MSN 377 - Exam 1 Practice Questions And Answers
Verified 100% Correct
Chapter 34: CAD & ACS - ANSWER
When developing a health teaching plan for a 60-year-old man with the following risk
factors for coronary artery disease (CAD), the nurse should focus on the
a. family history of coronary artery disease.
b. increased risk associated with the patients gender.
c. high incidence of cardiovascular disease in older people.
d. elevation of the patients serum low density lipoprotein (LDL) level. - ANSWER
ANS: D
Because family history, gender, and age are nonmodifiable risk factors, the nurse
should focus on the patients LDL level. Decreases in LDL will help reduce the patients
risk for developing CAD.
To assist the patient with coronary artery disease (CAD) in making appropriate dietary
changes, which of these nursing interventions will be most effective?
a. Instruct the patient that a diet containing no saturated fat and minimal sodium will be
necessary.
b. Emphasize the increased risk for cardiac problems unless the patient makes the
dietary changes.
c. Assist the patient to modify favorite high-fat recipes by using monosaturated oils
when possible.
d. Provide the patient with a list of low-sodium, low-cholesterol foods that should be
included in the diet. - ANSWER ANS: C
Lifestyle changes are more likely to be successful when consideration is given to the
patients values and preferences. The highest percentage of calories from fat should
come from monosaturated fats. Although low-sodium and low-cholesterol foods are
appropriate, providing the patient with a list alone is not likely to be successful in making
dietary changes. Removing saturated fat from the diet completely is not a realistic
,expectation; up to 7% of calories in the therapeutic lifestyle changes (TLC) diet can
come from saturated fat. Telling the patient about the increased risk without assisting
further with strategies for dietary change is unlikely to be successful.
Which information collected by the nurse who is admitting a patient with chest pain
suggests that the pain is caused by an acute myocardial infarction (AMI)?
a. The pain increases with deep breathing.
b. The pain has persisted longer than 30 minutes.
c. The pain worsens when the patient raises the arms.
d. The pain is relieved after the patient takes nitroglycerin. - ANSWER ANS: B
Chest pain that lasts for 20 minutes or more is characteristic of AMI. Changes in pain
that occur with raising the arms or with deep breathing are more typical of pericarditis or
musculoskeletal pain. Stable angina is usually relieved when the patient takes
nitroglycerin.
Which information given by a patient admitted with chronic stable angina will help the
nurse confirm this diagnosis?
a. The patient rates the pain at a level 3 to 5 (0 to 10 scale).
b. The patient states that the pain wakes me up at night.
c. The patient says that the frequency of the pain has increased over the last few
weeks.
d. The patient states that the pain is resolved after taking one sublingual nitroglycerin
tablet. - ANSWER ANS: D
Chronic stable angina is typically relieved by rest or nitroglycerin administration. The
level of pain is not a consistent indicator of the type of angina. Pain occurring at rest or
with increased frequency is typical of unstable angina.
After the nurse has finished teaching a patient about use of sublingual nitroglycerin
(Nitrostat), which patient statement indicates that the teaching has been effective?
a. I can expect indigestion as a side effect of nitroglycerin.
b. I can only take the nitroglycerin if I start to have chest pain.
,c. I will call an ambulance if I still have pain 5 minutes after taking the nitroglycerin.
d. I will help slow down the progress of the plaque formation by taking nitroglycerin. -
ANSWER ANS: C
The emergency medical services (EMS) system should be activated when chest pain or
other symptoms are not completely relieved 5 minutes after taking one nitroglycerin.
Nitroglycerin can be taken to prevent chest pain or other symptoms from developing
(e.g., before intercourse). Gastric upset is not an expected side effect of nitroglycerin.
Nitroglycerin does not impact the underlying pathophysiology of coronary artery
atherosclerosis.
Which of these statements made by a patient with coronary artery disease after the
nurse has completed teaching about the therapeutic lifestyle changes (TLC) diet
indicates that further teaching is needed?
a. I will switch from whole milk to 1% or nonfat milk.
b. I like fresh salmon and I will plan to eat it more often.
c. I will miss being able to eat peanut butter sandwiches.
d. I can have a cup of coffee with breakfast if I want one. - ANSWER ANS: C
Although only 30% of the daily calories should come from fats, most of the fat in the
TLC diet should come from monosaturated fats such as are found in nuts, olive oil, and
canola oil. The patient can include peanut butter sandwiches as part of the TLC diet.
The other patient comments indicate a good understanding of the TLC diet.
After the nurse teaches the patient about the use of atenolol (Tenormin) in preventing
anginal episodes, which statement by a patient indicates that the teaching has been
effective?
a. It is important not to suddenly stop taking the atenolol.
b. Atenolol will increase the strength of my heart muscle.
c. I can expect to feel short of breath when taking atenolol.
d. Atenolol will improve the blood flow to my coronary arteries. - ANSWER ANS: A
, Patients who have been taking b-blockers can develop intense and frequent angina if
the medication is suddenly discontinued. Atenolol (Tenormin) decreases myocardial
contractility. Shortness of breath that occurs when taking b-blockers for angina may be
due to bronchospasm and should be reported to the health care provider. Atenolol
works by decreasing myocardial oxygen demand, not by increasing blood flow to the
coronary arteries.
A patient who has had severe chest pain for several hours is admitted with a diagnosis
of possible acute myocardial infarction (AMI). Which of these ordered laboratory tests
should the nurse monitor to help determine whether the patient has had an AMI?
a. Homocysteine
b. C-reactive protein
c. Cardiac-specific troponin I and troponin T
d. High-density lipoprotein (HDL) cholesterol - ANSWER ANS: C
Troponin levels increase about 4 to 6 hours after the onset of myocardial infarction (MI).
The other laboratory data are useful in determining the patients risk for developing
coronary artery disease (CAD) but are not helpful in determining whether an acute MI is
in progress.
Amlodipine (Norvasc) is ordered for a patient with newly diagnosed Prinzmetals
(variant) angina. When teaching the patient, the nurse will include the information that
amlodipine will
a. reduce the fight or flight response.
b. decrease spasm of the coronary arteries.
c. increase the force of myocardial contraction.
d. help prevent clotting in the coronary arteries. - ANSWER ANS: B
Prinzmetals angina is caused by coronary artery spasm. Calcium channel blockers
(e.g., amlodipine, nifedipine [Procardia]) are a first-line therapy for this type of angina.
Platelet inhibitors, such as aspirin, help prevent coronary artery thrombosis, and
bblockers decrease sympathetic stimulation of the heart. Medications or activities that
increase myocardial contractility will increase the incidence of angina by increasing
oxygen demand.
Verified 100% Correct
Chapter 34: CAD & ACS - ANSWER
When developing a health teaching plan for a 60-year-old man with the following risk
factors for coronary artery disease (CAD), the nurse should focus on the
a. family history of coronary artery disease.
b. increased risk associated with the patients gender.
c. high incidence of cardiovascular disease in older people.
d. elevation of the patients serum low density lipoprotein (LDL) level. - ANSWER
ANS: D
Because family history, gender, and age are nonmodifiable risk factors, the nurse
should focus on the patients LDL level. Decreases in LDL will help reduce the patients
risk for developing CAD.
To assist the patient with coronary artery disease (CAD) in making appropriate dietary
changes, which of these nursing interventions will be most effective?
a. Instruct the patient that a diet containing no saturated fat and minimal sodium will be
necessary.
b. Emphasize the increased risk for cardiac problems unless the patient makes the
dietary changes.
c. Assist the patient to modify favorite high-fat recipes by using monosaturated oils
when possible.
d. Provide the patient with a list of low-sodium, low-cholesterol foods that should be
included in the diet. - ANSWER ANS: C
Lifestyle changes are more likely to be successful when consideration is given to the
patients values and preferences. The highest percentage of calories from fat should
come from monosaturated fats. Although low-sodium and low-cholesterol foods are
appropriate, providing the patient with a list alone is not likely to be successful in making
dietary changes. Removing saturated fat from the diet completely is not a realistic
,expectation; up to 7% of calories in the therapeutic lifestyle changes (TLC) diet can
come from saturated fat. Telling the patient about the increased risk without assisting
further with strategies for dietary change is unlikely to be successful.
Which information collected by the nurse who is admitting a patient with chest pain
suggests that the pain is caused by an acute myocardial infarction (AMI)?
a. The pain increases with deep breathing.
b. The pain has persisted longer than 30 minutes.
c. The pain worsens when the patient raises the arms.
d. The pain is relieved after the patient takes nitroglycerin. - ANSWER ANS: B
Chest pain that lasts for 20 minutes or more is characteristic of AMI. Changes in pain
that occur with raising the arms or with deep breathing are more typical of pericarditis or
musculoskeletal pain. Stable angina is usually relieved when the patient takes
nitroglycerin.
Which information given by a patient admitted with chronic stable angina will help the
nurse confirm this diagnosis?
a. The patient rates the pain at a level 3 to 5 (0 to 10 scale).
b. The patient states that the pain wakes me up at night.
c. The patient says that the frequency of the pain has increased over the last few
weeks.
d. The patient states that the pain is resolved after taking one sublingual nitroglycerin
tablet. - ANSWER ANS: D
Chronic stable angina is typically relieved by rest or nitroglycerin administration. The
level of pain is not a consistent indicator of the type of angina. Pain occurring at rest or
with increased frequency is typical of unstable angina.
After the nurse has finished teaching a patient about use of sublingual nitroglycerin
(Nitrostat), which patient statement indicates that the teaching has been effective?
a. I can expect indigestion as a side effect of nitroglycerin.
b. I can only take the nitroglycerin if I start to have chest pain.
,c. I will call an ambulance if I still have pain 5 minutes after taking the nitroglycerin.
d. I will help slow down the progress of the plaque formation by taking nitroglycerin. -
ANSWER ANS: C
The emergency medical services (EMS) system should be activated when chest pain or
other symptoms are not completely relieved 5 minutes after taking one nitroglycerin.
Nitroglycerin can be taken to prevent chest pain or other symptoms from developing
(e.g., before intercourse). Gastric upset is not an expected side effect of nitroglycerin.
Nitroglycerin does not impact the underlying pathophysiology of coronary artery
atherosclerosis.
Which of these statements made by a patient with coronary artery disease after the
nurse has completed teaching about the therapeutic lifestyle changes (TLC) diet
indicates that further teaching is needed?
a. I will switch from whole milk to 1% or nonfat milk.
b. I like fresh salmon and I will plan to eat it more often.
c. I will miss being able to eat peanut butter sandwiches.
d. I can have a cup of coffee with breakfast if I want one. - ANSWER ANS: C
Although only 30% of the daily calories should come from fats, most of the fat in the
TLC diet should come from monosaturated fats such as are found in nuts, olive oil, and
canola oil. The patient can include peanut butter sandwiches as part of the TLC diet.
The other patient comments indicate a good understanding of the TLC diet.
After the nurse teaches the patient about the use of atenolol (Tenormin) in preventing
anginal episodes, which statement by a patient indicates that the teaching has been
effective?
a. It is important not to suddenly stop taking the atenolol.
b. Atenolol will increase the strength of my heart muscle.
c. I can expect to feel short of breath when taking atenolol.
d. Atenolol will improve the blood flow to my coronary arteries. - ANSWER ANS: A
, Patients who have been taking b-blockers can develop intense and frequent angina if
the medication is suddenly discontinued. Atenolol (Tenormin) decreases myocardial
contractility. Shortness of breath that occurs when taking b-blockers for angina may be
due to bronchospasm and should be reported to the health care provider. Atenolol
works by decreasing myocardial oxygen demand, not by increasing blood flow to the
coronary arteries.
A patient who has had severe chest pain for several hours is admitted with a diagnosis
of possible acute myocardial infarction (AMI). Which of these ordered laboratory tests
should the nurse monitor to help determine whether the patient has had an AMI?
a. Homocysteine
b. C-reactive protein
c. Cardiac-specific troponin I and troponin T
d. High-density lipoprotein (HDL) cholesterol - ANSWER ANS: C
Troponin levels increase about 4 to 6 hours after the onset of myocardial infarction (MI).
The other laboratory data are useful in determining the patients risk for developing
coronary artery disease (CAD) but are not helpful in determining whether an acute MI is
in progress.
Amlodipine (Norvasc) is ordered for a patient with newly diagnosed Prinzmetals
(variant) angina. When teaching the patient, the nurse will include the information that
amlodipine will
a. reduce the fight or flight response.
b. decrease spasm of the coronary arteries.
c. increase the force of myocardial contraction.
d. help prevent clotting in the coronary arteries. - ANSWER ANS: B
Prinzmetals angina is caused by coronary artery spasm. Calcium channel blockers
(e.g., amlodipine, nifedipine [Procardia]) are a first-line therapy for this type of angina.
Platelet inhibitors, such as aspirin, help prevent coronary artery thrombosis, and
bblockers decrease sympathetic stimulation of the heart. Medications or activities that
increase myocardial contractility will increase the incidence of angina by increasing
oxygen demand.
