Management Of Patients With Coronary Vascular Disorders Test
Chapter 28: Management Of Patients With Coronary Vascular Disorders
1. The nurse is caring for a patient who has been diagnosed with an elevated cholesterol
level. The nurse is aware that plaque on the inner lumen of arteries is composed chiefly of
what?
A) Lipids and fibrous tissue
B) WBCs
C) Lipoproteins
D) High-density cholesterol
ANS: A
As T-lymphocytes and monocytes infiltrate to ingest lipids on the arterial wall and then die,
a fibrous tissue develops. This causes plaques to form on the inner lumen of arterial walls.
PTS: 1 DIF: Easy REF: 756 OBJ: 1
TOP: Coronary Atherosclerosis
KEY: Client Needs: D-4 | Cognitive Level: Comprehension | Integrated Process: Nursing
Process
2. A patient comes to the walk-in clinic complaining of chest pain on exertion. The patient is
diagnosed with angina pectoris. The patient asks what causes angina. The nurse informs
the patient that most often angina is caused by what?
A) Smoking
B) Inadequate cardiac output
C) Infarction of the myocardium
D) Coronary arteriosclerosis
ANS: D
In most cases, angina pectoris is due to arteriosclerosis, particularly in older patients.
Smoking, hypertension, high cholesterol levels, and diabetes mellitus are all associated with
coronary arteriosclerosis.
PTS: 1 DIF: Moderate REF: 757 OBJ: 2
TOP: Coronary Atherosclerosis
KEY: Client Needs: D-4 | Cognitive Level: Application | Integrated Process:
Teaching/Learning
3. You are caring for an adult patient who had symptoms of unstable angina during
admission to the hospital. The most appropriate nursing diagnosis for the discomfort
associated with angina is what?
A) Deficient knowledge about underlying disease and methods for avoiding complica-
tions
B) Anxiety related to fear of death
C) Ineffective cardiopulmonary tissue perfusion secondary to CAD, as evidenced
by chest pain
D) Noncompliance related to failure to accept necessary lifestyle
changes ANS: C
,Management Of Patients With Coronary Vascular Disorders Test
Ineffective cardiopulmonary tissue perfusion describes the symptoms of discomfort associ-
ated with angina. Deficient knowledge describes the patient awareness of disease process
and treatment. Anxiety identifies psychological effects of angina, while noncompliance is
related to a patient's resistance to changing behaviors/patterns necessary to treat and manage
the disease.
PTS: 1 DIF: Moderate REF: 766 OBJ: 3
TOP: Angina Pectoris
KEY: Client Needs: D-4 | Cognitive Level: Application | Integrated Process: Nursing Pro-
cess
4. The triage nurse in the emergency department assesses a 66-year-old male patient who
presents to the emergency department with complaints of midsternal chest pain that has las-
ted for the last 5 hours. The nurse is aware that because of the length of time the patient has
been experiencing symptoms, if they are due to a MI, what has happened to the myocardi-
um?
A) May have developed an increased area of infarction
B) Will probably not have more damage than if he came in immediately
C) Can have restoration of the area of dead cells with proper treatment
D) Has been damaged already, so immediate treatment is no longer necessary
ANS: A
When the patient experiences lack of oxygen to myocardium cells during a MI, the sooner
treatment is initiated the more likely the treatment will prevent or minimize myocardial tis-
sue necrosis. Despite the length of time the symptoms have been present, treatment needs to
be initiated immediately to minimize further damage.
PTS: 1 DIF: Difficult REF: 768 OBJ: 4
TOP: Acute Coronary Syndrome and Myocardial Infarction
KEY: Client Needs: D-4 | Cognitive Level: Application | Integrated Process: Nursing Pro-
cess
5. Family members bring a patient to the emergency department with pale cool skin, mid-
sternal chest pain unrelieved with rest, and a history of CAD. What is the nurse aware
of?
A) The symptoms indicate angina and should be treated as such.
B) The symptoms indicate anxiety and should be treated as such.
C) The symptoms indicate an acute coronary episode and should be treated as such.
D) Treatment should be held until an ECG is completed.
ANS: C
Angina and MI have similar symptoms and are considered the same process but are on dif-
ferent points along a continuum. Acute coronary syndrome may be used to represent these
diagnoses. Treatment should be initiated immediately regardless of diagnosis.
PTS: 1 DIF: Moderate REF: 768 OBJ: 5
TOP: Acute Coronary Syndrome and Myocardial Infarction
KEY: Client Needs: D-4 | Cognitive Level: Application | Integrated Process: Nursing Pro-
cess
, Management Of Patients With Coronary Vascular Disorders Test
6. Hospital staff that often assist with coronary bypass graft surgery include the operating
room (OR) nurse. The OR nurse knows that the vessel most commonly used as source for
a CABG is what?
A) Brachial artery
B) Brachial vein
C) Femoral artery
D) Greater saphenous vein
ANS: D
The greater saphenous vein is the most commonly used graft site for CABG. The right and
left internal mammary arteries, radial arteries, and gastroepiploic artery are other graft sites
used, though not as frequently.
PTS: 1 DIF: Moderate REF: 780 OBJ: 7
TOP: Surgical Procedures: Coronary Artery Revascularization
KEY: Client Needs: D-4 | Cognitive Level: Comprehension | Integrated Process: Nursing
Process
7. A patient with an occluded coronary artery is admitted and has an emergency PTCA. The
patient is admitted to the unit after the PTCA. What does the nurse monitor the patient
for?
A) Hypocalcemia
B) Bleeding at insertion site
C) Left ventricular hypertrophy
D) Congestive heart failure
ANS: B
Complications of PTCA may include bleeding at the insertion site, abrupt closure of the
artery, arterial thrombosis, and perforation of the artery. Complications do not include hypo-
calcemia, left ventricular hypertrophy, or congestive heart failure.
PTS: 1 DIF: Moderate REF: 777 OBJ: 6
TOP: Percutaneous Coronary Interventions
KEY: Client Needs: D-3 | Cognitive Level: Application | Integrated Process: Nursing Pro-
cess
8. You are caring for a patient scheduled for cardiac surgery. What should your
preoperatiave care include?
A) Clarify surgical procedure preoperatively
B) Do not alter medication regimen preoperatively
C) Save teaching material until after the surgery
D) Not discuss fears with patient to avoid worsening them
ANS: A
Preoperative teaching is important; patients and their families may be very anxious, as the
association of the heart with life and death intensifies their emotions. Before surgery, phys-
ical and psychological assessments establish a baseline for future reference. In addition, it is
necessary to evaluate the patient's understanding of the surgical procedure, informed con-
sent, and adherence to treatment protocols. Preoperatively you would give teaching material
to better prepare the patient; you would encourage the patient to discuss his or her fears; the
Chapter 28: Management Of Patients With Coronary Vascular Disorders
1. The nurse is caring for a patient who has been diagnosed with an elevated cholesterol
level. The nurse is aware that plaque on the inner lumen of arteries is composed chiefly of
what?
A) Lipids and fibrous tissue
B) WBCs
C) Lipoproteins
D) High-density cholesterol
ANS: A
As T-lymphocytes and monocytes infiltrate to ingest lipids on the arterial wall and then die,
a fibrous tissue develops. This causes plaques to form on the inner lumen of arterial walls.
PTS: 1 DIF: Easy REF: 756 OBJ: 1
TOP: Coronary Atherosclerosis
KEY: Client Needs: D-4 | Cognitive Level: Comprehension | Integrated Process: Nursing
Process
2. A patient comes to the walk-in clinic complaining of chest pain on exertion. The patient is
diagnosed with angina pectoris. The patient asks what causes angina. The nurse informs
the patient that most often angina is caused by what?
A) Smoking
B) Inadequate cardiac output
C) Infarction of the myocardium
D) Coronary arteriosclerosis
ANS: D
In most cases, angina pectoris is due to arteriosclerosis, particularly in older patients.
Smoking, hypertension, high cholesterol levels, and diabetes mellitus are all associated with
coronary arteriosclerosis.
PTS: 1 DIF: Moderate REF: 757 OBJ: 2
TOP: Coronary Atherosclerosis
KEY: Client Needs: D-4 | Cognitive Level: Application | Integrated Process:
Teaching/Learning
3. You are caring for an adult patient who had symptoms of unstable angina during
admission to the hospital. The most appropriate nursing diagnosis for the discomfort
associated with angina is what?
A) Deficient knowledge about underlying disease and methods for avoiding complica-
tions
B) Anxiety related to fear of death
C) Ineffective cardiopulmonary tissue perfusion secondary to CAD, as evidenced
by chest pain
D) Noncompliance related to failure to accept necessary lifestyle
changes ANS: C
,Management Of Patients With Coronary Vascular Disorders Test
Ineffective cardiopulmonary tissue perfusion describes the symptoms of discomfort associ-
ated with angina. Deficient knowledge describes the patient awareness of disease process
and treatment. Anxiety identifies psychological effects of angina, while noncompliance is
related to a patient's resistance to changing behaviors/patterns necessary to treat and manage
the disease.
PTS: 1 DIF: Moderate REF: 766 OBJ: 3
TOP: Angina Pectoris
KEY: Client Needs: D-4 | Cognitive Level: Application | Integrated Process: Nursing Pro-
cess
4. The triage nurse in the emergency department assesses a 66-year-old male patient who
presents to the emergency department with complaints of midsternal chest pain that has las-
ted for the last 5 hours. The nurse is aware that because of the length of time the patient has
been experiencing symptoms, if they are due to a MI, what has happened to the myocardi-
um?
A) May have developed an increased area of infarction
B) Will probably not have more damage than if he came in immediately
C) Can have restoration of the area of dead cells with proper treatment
D) Has been damaged already, so immediate treatment is no longer necessary
ANS: A
When the patient experiences lack of oxygen to myocardium cells during a MI, the sooner
treatment is initiated the more likely the treatment will prevent or minimize myocardial tis-
sue necrosis. Despite the length of time the symptoms have been present, treatment needs to
be initiated immediately to minimize further damage.
PTS: 1 DIF: Difficult REF: 768 OBJ: 4
TOP: Acute Coronary Syndrome and Myocardial Infarction
KEY: Client Needs: D-4 | Cognitive Level: Application | Integrated Process: Nursing Pro-
cess
5. Family members bring a patient to the emergency department with pale cool skin, mid-
sternal chest pain unrelieved with rest, and a history of CAD. What is the nurse aware
of?
A) The symptoms indicate angina and should be treated as such.
B) The symptoms indicate anxiety and should be treated as such.
C) The symptoms indicate an acute coronary episode and should be treated as such.
D) Treatment should be held until an ECG is completed.
ANS: C
Angina and MI have similar symptoms and are considered the same process but are on dif-
ferent points along a continuum. Acute coronary syndrome may be used to represent these
diagnoses. Treatment should be initiated immediately regardless of diagnosis.
PTS: 1 DIF: Moderate REF: 768 OBJ: 5
TOP: Acute Coronary Syndrome and Myocardial Infarction
KEY: Client Needs: D-4 | Cognitive Level: Application | Integrated Process: Nursing Pro-
cess
, Management Of Patients With Coronary Vascular Disorders Test
6. Hospital staff that often assist with coronary bypass graft surgery include the operating
room (OR) nurse. The OR nurse knows that the vessel most commonly used as source for
a CABG is what?
A) Brachial artery
B) Brachial vein
C) Femoral artery
D) Greater saphenous vein
ANS: D
The greater saphenous vein is the most commonly used graft site for CABG. The right and
left internal mammary arteries, radial arteries, and gastroepiploic artery are other graft sites
used, though not as frequently.
PTS: 1 DIF: Moderate REF: 780 OBJ: 7
TOP: Surgical Procedures: Coronary Artery Revascularization
KEY: Client Needs: D-4 | Cognitive Level: Comprehension | Integrated Process: Nursing
Process
7. A patient with an occluded coronary artery is admitted and has an emergency PTCA. The
patient is admitted to the unit after the PTCA. What does the nurse monitor the patient
for?
A) Hypocalcemia
B) Bleeding at insertion site
C) Left ventricular hypertrophy
D) Congestive heart failure
ANS: B
Complications of PTCA may include bleeding at the insertion site, abrupt closure of the
artery, arterial thrombosis, and perforation of the artery. Complications do not include hypo-
calcemia, left ventricular hypertrophy, or congestive heart failure.
PTS: 1 DIF: Moderate REF: 777 OBJ: 6
TOP: Percutaneous Coronary Interventions
KEY: Client Needs: D-3 | Cognitive Level: Application | Integrated Process: Nursing Pro-
cess
8. You are caring for a patient scheduled for cardiac surgery. What should your
preoperatiave care include?
A) Clarify surgical procedure preoperatively
B) Do not alter medication regimen preoperatively
C) Save teaching material until after the surgery
D) Not discuss fears with patient to avoid worsening them
ANS: A
Preoperative teaching is important; patients and their families may be very anxious, as the
association of the heart with life and death intensifies their emotions. Before surgery, phys-
ical and psychological assessments establish a baseline for future reference. In addition, it is
necessary to evaluate the patient's understanding of the surgical procedure, informed con-
sent, and adherence to treatment protocols. Preoperatively you would give teaching material
to better prepare the patient; you would encourage the patient to discuss his or her fears; the
