G150/ PHA1500 MODULE 4
Coronary Artery
Disease Review Exam
Q&A
2024
,1. A 55-year-old male patient presents to the emergency department with
chest pain, dyspnea, diaphoresis, and nausea. He has a history of
hypertension, diabetes, and smoking. The nurse suspects that he is having
a myocardial infarction (MI) and orders an electrocardiogram (ECG) and
cardiac enzymes. Which of the following ECG changes is most indicative
of an acute MI?
a) ST-segment elevation*
b) T-wave inversion
c) Q-wave formation
d) U-wave appearance
Rationale: ST-segment elevation is the most specific and sensitive sign of
an acute MI, indicating transmural ischemia and injury of the
myocardium. T-wave inversion, Q-wave formation, and U-wave
appearance are other ECG changes that may occur in MI, but they are less
specific and may indicate other cardiac conditions.
2. A 65-year-old female patient is diagnosed with coronary artery disease
(CAD) and is prescribed a statin drug to lower her cholesterol levels. The
nurse educates her about the importance of adhering to the medication
regimen and monitoring for any adverse effects. Which of the following
statements by the patient indicates a need for further teaching?
a) "I will take the statin drug at night before going to bed."*
b) "I will report any muscle pain or weakness to my doctor."
c) "I will have my liver function tests done regularly."
d) "I will avoid grapefruit juice while taking this drug."
Rationale: Statin drugs are usually taken at night because they inhibit
cholesterol synthesis when it is most active. Taking the drug in the
morning may reduce its effectiveness and increase the risk of side effects.
Muscle pain or weakness, liver dysfunction, and grapefruit juice
interaction are potential adverse effects of statin drugs that the patient
should be aware of and report to the doctor.
3. A 60-year-old male patient undergoes a coronary angiography to assess
the extent of his CAD. The nurse explains the procedure to him and
obtains his informed consent. Which of the following interventions should
the nurse perform before the procedure?
, a) Administer a sedative to reduce anxiety and discomfort.
b) Check for any allergies to iodine or shellfish.
c) Shave the groin area where the catheter will be inserted.
d) All of the above.*
Rationale: A coronary angiography is an invasive procedure that involves
inserting a catheter into a femoral artery in the groin and injecting a
contrast dye into the coronary arteries to visualize any blockages or
narrowing. The nurse should administer a sedative to help the patient
relax, check for any allergies to iodine or shellfish as they may cause
anaphylaxis due to the contrast dye, and shave the groin area to prevent
infection and facilitate catheter insertion.
4. A 50-year-old female patient is admitted to the cardiac care unit with
unstable angina. She reports having chest pain that occurs at rest and is not
relieved by nitroglycerin. The nurse monitors her vital signs and
administers oxygen, aspirin, heparin, and beta-blockers as ordered by the
doctor. Which of the following nursing diagnoses is most appropriate for
this patient?
a) Acute pain related to myocardial ischemia.*
b) Decreased cardiac output related to dysrhythmias.
c) Impaired gas exchange related to pulmonary edema.
d) Risk for infection related to invasive procedures.
Rationale: Acute pain related to myocardial ischemia is the most
appropriate nursing diagnosis for this patient, as unstable angina is caused
by reduced blood flow to the heart muscle due to CAD. Decreased cardiac
output, impaired gas exchange, and risk for infection are other possible
nursing diagnoses for patients with CAD, but they are not specific to
unstable angina.
5. A 70-year-old male patient undergoes a coronary artery bypass graft
(CABG) surgery to improve his blood flow to the heart. He is transferred
to the intensive care unit (ICU) after the surgery and is intubated and
mechanically ventilated. The nurse assesses his surgical site and observes
a mediastinal chest tube that drains bloody fluid into a collection chamber.
Which of the following actions should the nurse take?
a) Clamp the chest tube to prevent air leaks.
b) Milk the chest tube to prevent clot formation.
c) Measure and record the amount and color of drainage.*
Coronary Artery
Disease Review Exam
Q&A
2024
,1. A 55-year-old male patient presents to the emergency department with
chest pain, dyspnea, diaphoresis, and nausea. He has a history of
hypertension, diabetes, and smoking. The nurse suspects that he is having
a myocardial infarction (MI) and orders an electrocardiogram (ECG) and
cardiac enzymes. Which of the following ECG changes is most indicative
of an acute MI?
a) ST-segment elevation*
b) T-wave inversion
c) Q-wave formation
d) U-wave appearance
Rationale: ST-segment elevation is the most specific and sensitive sign of
an acute MI, indicating transmural ischemia and injury of the
myocardium. T-wave inversion, Q-wave formation, and U-wave
appearance are other ECG changes that may occur in MI, but they are less
specific and may indicate other cardiac conditions.
2. A 65-year-old female patient is diagnosed with coronary artery disease
(CAD) and is prescribed a statin drug to lower her cholesterol levels. The
nurse educates her about the importance of adhering to the medication
regimen and monitoring for any adverse effects. Which of the following
statements by the patient indicates a need for further teaching?
a) "I will take the statin drug at night before going to bed."*
b) "I will report any muscle pain or weakness to my doctor."
c) "I will have my liver function tests done regularly."
d) "I will avoid grapefruit juice while taking this drug."
Rationale: Statin drugs are usually taken at night because they inhibit
cholesterol synthesis when it is most active. Taking the drug in the
morning may reduce its effectiveness and increase the risk of side effects.
Muscle pain or weakness, liver dysfunction, and grapefruit juice
interaction are potential adverse effects of statin drugs that the patient
should be aware of and report to the doctor.
3. A 60-year-old male patient undergoes a coronary angiography to assess
the extent of his CAD. The nurse explains the procedure to him and
obtains his informed consent. Which of the following interventions should
the nurse perform before the procedure?
, a) Administer a sedative to reduce anxiety and discomfort.
b) Check for any allergies to iodine or shellfish.
c) Shave the groin area where the catheter will be inserted.
d) All of the above.*
Rationale: A coronary angiography is an invasive procedure that involves
inserting a catheter into a femoral artery in the groin and injecting a
contrast dye into the coronary arteries to visualize any blockages or
narrowing. The nurse should administer a sedative to help the patient
relax, check for any allergies to iodine or shellfish as they may cause
anaphylaxis due to the contrast dye, and shave the groin area to prevent
infection and facilitate catheter insertion.
4. A 50-year-old female patient is admitted to the cardiac care unit with
unstable angina. She reports having chest pain that occurs at rest and is not
relieved by nitroglycerin. The nurse monitors her vital signs and
administers oxygen, aspirin, heparin, and beta-blockers as ordered by the
doctor. Which of the following nursing diagnoses is most appropriate for
this patient?
a) Acute pain related to myocardial ischemia.*
b) Decreased cardiac output related to dysrhythmias.
c) Impaired gas exchange related to pulmonary edema.
d) Risk for infection related to invasive procedures.
Rationale: Acute pain related to myocardial ischemia is the most
appropriate nursing diagnosis for this patient, as unstable angina is caused
by reduced blood flow to the heart muscle due to CAD. Decreased cardiac
output, impaired gas exchange, and risk for infection are other possible
nursing diagnoses for patients with CAD, but they are not specific to
unstable angina.
5. A 70-year-old male patient undergoes a coronary artery bypass graft
(CABG) surgery to improve his blood flow to the heart. He is transferred
to the intensive care unit (ICU) after the surgery and is intubated and
mechanically ventilated. The nurse assesses his surgical site and observes
a mediastinal chest tube that drains bloody fluid into a collection chamber.
Which of the following actions should the nurse take?
a) Clamp the chest tube to prevent air leaks.
b) Milk the chest tube to prevent clot formation.
c) Measure and record the amount and color of drainage.*
