Nokea
Which of the following information given by a patient admitted with persistent stable angina will help the nurse confirm this diagnosis?
- A. The patient rates the pain at a level 3-5 (0-10 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.
Correct Answer: D
Rationale: Persistent 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.
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The nurse is caring for a patient with a non-ST-segment-elevation myocardial infarction (NSTEMI) who is receiving heparin. Which of the following information explains the purpose of the heparin?
- A. Platelet aggregation is enhanced by IV heparin infusion.
- B. Heparin will dissolve the clot that is blocking blood flow to the heart.
- C. Coronary artery plaque size and adherence are decreased with heparin.
- D. Heparin will prevent the development of new clots in the coronary arteries.
Correct Answer: D
Rationale: Heparin helps prevent the conversion of fibrinogen to fibrin and decreases coronary artery thrombosis. It does not change coronary artery plaque, dissolve already formed clots, or enhance platelet aggregation.
The nurse is providing teaching to a patient who has a prescription for transdermal nitroglycerin patches. The patient asks the nurse how often they should remove the previously applied patch. Which of the following information is the basis for the nurse's response?
- A. Every 4 hours while awake
- B. Every 6 hours around the clock
- C. Every 12 hours
- D. Remove at bedtime
Correct Answer: D
Rationale: NTG patches should be applied in the am and removed at bedtime to prevent tolerance.
Three days after a myocardial infarction (MI), the patient develops chest pain that increases when taking a deep breath and is relieved by leaning forward. Which of the following actions should the nurse take next?
- A. Palpate the radial pulses bilaterally.
- B. Assess the feet for peripheral edema.
- C. Auscultate for a pericardial friction rub.
- D. Check the cardiac monitor for dysrhythmias.
Correct Answer: C
Rationale: The patient's symptoms are consistent with the development of pericarditis, a possible complication of MI. The other assessments listed are not consistent with the description of the patient's symptoms.
Four days after having a myocardial infarction (MI), a patient who is scheduled for discharge asks for assistance with all the daily activities, saying, 'I don't understand how to care for myself' Based on this information, which of the following nursing diagnoses is appropriate?
- A. Ineffective health management related to insufficient knowledge
- B. Activity intolerance related to physical deconditioning
- C. Ineffective denial related to ineffective coping strategies
- D. Social isolation related to insufficient personal resources
Correct Answer: A
Rationale: The patient data indicate ineffective health management related to lack of knowledge of disease process, and care after discharge. The other nursing diagnoses may be appropriate for some patients after an MI, but the data for this patient do not support denial, activity intolerance, or social isolation.
The nurse is developing a health teaching plan for a 60-year-old man with the following risk factors for coronary artery disease (CAD). Which of the following risk factors should the nurse focus on when teaching the patient?
- A. Family history of coronary artery disease
- B. Increased risk associated with the patient's gender
- C. High incidence of cardiovascular disease in older people
- D. Elevation of the patient's serum low density lipoprotein (LDL) level
Correct Answer: D
Rationale: Because family history, gender, and age are nonmodifiable risk factors, the nurse should focus on the patient's LDL level. Decreases in LDL will help reduce the patient's risk for developing CAD.