Lewis Med-Surg Chapter 33; CAD and Acute Coronary
Syndrome Practice test exam Questions with complete
solutions verified by experts 2025/2026
When evaluating the effectiveness of preoperative teaching with a patient scheduled for
coronary artery bypass graft (CABG) surgery using the internal mammary artery, the
nurse determines that additional teaching is needed when the patient says which of the
following?
a. "They will circulate my blood with a machine during surgery."
b. "I will have incisions in my leg where they will remove the vein."
c. "They will use an artery near my heart to go around the area that is blocked."
d. "I will need to take an aspirin every day after the surgery to keep the graft open." -
correct answer ANS: B
When the internal mammary artery is used there is no need to have a saphenous vein
removed from the leg. The other statements by the patient are accurate and indicate
that the teaching has been effective.
DIF: Cognitive Level: Apply (application)
A patient who is recovering from an acute myocardial infarction (AMI) asks the nurse
when sexual intercourse can be resumed. Which response by the nurse is best?
a. "Most patients are able to enjoy intercourse without any complications."
b. "Sexual activity uses about as much energy as climbing two flights of stairs."
c. "The doctor will provide sexual guidelines when your heart is strong enough."
d. "Holding and cuddling are good ways to maintain intimacy after a heart attack." -
correct answer ANS: B
Sexual activity places about as much physical stress on the cardiovascular system as
most moderate-energy activities such as climbing two flights of stairs. The other
responses do not directly address the patient's question or may not be accurate for this
patient.
DIF: Cognitive Level: Apply (application)
,A patient with hyperlipidemia has a new order for colesevelam (Welchol). Which nursing
action is appropriate when scheduling this medication?
a. Administer the medication at the patient's usual bedtime.
b. Have the patient take the colesevelam 1 hour before breakfast.
c. Give the patient's other medications 2 hours after colesevelam.
d. Have the patient take the dose at the same time as the prescribed aspirin. - correct
answer ANS: C
The bile acid sequestrants interfere with the absorption of many other drugs and giving
other medications at the same time should be avoided. Taking an aspirin concurrently
with the colesevelam may increase the incidence of gastrointestinal side effects such as
heartburn. For maximum effect, colesevelam should be administered with meals.
DIF: Cognitive Level: Apply (application)
The nurse is caring for a patient who was admitted to the coronary care unit following an
acute myocardial infarction (AMI) and percutaneous coronary intervention the previous
day. Teaching for this patient would include
a. when cardiac rehabilitation will begin.
b. the typical emotional responses to AMI.
c. information regarding discharge medications.
d. the pathophysiology of coronary artery disease. - correct answer ANS: A
Early after an AMI, the patient will want to know when resumption of usual activities can
be expected. At this time, the patient's anxiety level or denial will interfere with good
understanding of complex information such as the pathophysiology of coronary artery
disease. Teaching about discharge medications should be done closer to discharge.
The nurse should support the patient by decreasing anxiety rather than discussing the
typical emotional responses to myocardial infarction.
DIF: Cognitive Level: Apply (application)
, A patient who has recently started taking pravastatin (Pravachol) and niacin reports
several symptoms to the nurse. Which information is most important to communicate to
the health care provider?
a. Generalized muscle aches and pains
b. Dizziness with rapid position changes
c. Nausea when taking the drugs before meals
d. Flushing and pruritus after taking the drugs - correct answer ANS: A
Muscle aches and pains may indicate myopathy and rhabdomyolysis, which have
caused acute kidney injury and death in some patients who have taken the statin
medications. These symptoms indicate that the pravastatin may need to be
discontinued. The other symptoms are common side effects when taking niacin, and
although the nurse should follow-up with the health care provider, they do not indicate
that a change in medication is needed.
DIF: Cognitive Level: Analyze (analysis)
A patient who is being admitted to the emergency department with intermittent chest
pain gives the following list of daily medications to the nurse. Which medication has the
most immediate implications for the patient's care?
a. captopril c. furosemide (Lasix)
b. sildenafil (Viagra) d. warfarin (Coumadin) - correct answer ANS: B
The nurse will need to avoid giving nitrates to the patient because nitrate administration
is contraindicated in patients who are using sildenafil because of the risk of severe
hypotension caused by vasodilation. The other home medications should also be
documented and reported to the health care provider but do not have as immediate an
impact on decisions about the patient's treatment.
DIF: Cognitive Level: Analyze (analysis)
Which assessment finding by the nurse caring for a patient who has had coronary artery
bypass grafting using a right radial artery graft is most important to communicate to the
health care provider?
a. Complaints of incisional chest pain
Syndrome Practice test exam Questions with complete
solutions verified by experts 2025/2026
When evaluating the effectiveness of preoperative teaching with a patient scheduled for
coronary artery bypass graft (CABG) surgery using the internal mammary artery, the
nurse determines that additional teaching is needed when the patient says which of the
following?
a. "They will circulate my blood with a machine during surgery."
b. "I will have incisions in my leg where they will remove the vein."
c. "They will use an artery near my heart to go around the area that is blocked."
d. "I will need to take an aspirin every day after the surgery to keep the graft open." -
correct answer ANS: B
When the internal mammary artery is used there is no need to have a saphenous vein
removed from the leg. The other statements by the patient are accurate and indicate
that the teaching has been effective.
DIF: Cognitive Level: Apply (application)
A patient who is recovering from an acute myocardial infarction (AMI) asks the nurse
when sexual intercourse can be resumed. Which response by the nurse is best?
a. "Most patients are able to enjoy intercourse without any complications."
b. "Sexual activity uses about as much energy as climbing two flights of stairs."
c. "The doctor will provide sexual guidelines when your heart is strong enough."
d. "Holding and cuddling are good ways to maintain intimacy after a heart attack." -
correct answer ANS: B
Sexual activity places about as much physical stress on the cardiovascular system as
most moderate-energy activities such as climbing two flights of stairs. The other
responses do not directly address the patient's question or may not be accurate for this
patient.
DIF: Cognitive Level: Apply (application)
,A patient with hyperlipidemia has a new order for colesevelam (Welchol). Which nursing
action is appropriate when scheduling this medication?
a. Administer the medication at the patient's usual bedtime.
b. Have the patient take the colesevelam 1 hour before breakfast.
c. Give the patient's other medications 2 hours after colesevelam.
d. Have the patient take the dose at the same time as the prescribed aspirin. - correct
answer ANS: C
The bile acid sequestrants interfere with the absorption of many other drugs and giving
other medications at the same time should be avoided. Taking an aspirin concurrently
with the colesevelam may increase the incidence of gastrointestinal side effects such as
heartburn. For maximum effect, colesevelam should be administered with meals.
DIF: Cognitive Level: Apply (application)
The nurse is caring for a patient who was admitted to the coronary care unit following an
acute myocardial infarction (AMI) and percutaneous coronary intervention the previous
day. Teaching for this patient would include
a. when cardiac rehabilitation will begin.
b. the typical emotional responses to AMI.
c. information regarding discharge medications.
d. the pathophysiology of coronary artery disease. - correct answer ANS: A
Early after an AMI, the patient will want to know when resumption of usual activities can
be expected. At this time, the patient's anxiety level or denial will interfere with good
understanding of complex information such as the pathophysiology of coronary artery
disease. Teaching about discharge medications should be done closer to discharge.
The nurse should support the patient by decreasing anxiety rather than discussing the
typical emotional responses to myocardial infarction.
DIF: Cognitive Level: Apply (application)
, A patient who has recently started taking pravastatin (Pravachol) and niacin reports
several symptoms to the nurse. Which information is most important to communicate to
the health care provider?
a. Generalized muscle aches and pains
b. Dizziness with rapid position changes
c. Nausea when taking the drugs before meals
d. Flushing and pruritus after taking the drugs - correct answer ANS: A
Muscle aches and pains may indicate myopathy and rhabdomyolysis, which have
caused acute kidney injury and death in some patients who have taken the statin
medications. These symptoms indicate that the pravastatin may need to be
discontinued. The other symptoms are common side effects when taking niacin, and
although the nurse should follow-up with the health care provider, they do not indicate
that a change in medication is needed.
DIF: Cognitive Level: Analyze (analysis)
A patient who is being admitted to the emergency department with intermittent chest
pain gives the following list of daily medications to the nurse. Which medication has the
most immediate implications for the patient's care?
a. captopril c. furosemide (Lasix)
b. sildenafil (Viagra) d. warfarin (Coumadin) - correct answer ANS: B
The nurse will need to avoid giving nitrates to the patient because nitrate administration
is contraindicated in patients who are using sildenafil because of the risk of severe
hypotension caused by vasodilation. The other home medications should also be
documented and reported to the health care provider but do not have as immediate an
impact on decisions about the patient's treatment.
DIF: Cognitive Level: Analyze (analysis)
Which assessment finding by the nurse caring for a patient who has had coronary artery
bypass grafting using a right radial artery graft is most important to communicate to the
health care provider?
a. Complaints of incisional chest pain
