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The physical therapist notifies the nurse that a patient with coronary artery disease (CAD) experiences a much greater-than-average increase in heart rate during physical therapy. The nurse recognizes that an increase in heart rate in a patient with CAD may result in what?
- A. Development of an atrial-septal defect
- B. Myocardial ischemia
- C. Formation of a pulmonary embolism
- D. Release of potassium ions from cardiac cells
Correct Answer: B
Rationale: Unlike other arteries, the coronary arteries are perfused during diastole. An increase in heart rate shortens diastole and can decrease myocardial perfusion. Patients, particularly those with CAD, can develop myocardial ischemia. An increase in heart rate will not usually result in a pulmonary embolism or create electrolyte imbalances. Atrial-septal defects are congenital.
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The nurse is conducting patient teaching about cholesterol levels. When discussing the patients elevated LDL and lowered HDL levels, the patient shows an understanding of the significance of these levels by stating what?
- A. Increased LDL and decreased HDL increase my risk of coronary artery disease
- B. Increased LDL has the potential to decrease my risk of heart disease
- C. The decreased HDL level will increase the amount of cholesterol moved away from the artery walls
- D. The increased LDL will decrease the amount of cholesterol deposited on the artery walls
Correct Answer: A
Rationale: Elevated LDL levels and decreased HDL levels are associated with a greater incidence of coronary artery disease.
The nurse is caring for an acutely ill patient who has central venous pressure monitoring in place. What intervention should be included in the care plan of a patient with CVP in place?
- A. Apply antibiotic ointment to the insertion site twice daily
- B. Change the site dressing whenever it becomes visibly soiled
- C. Perform passive range-of-motion exercises to prevent venous stasis
- D. Aspirate blood from the device once daily to test pH
Correct Answer: B
Rationale: Gauze dressings should be changed every 2 days or transparent dressings at least every 7 days and whenever dressings become damp, loosened, or visibly soiled. Passive ROM exercise is not indicated and it is unnecessary and inappropriate to aspirate blood to test it for pH. Antibiotic ointments are contraindicated.
The nurse is doing discharge teaching with a patient who has coronary artery disease. The patient asks why he has to take an aspirin every day if he doesnt have any pain. What would be the nurses best response?
- A. Taking an aspirin every day is an easy way to help restore the normal function of your heart
- B. An aspirin a day can help prevent some of the blockages that can cause chest pain or heart attacks
- C. Taking an aspirin every day is a simple way to make your blood penetrate your heart more freely
- D. An aspirin a day eventually helps your blood carry more oxygen that it would otherwise
Correct Answer: B
Rationale: An aspirin a day is a common nonprescription medication that improves outcomes in patients with CAD due to its antiplatelet action. It does not affect oxygen carrying capacity or perfusion. Aspirin does not restore cardiac function.
A patient with a complex cardiac history is scheduled for transthoracic echocardiography. What should the nurse teach the patient in anticipation of this diagnostic procedure?
- A. The test is noninvasive, and nothing will be inserted into the patients body
- B. The patients pain will be managed aggressively during the procedure
- C. The test will provide a detailed profile of the hearts electrical activity
- D. The patient will remain on bed rest for 1 to 2 hours after the test
Correct Answer: A
Rationale: Before transthoracic echocardiography, the nurse informs the patient about the test, explaining that it is painless. The test does not evaluate electrophysiology and bed rest is unnecessary after the procedure.
The physician has ordered a high-sensitivity C-reactive protein (hs-CRP) drawn on a patient. The results of this test will allow the nurse to evaluate the role of what process that is implicated in the development of atherosclerosis?
- A. Immunosuppression
- B. Inflammation
- C. Infection
- D. Hemostasis
Correct Answer: B
Rationale: High-sensitivity CRP is a protein produced by the liver in response to systemic inflammation. Inflammation is thought to play a role in the development and progression of atherosclerosis.