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Diltiazem (Cardizem) is ordered for a patient with newly diagnosed Prinzmetal’s (variant) angina. When teaching the patient, the nurse will include the information that diltiazem will
- A. reduce heart palpitations.
- B. prevent coronary artery plaque.
- C. decrease coronary artery spasms.
- D. increase contractile force of the heart.
Correct Answer: C
Rationale: The correct answer is C: decrease coronary artery spasms. Diltiazem is a calcium channel blocker that helps to relax and dilate coronary arteries, reducing the frequency and severity of coronary artery spasms in Prinzmetal's angina. This action improves blood flow to the heart muscle, relieving chest pain.
A: reduce heart palpitations - Diltiazem may cause bradycardia (slow heart rate) but is not primarily used to reduce heart palpitations.
B: prevent coronary artery plaque - Diltiazem does not prevent the formation of coronary artery plaque.
D: increase contractile force of the heart - Diltiazem actually decreases the contractile force of the heart by reducing cardiac workload and oxygen demand.
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In any acute cardiovascular problem, the essential goal is to
- A. decrease metabolic activity
- B. decrease carbohydrate intake
- C. decrease obesity
- D. increase protein intake
Correct Answer: A
Rationale: Reducing metabolic demand supports recovery.
When caring for a patient who is recovering from a sudden cardiac death (SCD) event and has no evidence of an acute myocardial infarction (AMI), the nurse will anticipate teaching the patient that
- A. sudden cardiac death events rarely reoccur.
- B. additional diagnostic testing will be required.
- C. long-term anticoagulation therapy will be needed.
- D. limiting physical activity will prevent future SCD events.
Correct Answer: B
Rationale: The correct answer is B because after a sudden cardiac death (SCD) event without evidence of an acute myocardial infarction (AMI), additional diagnostic testing is needed to determine the underlying cause and assess the risk of recurrence. This testing may include cardiac imaging, electrophysiological studies, and genetic testing. By identifying the specific cause, healthcare providers can tailor treatment plans to prevent future SCD events.
A: This is incorrect because the risk of SCD recurrence can vary based on the underlying cause and individual patient factors.
C: Long-term anticoagulation therapy is not typically indicated for SCD without evidence of AMI unless there is a specific indication such as atrial fibrillation or a clotting disorder.
D: Limiting physical activity alone is not a comprehensive strategy for preventing future SCD events; individualized recommendations should be based on diagnostic findings.
The registered nurse has finished reviewing the 7:00 a.m shift report on a telemetry unit. Which of the following clients would be the best for the RN to assign to the licensed practical nurse?
- A. A 7-day postoperative CABG client with an infection in the sternal surgical incision, requiring dressings and irrigation.
- B. A client who has just arrived on the unit from the emergency room for observation to rule out a myocardial infarction.
- C. A client who has had successful valve replacement therapy and will be discharged this morning.
- D. A client who is scheduled for a percutaneous transluminal coronary angioplasty (PTCA) at 10:00 a.m.
Correct Answer: A
Rationale: The correct answer is A because the 7-day postoperative CABG client with an infection in the sternal surgical incision requires ongoing wound care with dressings and irrigation. This assignment is suitable for an LPN due to their skill level in wound care. Choice B is incorrect because a client being observed for a myocardial infarction requires close monitoring by an RN. Choice C is incorrect because a client being discharged soon requires coordination and paperwork, which is typically done by an RN. Choice D is incorrect because a client scheduled for a PTCA procedure requires pre-procedure assessments and care typically done by an RN. Thus, choice A is the best option for an LPN assignment.
Describe the pathophysiology of Acute Myocardial Infarction.
- A. Coronary artery blockage
- B. Myocardial oxygen demand exceeds supply
- C. Both A and B
- D. None of the above
Correct Answer: C
Rationale: Acute MI occurs when coronary artery blockage leads to myocardial ischemia and necrosis due to oxygen demand exceeding supply.
The client is experiencing a drug-drug reaction by taking aspirin with what other drug?
- A. Cimetidine
- B. Prednisone
- C. Heparin
- D. Amoxicillin
Correct Answer: C
Rationale: The correct answer is C: Heparin. Aspirin and Heparin can interact and increase the risk of bleeding due to their combined antiplatelet effects. This interaction can lead to serious complications in the client. Cimetidine (A) is not typically known to interact significantly with aspirin. Prednisone (B) is a corticosteroid and does not have a significant interaction with aspirin in terms of drug-drug reactions. Amoxicillin (D) is an antibiotic and is not known to interact significantly with aspirin in a drug-drug reaction scenario. In conclusion, the correct choice (C) stands out due to its potential for a significant adverse outcome when combined with aspirin.