NUR 213 Cardio Practice Questions

NUR 213 Cardio Practice Questions

• The nurse is caring for a client with a history of atherosclerosis. The client has chest pain that

occurs with physical exertion or stress and is relieved with sublingual nitroglycerin. The nurse recognizes that the client is most likely experiencing which disorder ?

Acute coronary syndrome Myocardial infarction Stable angina Prinzmetal angina

Answer Stable angina

Stable angina is a predictable form ofangina, which usually occurs when the work of the heart is increased by physicalexertion, exposure tocold, or stress. Prinzmetal(variant) angina occurs unpredictably and often at night. The client is currently experiencing a predictable form of angina. Clinical manifestations of myocardial infarction include pain that is lesspredictable, moreprolonged, and unrelieved by sublingual nitroglycerin. Clinical manifestations of acute coronary syndrome include pain that is more severe and longer than previously experienced.The pain is not predictable and is unrelieved by sublingual nitroglycerin.

• The client with a history of atherosclerosis has chest pain that is unrelated toactivity,

unpredictable, and often occurs while at rest. The client reports the pain has been becoming more frequent andsevere, rating the current pain as 9 on a scale of 1 to 10.You recognize that the client is at severe risk of which disorder?

Coronary artery disease Prinzmetal angina Stable angina Myocardial infarction

Answer Myocardial infarction

Prinzmetal(variant) angina occurs unpredictably and often at night.The client is currently experiencing either Prinzmetal or unstable angina and is at severe risk of a myocardial infarction. Stable angina is a predictable form ofangina, which usually occurs when the work of the heart is increased by physicalexertion, exposure tocold, or stress.Thisclient's angina is unpredictable and occurs at res Coronary artery disease is the cause 1 / 3

ofangina, not the disorder which develops as a result of it.

• You are developing a plan of care for a client with coronary artery dis- ease.Which

pharmacological treatment would help increase blood flow to the client's coronaryarteries?

Use of salicylic acid daily Discontinue the use of statins Use an analgesic to control chest pain Discontinue the use of daily ibuprofen

Answer Use of salicylic acid daily

To increase theclient's bloodflow, one goal is to prevent the aggregatio of platelets in the arteries. Salicylic acid(aspirin) is a pharmacological measure to control the aggregation. Statins are used to decrease cholesterol and would be a part of theclient's protocol unless the client experienced side effects. Analgesics are given for chestpain, but do not increase blood flow.Nitrates for angina would increase blood flow. There is no reason to discontinue the use of daily ibuprofen as a means of increasing blood flow to the coronary arteries.

• The nurse is developing a plan of care for a client with coronary artery disease. Which

mechanism contributes to a decreased blood flow to the client's coronary arteries?

Fat and fibrin deposits on the arterial walls Increased vasodilation of the arteries Decreased platelet aggregation Injury to arterial walls from increased arterial pressures

Answer Fat and fibrin deposits on the arterial walls

Fat and fibrin deposits on the arterial walls are called plaque. They cause the artery to become thick and hardened with narrowing of the lumen and decreased blood flow.Platelet aggregation(clumping together)increases, notdecreases, le ing to the formation of clots that narrow the lumen of the arterial vessel.Vasodilation, or opening of thearteries, would increase blood flow. The walls of the arteries become hardened and have decreasedelasticity, which makes vasodilation more difficult. Spasms of the arterial vessels cause constriction and narrowing of the vessels. Injury that occurs from increased arterial pressure causes an increased risk of the formation of fibrin plaques.The injury does not cause a decrease in blood flow.

• The nurse is providing care to a client admitted to the coronary care unit for a suspected heart

attack. Which diagnostic tests does the nurse anticipate to confirm the diagnosis? (Select all 2 / 3

that apply.)

CK-MB WBC

CBC CPK

ECG

Answer

CK-MB CPK

ECG

When the healthcare provider believes that a client has experienced a heartattack, or myocardial infarction(MI), diagnostic tests will include cardiac markers including CPK andCK-MB and an ECG. A CBC and WBC will not be useful to confirm the diagnosis of an MI.

• functions as an antiplatelet aggregate; platelets become "less sticky" and flow smoother

through the vessels.

Answer Aspirin

• work by slowing the heart rate and lowering blood pressure, thereby decreasing the oxygen

demand on the heart.

Answer Beta-blockers

• work by lowering the client's cholesterol, specifically re- moving the "bad" cholesterol from

the blood (LDL).

Answer Statins

• may be used to dilate the smooth muscles of arteries and veins. By dilating veins, preload

can be reduced, thus allowing the heart to work less.

Answer Nitrates

• work to reduce blood pressure, and in some cases, reduce heart rate.

Answer Calcium channel blockers

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