PMC EXAM 1 CHAPTER 6,7 QUESTIONS AND
ANSWERS
The nurse is teaching a patient about acute coronary syndrome. What should the nurse
teach that
describes the progression of events in this disorder?
A) The growth of platelet-rich thrombi in the smaller vessels creates a blockage and is
the cause for unstable angina symptoms in ACS.
B) When complete platelet occlusion occurs in a vessel, the ECG changes include
nonspecific ST elevation without necrosis occurring in ACS.
C) Sudden plaque buildup in a narrow vessel immediately leads to an acute myocardial
infarction when stable angina is present in ACS.
D) A thin fibrin layer stabilizes the ruptured plaque and prevents the occlusion of
coronary vessels when stable angina is present in ACS. - Answers :A
A nurse is discussing management of hypertension with a patient. Which patient
statement
indicates that additional teaching about the relationship between hypertension and
acute coronary syndrome (ACS) is needed?
A) "Because I'm over 80, even a 20 mm Hg drop in my blood pressure can reduce my
risk."
B) "High blood pressure will increase my body's need for oxygen and increase my
heart's workload."
C) "My high blood pressure has no relationship to the severity of heart disease or its
outcomes."
D) "Controlling my blood pressure will decrease my risk of having a heart attack to some
degree." - Answers :C
A patient tells a nurse, "My chest pain starts when I am resting, and when I had a
cardiac catheterization, the doctor said I was having vasospasms." Which type of
medication should the nurse anticipate to be prescribed to treat the patient's angina?
A) A beta adrenergic blocking agent
B) A vasodilator, such as nitroglycerin (NTG)
C) An antidysrhythmic, such as lidocaine
D) A calcium channel blocking agent - Answers :D
The nurse instructs a patient with a myocardial infarction about the disease process.
Which patient
statement indicates that additional teaching is needed?
A) "A heart attack is the same as a myocardial infarction (MI)."
B) "A heart attack in the anterior wall of the heart can be very serious because a large
portion of the heart may not pump as well."
C) "Angina always leads first to decreased blood flow to the heart muscle and then to
tissue death."
, D) "A heart attack causes tissue death, and that part of the heart may not pump as
well." - Answers :C
Following angioplasty, a patient develops hematuria, hypotension, tachycardia, a drop
in hemoglobin and hematocrit, and a decrease in oxygen saturation. What is most likely
the cause for these symptoms?
A) Peripheral emboli distal to the insertion site
B) Over-anticoagulation
C) Myocardial ischemia
D) Reaction to vasovagal stimulation - Answers :B
why? The symptoms are a result of over-anticoagulation, which results in blood loss
through the kidneys and other organs, resulting in a declining hemoglobin/hematocrit
(H/H). The decrease of RBCs results in the compensation mechanism for shock by
increasing the HR when compensating for the tissue hypoxia present from the lack of
RBCs. Decreased perfusion and O2 saturation in the tissues will be present.
To increase compliance and reduce postoperative complications, the nurse should
include which topics in the preoperative teaching for a patient who is to have a coronary
artery bypass graft (CABG)? Select all that apply.
Note: Credit will be given only if all correct choices and no incorrect choices are
selected.
A) Equipment used: IVs, Foley, pacer wires, chest tubes, NG tubes, ECG leads
B) Alternate methods for communicating when intubated
C) Drug management: need for sedation when intubated, pain med through PCA
D) Reasons for cooling blankets in postop period
E) Reasons and techniques of turning, coughing, and deep breathing once extubated -
Answers :A,B,C,E
What should be included in the collaborative management of a patient's pulmonary
status
following coronary artery bypass graft surgery?
A) Mobilizing the patient as soon as possible to prevent atelectasis and venous stasis
B) Keeping the patient intubated for at least 48 hours to maximize gas exchange
C) Evaluating readiness for extubation based on guidelines: PO2 less than 80 mm Hg
with an FiO2 greater than 40% and a PCO2 greater than 45
D) Extubating when the patient is arousable to noxious stimuli and shows increased
effort for spontaneous breathing - Answers :A
Which finding should cause the nurse to suspect that a patient recovering from coronary
artery
bypass surgery might be developing cardiac tamponade? Select all that apply.
Note: Credit will be given only if all correct choices and no incorrect choices are
selected.
A) Widening pulse pressure
B) Decreasing central venous pressure (CVP)
C) Increased jugular vein distension
ANSWERS
The nurse is teaching a patient about acute coronary syndrome. What should the nurse
teach that
describes the progression of events in this disorder?
A) The growth of platelet-rich thrombi in the smaller vessels creates a blockage and is
the cause for unstable angina symptoms in ACS.
B) When complete platelet occlusion occurs in a vessel, the ECG changes include
nonspecific ST elevation without necrosis occurring in ACS.
C) Sudden plaque buildup in a narrow vessel immediately leads to an acute myocardial
infarction when stable angina is present in ACS.
D) A thin fibrin layer stabilizes the ruptured plaque and prevents the occlusion of
coronary vessels when stable angina is present in ACS. - Answers :A
A nurse is discussing management of hypertension with a patient. Which patient
statement
indicates that additional teaching about the relationship between hypertension and
acute coronary syndrome (ACS) is needed?
A) "Because I'm over 80, even a 20 mm Hg drop in my blood pressure can reduce my
risk."
B) "High blood pressure will increase my body's need for oxygen and increase my
heart's workload."
C) "My high blood pressure has no relationship to the severity of heart disease or its
outcomes."
D) "Controlling my blood pressure will decrease my risk of having a heart attack to some
degree." - Answers :C
A patient tells a nurse, "My chest pain starts when I am resting, and when I had a
cardiac catheterization, the doctor said I was having vasospasms." Which type of
medication should the nurse anticipate to be prescribed to treat the patient's angina?
A) A beta adrenergic blocking agent
B) A vasodilator, such as nitroglycerin (NTG)
C) An antidysrhythmic, such as lidocaine
D) A calcium channel blocking agent - Answers :D
The nurse instructs a patient with a myocardial infarction about the disease process.
Which patient
statement indicates that additional teaching is needed?
A) "A heart attack is the same as a myocardial infarction (MI)."
B) "A heart attack in the anterior wall of the heart can be very serious because a large
portion of the heart may not pump as well."
C) "Angina always leads first to decreased blood flow to the heart muscle and then to
tissue death."
, D) "A heart attack causes tissue death, and that part of the heart may not pump as
well." - Answers :C
Following angioplasty, a patient develops hematuria, hypotension, tachycardia, a drop
in hemoglobin and hematocrit, and a decrease in oxygen saturation. What is most likely
the cause for these symptoms?
A) Peripheral emboli distal to the insertion site
B) Over-anticoagulation
C) Myocardial ischemia
D) Reaction to vasovagal stimulation - Answers :B
why? The symptoms are a result of over-anticoagulation, which results in blood loss
through the kidneys and other organs, resulting in a declining hemoglobin/hematocrit
(H/H). The decrease of RBCs results in the compensation mechanism for shock by
increasing the HR when compensating for the tissue hypoxia present from the lack of
RBCs. Decreased perfusion and O2 saturation in the tissues will be present.
To increase compliance and reduce postoperative complications, the nurse should
include which topics in the preoperative teaching for a patient who is to have a coronary
artery bypass graft (CABG)? Select all that apply.
Note: Credit will be given only if all correct choices and no incorrect choices are
selected.
A) Equipment used: IVs, Foley, pacer wires, chest tubes, NG tubes, ECG leads
B) Alternate methods for communicating when intubated
C) Drug management: need for sedation when intubated, pain med through PCA
D) Reasons for cooling blankets in postop period
E) Reasons and techniques of turning, coughing, and deep breathing once extubated -
Answers :A,B,C,E
What should be included in the collaborative management of a patient's pulmonary
status
following coronary artery bypass graft surgery?
A) Mobilizing the patient as soon as possible to prevent atelectasis and venous stasis
B) Keeping the patient intubated for at least 48 hours to maximize gas exchange
C) Evaluating readiness for extubation based on guidelines: PO2 less than 80 mm Hg
with an FiO2 greater than 40% and a PCO2 greater than 45
D) Extubating when the patient is arousable to noxious stimuli and shows increased
effort for spontaneous breathing - Answers :A
Which finding should cause the nurse to suspect that a patient recovering from coronary
artery
bypass surgery might be developing cardiac tamponade? Select all that apply.
Note: Credit will be given only if all correct choices and no incorrect choices are
selected.
A) Widening pulse pressure
B) Decreasing central venous pressure (CVP)
C) Increased jugular vein distension
