acute coronary syndrome NCLEX
The client with unstable angina has received education about the acute coronary
syndrome. Which of the following indicates that he understood the teaching?
1. "This is a big warning, I must modify my lifestyle or risk having a heart attack in
the next year."
2. "Angina is just a temporary interruption of blood flow to my heart."
3. "I need to tell my wife I've had a heart attack."
4. "Because this was temporary, I will not need to take any medications for my
heart."
1. Among people who have unstable angina, 10% to 30% have a myocardial infarction
(MI) within 1 year. Although angina pain is temporary, it reflects underlying coronary
artery disease (CAD), which requires attention, including lifestyle modifications.
Unstable angina reflects tissue ischemia, but infarction represents tissue necrosis.
Clients with underlying CAD may need medications such as aspirin (ASA), lipid-lowering
agents, antianginals, or antihypertensives.
The nurse is caring for a group of clients who have sustained myocardial
infarction (MI). The nurse observes the client with which type of MI most carefully
for the development of left ventricular heart failure?
1. Inferior wall
2. Anterior wall
3. Lateral wall
4. Posterior wall
2. Owing to the large size of the anterior wall, the amount of tissue infarction may be
large enough to decrease the force of contraction, leading to heart failure. with the
inferior wall, the client is more likely to develop right ventricular MI. regarding clients
with obstruction of the circumflex artery may experience a lateral wall or posterior wall
MI and sinus dysrhythmias.
The nurse is providing a cardiac class for a women's group. The nurse
emphasizes that which characteristics place women at high risk for myocardial
infarction (MI)? Select all that apply.
Premenopausal
Increasing age
Family history
Abdominal obesity
Breast cancer
Increasing age, especially after 70 yo
Family history is a risk factor in both men and women
Abdominal obesity: A large waist size/abdominal obesity is a risk factor for both
metabolic syndrome and MI.
The nurse is teaching a group of teens about prevention of heart disease. Which
point should the nurse emphasize?
1.Reduce abdominal fat.
2. Avoid stress.
3. Do not smoke or chew tobacco.
4. Avoid alcoholic beverages.
, 3. Tobacco exposure, including secondhand smoke, reduces coronary blood flow,
causes vasoconstriction and endothelial dysfunction and thickening of the vessel wall,
increases carbon monoxide, and decreases oxygen. Because this is highly addicting,
beginning smoking in the teen years may lead to decades of exposure.
The nurse is teaching the client that metabolic syndrome can increase the risk for
myocardial infarction (MI). Which signs of metabolic syndrome should the nurse
include in the discussion? Select all that apply.
Truncal obesity
Hypercholesterolemia
Elevated homocysteine levels
Glucose intolerance
Client taking losartan (Cozaar)
Hypercholesterolemia: Decreased high-density lipoprotein cholesterol (HDL-C) (usually
with high low-density lipoprotein cholesterol [LDL-C]), HDL-C less than 40 mg/dL for
men or less than 50 mg/dL for women, or taking an anticholesterol drug is a sign of
metabolic syndrome.
Glucose intolerance: Increased fasting blood glucose (caused by diabetes, glucose
intolerance, or insulin resistance) is included in the constellation of metabolic syndrome.
Client taking losartan (Cozaar): Blood pressure greater than 130/85 or taking
antihypertensive medication indicates metabolic syndrome.
Which of the following atypical symptoms may be present in the female client
experiencing myocardial infarction (MI)? Select all that apply.
Sharp, inspiratory chest pain
Dyspnea
Dizziness
Extreme fatigue
Anorexia
Dyspnea, Dizziness, Extreme fatigue
To validate that the client has had a myocardial infarction (MI), the nurse
assesses for positive findings on which tests?
1. Creatine kinase-MB fraction (CK-MB) and alkaline phosphatase
2. Homocysteine and C-reactive protein
3. Total cholesterol, low-density lipoprotein (LDL) and high-density lipoprotein
(HDL) cholesterols
4. Myoglobin and troponin
4. Myoglobin, troponin, and CK-MB are the cardiac markers used to determine whether
MI has occurred. Homocysteine and C-reactive protein are markers of inflammation,
which may represent risk for MI, but they are not diagnostic for MI.
When caring for a client with acute myocardial infarction, the nurse recognizes
that prompt pain management is essential for which reason?
1.The discomfort will increase client anxiety and reduce coping.
2. Pain relief improves the oxygen supply and decreases oxygen demand.
3. Relief of pain indicates that the myocardial infarction is resolving.
4. Pain medication should not be used until a definitive diagnosis has been
established.
The client with unstable angina has received education about the acute coronary
syndrome. Which of the following indicates that he understood the teaching?
1. "This is a big warning, I must modify my lifestyle or risk having a heart attack in
the next year."
2. "Angina is just a temporary interruption of blood flow to my heart."
3. "I need to tell my wife I've had a heart attack."
4. "Because this was temporary, I will not need to take any medications for my
heart."
1. Among people who have unstable angina, 10% to 30% have a myocardial infarction
(MI) within 1 year. Although angina pain is temporary, it reflects underlying coronary
artery disease (CAD), which requires attention, including lifestyle modifications.
Unstable angina reflects tissue ischemia, but infarction represents tissue necrosis.
Clients with underlying CAD may need medications such as aspirin (ASA), lipid-lowering
agents, antianginals, or antihypertensives.
The nurse is caring for a group of clients who have sustained myocardial
infarction (MI). The nurse observes the client with which type of MI most carefully
for the development of left ventricular heart failure?
1. Inferior wall
2. Anterior wall
3. Lateral wall
4. Posterior wall
2. Owing to the large size of the anterior wall, the amount of tissue infarction may be
large enough to decrease the force of contraction, leading to heart failure. with the
inferior wall, the client is more likely to develop right ventricular MI. regarding clients
with obstruction of the circumflex artery may experience a lateral wall or posterior wall
MI and sinus dysrhythmias.
The nurse is providing a cardiac class for a women's group. The nurse
emphasizes that which characteristics place women at high risk for myocardial
infarction (MI)? Select all that apply.
Premenopausal
Increasing age
Family history
Abdominal obesity
Breast cancer
Increasing age, especially after 70 yo
Family history is a risk factor in both men and women
Abdominal obesity: A large waist size/abdominal obesity is a risk factor for both
metabolic syndrome and MI.
The nurse is teaching a group of teens about prevention of heart disease. Which
point should the nurse emphasize?
1.Reduce abdominal fat.
2. Avoid stress.
3. Do not smoke or chew tobacco.
4. Avoid alcoholic beverages.
, 3. Tobacco exposure, including secondhand smoke, reduces coronary blood flow,
causes vasoconstriction and endothelial dysfunction and thickening of the vessel wall,
increases carbon monoxide, and decreases oxygen. Because this is highly addicting,
beginning smoking in the teen years may lead to decades of exposure.
The nurse is teaching the client that metabolic syndrome can increase the risk for
myocardial infarction (MI). Which signs of metabolic syndrome should the nurse
include in the discussion? Select all that apply.
Truncal obesity
Hypercholesterolemia
Elevated homocysteine levels
Glucose intolerance
Client taking losartan (Cozaar)
Hypercholesterolemia: Decreased high-density lipoprotein cholesterol (HDL-C) (usually
with high low-density lipoprotein cholesterol [LDL-C]), HDL-C less than 40 mg/dL for
men or less than 50 mg/dL for women, or taking an anticholesterol drug is a sign of
metabolic syndrome.
Glucose intolerance: Increased fasting blood glucose (caused by diabetes, glucose
intolerance, or insulin resistance) is included in the constellation of metabolic syndrome.
Client taking losartan (Cozaar): Blood pressure greater than 130/85 or taking
antihypertensive medication indicates metabolic syndrome.
Which of the following atypical symptoms may be present in the female client
experiencing myocardial infarction (MI)? Select all that apply.
Sharp, inspiratory chest pain
Dyspnea
Dizziness
Extreme fatigue
Anorexia
Dyspnea, Dizziness, Extreme fatigue
To validate that the client has had a myocardial infarction (MI), the nurse
assesses for positive findings on which tests?
1. Creatine kinase-MB fraction (CK-MB) and alkaline phosphatase
2. Homocysteine and C-reactive protein
3. Total cholesterol, low-density lipoprotein (LDL) and high-density lipoprotein
(HDL) cholesterols
4. Myoglobin and troponin
4. Myoglobin, troponin, and CK-MB are the cardiac markers used to determine whether
MI has occurred. Homocysteine and C-reactive protein are markers of inflammation,
which may represent risk for MI, but they are not diagnostic for MI.
When caring for a client with acute myocardial infarction, the nurse recognizes
that prompt pain management is essential for which reason?
1.The discomfort will increase client anxiety and reduce coping.
2. Pain relief improves the oxygen supply and decreases oxygen demand.
3. Relief of pain indicates that the myocardial infarction is resolving.
4. Pain medication should not be used until a definitive diagnosis has been
established.
