Nokea
A patient admitted to the hospital for evaluation of chest pain has no abnormal serum cardiac markers 4 hours after the onset of pain. What noninvasive diagnostic test can be used to differentiate angina from other types of chest pain?
- A. 12-lead ECG
- B. Exercise stress test
- C. Coronary angiogram
- D. Transesophageal echocardiogram
Correct Answer: B
Rationale: Stress testing detects ischemia.
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What is a chronic condition where the heart is unable to pump blood effectively, leading to fluid buildup in the lungs and other parts of the body?
- A. Heart failure
- B. Myocardial infarction
- C. Pericarditis
- D. Pulmonary edema
Correct Answer: A
Rationale: Step 1: Heart failure is the correct answer because it is a chronic condition where the heart is unable to pump blood effectively.
Step 2: This ineffective pumping leads to fluid buildup in the lungs (pulmonary congestion) and other parts of the body (edema).
Step 3: Myocardial infarction (B) is incorrect as it is an acute condition resulting from a blockage in coronary arteries causing heart muscle damage.
Step 4: Pericarditis (C) is incorrect as it is inflammation of the pericardium, the outer lining of the heart, not directly related to heart pumping efficiency.
Step 5: Pulmonary edema (D) is incorrect as it specifically refers to fluid accumulation in the lungs, not necessarily linked to heart failure.
What accurately describes the pathophysiology of CAD?
- A. Partial or total occlusion of the coronary artery occurs during the stage of raised fibrous plaque
- B. Endothelial alteration may be caused by chemical irritants such as hyperlipidemia or by tobacco use
- C. Collateral circulation in the coronary circulation is more likely to be present in the young patient with CAD
- D. The leading theory of atherogenesis proposes that infection and fatty dietary intake are the basic underlying causes of atherosclerosis
Correct Answer: B
Rationale: Endothelial damage initiates plaque formation.
Two months after Mr. Edwards' myocardial infarction, which goal assumes highest priority?
- A. Having his wife perform most of his activities of daily living
- B. Following a weight-reduction diet
- C. Developing a physical-conditioning program
- D. Assisting him to prepare for retirement
Correct Answer: C
Rationale: Physical conditioning promotes long-term health.
The nurse is caring for a client on warfarin with an INR of 5.2. What is the most appropriate action?
- A. Administer vitamin K as an antidote.
- B. Hold the next dose of warfarin.
- C. Increase the dose of warfarin.
- D. Monitor the client's INR closely.
Correct Answer: A
Rationale: The correct answer is A: Administer vitamin K as an antidote. A high INR level of 5.2 indicates the client is at risk of bleeding due to excess anticoagulation from warfarin. Vitamin K helps reverse the effects of warfarin by promoting clotting factor production. Administering vitamin K is crucial to prevent bleeding complications. Holding the next dose of warfarin (B) is not enough to rapidly lower the INR. Increasing the dose of warfarin (C) would worsen the situation. Monitoring the client's INR closely (D) is important, but immediate action with vitamin K is necessary in this case.
The nurse is administering digoxin to a client. What is the most important parameter to check before administration?
- A. Heart rate
- B. Blood pressure
- C. Respiratory rate
- D. Oxygen saturation
Correct Answer: A
Rationale: The correct answer is A: Heart rate. Before administering digoxin, it is crucial to check the client's heart rate because digoxin is a medication that affects the heart. Monitoring the heart rate helps assess the client's cardiac function and determines if the medication can be safely given. Checking heart rate ensures that the client is not at risk for potential adverse effects such as bradycardia or arrhythmias. Blood pressure (B), respiratory rate (C), and oxygen saturation (D) are important parameters to monitor but are not as directly related to the action of digoxin on the heart.