may result from thinning of the infarcted
myocardial walls. Papillary muscle dysfunction occurs when the infarcted area includes
the papillary muscle that attaches to the mitral valve.) p. 721
A patient experienced sudden cardiac death (SCD) while hospitalized and survived. The
nurse expects that what preventive treatment will be prescribed?
1. External pacemaker
2. An electrophysiologic study (EPS)
3. Medications to prevent dysrhythmias
4. Implantable cardioverter-defibrillator (ICD)
4. Implantable cardioverter-defibrillator (ICD)
(An ICD is the most common approach to preventing recurrence of SCD. An external
pacemaker may be used in the hospital, but will not be used for the patient living daily
life at home. An EPS may be done to determine if a recurrence is likely and determine
the most effective medication treatment. Medications to prevent dysrhythmias are used,
but are not best for prevention of SCD.) p. 730
**The most common approach to preventing a recurrence is the use of an ICD. It has
been shown that an ICD improves survival compared with drug therapy alone. Drug
therapy and a PCI will not prevent a recurrence of SCD. A CABG is not necessary.
The nurse provides basic physical activity guidelines for a patient that is being
discharged following acute coronary syndrome (ACS). The nurse recommends following
the FITT formula, which includes which guidelines?
, 1. Physical activity that is regular, rhythmic, and repetitive
2. An increase in heart rate of 25 beats/minute over the resting heart rate
3. Physical activity sessions that begin at 5 to 10 minutes and build up to 45 minutes.
4. Mild weightlifting for 10 minutes to allow stretching of muscles before exercising
1. Physical activity that is regular, rhythmic, and repetitive
(The FITT formula includes physical activities that are regular, rhythmic, and repetitive,
using large muscles to build up endurance. The increase in heart rate (HR) should not
exceed 20 beats/min over the resting HR. The physical activity session should build up
to 30 minutes. There is no weightlifting included in the formula.)
Upon taking a lipid-lowering medication for hyperlipidemia, a patient reports muscle
pain. The nurse notes the patient has elevated liver enzymes and creatine kinase
levels. It is most likely that the patient takes which lipid-lowering medication?
1. Niacin
2. Colestipol
3. Simvastatin
4. Gemfibrozil
3. Simvastatin
(Muscle pain and elevated creatine kinase levels are manifestations of rhabdomyolysis.
Elevated liver enzymes and rhabdomyolysis are adverse effects of statin drugs such as
simvastatin. Side effects of niacin include pruritus and flushing. High doses of this drug
may cause decreased liver function. Gemfibrozil is a fibric acid derivative that can cause
rhabdomyolysis when given with a statin drug. Colestipol is a bile-acid sequestrant drug.
This drug does not have any major adverse effects except that it lowers the absorption
of drugs such as warfarin, digoxin, and thiazide diuretics. Colestipol is not related to
rhabdomyolysis.)
A patient with acute coronary syndrome (ACS) receives a prescription for niacin to treat
hyperlipidemia. The nurse observes another care provider giving information about the
medication to the patient. The nurse should question which item that was included in the
education?
1. "Most side effects subside with time."
