Nokea
In the treatment of coronary artery disease (CAD), medications are often ordered to control blood pressure in the client. Which of the following is a primary purpose of using beta-adrenergic blockers in the nursing management of CAD?
- A. To dilate coronary arteries
- B. To decrease workload of the heart
- C. To decrease homocysteine levels
- D. To prevent angiotensin II conversion
Correct Answer: B
Rationale: Beta-adrenergic blockers are used in the treatment of CAD to decrease the consumption of myocardial oxygen by reducing heart rate and workload of the heart. Nitrates are used for vasodilation. Anti-lipid drugs (such as statins and B vitamins) are used to decrease homocysteine levels. ACE inhibitors inhibit the conversion of angiotensin.
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A client, who has undergone a percutaneous transluminal coronary angioplasty (PTCA), has received discharge instructions. Which statement by the client would indicate the need for further teaching by the nurse?
- A. I should avoid taking a tub bath until my catheter site heals
- B. I should expect a low-grade fever and swelling at the site for the next week
- C. I should avoid prolonged sitting
- D. I should expect bruising at the catheter site for up to 3 weeks
Correct Answer: B
Rationale: Fever and swelling at the site are signs of infection and should be reported to the physician. Showers should be taken until the insertion site is healed. Prolonged sitting can result in thrombosis formation. Bruising at the insertion site is common and may take from 1 to 3 weeks to resolve.
A client with venous insufficiency is instructed to exercise, apply elastic stockings, and elevate the extremities. Which is the primary benefit for this nursing management regimen?
- A. Improve arterial flow
- B. Strengthen venous valves
- C. Increase venous congestion
- D. Improve venous return
Correct Answer: D
Rationale: The major goal in management of venous insufficiency is to promote venous circulation. Arterial flow improvement is not the goal of treatment for this disorder. Venous valves that are incompetent cannot be strengthened. Venous congestion is a complication of venous insufficiency.
The client asks the nurse to explain the difference between arteriosclerosis and atherosclerosis. Which is the best explanation the nurse can give to the client?
- A. Both terms refer to the same disorder and can be used interchangeably
- B. Both are disorders in which the lining of the vessels become narrowed due to plaque
- C. Arteriosclerosis is when the vessels become dilated and weakened, whereas atherosclerosis is the deposit of fatty substances in the vessel lining
- D. Arteriosclerosis is a loss of elasticity of the arteries that accompanies the aging process, whereas atherosclerosis is a condition in which the arteries fill with plaque
Correct Answer: D
Rationale: Arteriosclerosis refers to the loss of elasticity or hardening of the arteries that accompanies the aging process, whereas atherosclerosis is a condition in which the lumen of arteries fills with fatty deposits called plaque. The two terms do not refer to the same disorder, nor can they be used interchangeably. The other responses provide the client with inaccurate information.
A client presents to the emergency room with characteristics of atherosclerosis. What characteristics would the client display?
- A. Fatty deposits in the lumen of arteries
- B. Cholesterol plugs in the lumen of veins
- C. Blood clots in the arteries
- D. Emboli in the veins
Correct Answer: A
Rationale: Atherosclerosis is a condition in which the lumen of arteries fill with fatty deposits called plaque. Therefore, the other options are incorrect.
A client is being evaluated for coronary artery disease (CAD) and is scheduled for an electron beam computed tomography (EBCT). The nurse understands that the primary advantage of this radiologic test is which of the following?
- A. Less exposure to radiation
- B. Clear images
- C. Less invasive procedure
- D. Quantifies calcified plaque
Correct Answer: D
Rationale: The primary advantage of EBCT is to detect and quantify calcified plaque in the coronary arteries even before symptoms arise. EBCT is noninvasive and provides clearer images with less exposure to radiation than a CT scan but not the primary reason for use.