Brunner: Medical-Surgical Nursing, 11th Edition
Test Bank
Chapter 28: Management of Patients With Coronary Vascular Disorders
Multiple Choice
1. A patient is diagnosed as having elevated cholesterol level. The nurse is aware that plaque on
the inner lumen of arteries is composed chiefly of:
A) Lipids and fibrous tissue
B) WBCs
C) Lipoproteins
D) High-density cholesterol
Ans: A
Chapter: 28
Cognitive Level: Comprehension
Difficulty: Easy
Integrated Process: Nursing Process
Objective: 1
Patient Needs: D-4
Feedback: 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.
2. The coronary arteries are susceptible to development of arteriosclerosis because
coronary arteries:
A) Are smaller in diameter
B) Accumulate more low-density cholesterol
C) Have numerous twist and turns
D) Have a decreased pulse pressure
Ans: C
Chapter: 28
Cognitive Level: Knowledge
Difficulty: Easy
,Chapter 28- Management of Patients With Coronary Vascular Disorders
Integrated Process: Nursing Process
Objective: 1
Patient Needs: D-4
Feedback: Due to the need of the coronary arteries to supply blood to the heart, they have many
twists and turns, creating more sites susceptible to developing atheroma.
3. An adult patient who experiences angina pectoris with exertion is informed by the nurse
that most often angina is caused by:
A) Smoking
B) Inadequate cardiac output
C) Infarction of the myocardium
D) Coronary arteriosclerosis
Ans: D
Chapter: 28
Cognitive Level: Application
Difficulty: Moderate
Integrated Process: Teaching/Learning
Objective: 2
Patient Needs: D-4
Feedback: 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.
4. The nurse is teaching a 45-year-old patient about ways to lower elevated cholesterol
levels. One method to lower cholesterol levels is to exercise, which:
A) Increases HDL and decreases triglycerides
B) Increases LDL and decreases triglycerides
C) Decreases HDL and increases LDL
D) Decreases both HDL and LDL
Ans: A
Chapter: 28
Cognitive Level: Application
Difficulty: Moderate
Integrated Process: Teaching/Learning
Objective: 1
Patient Needs: B-2
Feedback: Moderate exercise increases HDL levels, which assists in lowering LDL levels.
Exercise also decreases triglyceride levels.
, Chapter 28- Management of Patients With Coronary Vascular Disorders
5. A patient angina with pectoris secondary to atherosclerotic disease asks why he
experiences chest pain with exertion. The nurse informs him that exertion:
A) Increases the heart's oxygen demands
B) Causes vasoconstriction of the heart
C) Increases blood flow to the mesenteric area
D) Reduces the effectiveness of medications
Ans: A
Chapter: 28
Cognitive Level: Application
Difficulty: Moderate
Integrated Process: Teaching/Learning
Objective: 2
Patient Needs: D-4
Feedback: Physical exertion increases the myocardial oxygen demand. If the patient has
arteriosclerosis of the coronary arteries, blood supply is diminished to the myocardium.
6. To relieve angina pectoris symptoms, the nurse administers nitroglycerin sublingual to
the patient. Which of the following is an action of nitroglycerin?
A) Decreases myocardial oxygen consumption
B) Causes venous constriction
C) Decreases collateral circulation in the heart
D) Causes arterial constriction
Ans: A
Chapter: 28
Cognitive Level: Application
Difficulty: Moderate
Integrated Process: Nursing Process
Objective: 2
Patient Needs: D-2
Feedback: Nitrates decrease myocardial oxygen consumption to decrease ischemia and relieve
pain. The veins, and in higher doses the arteries, are also dilated. It also increases perfusion
through the collateral vessels.
7. An adult patient has symptoms of unstable angina during admission to the hospital. The most