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Nursing 354 Myocardial Infarction
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Rationales 2026 Q&A Instant Download
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1. A client arrives in the emergency department reporting crushing substernal
chest pain that began 30 minutes ago. Which action should the nurse prioritize?
A. Obtain a 12-lead electrocardiogram
B. Administer a stool softener
C. Encourage ambulation
D. Provide a high-fat snack
Answer: A. Obtain a 12-lead electrocardiogram
Rationale: A 12-lead electrocardiogram should be obtained promptly in a client
with suspected myocardial infarction because it can identify ischemic changes
and ST-segment elevation and helps guide urgent treatment.
2. Which assessment finding is most characteristic of an acute myocardial
infarction?
A. Intermittent mild chest discomfort relieved by rest
B. Severe or persistent chest pressure that may radiate to the arm or jaw
,C. Pain occurring only after eating spicy foods
D. Brief chest discomfort lasting several seconds
Answer: B. Severe or persistent chest pressure that may radiate to the arm or
jaw
Rationale: Acute myocardial infarction commonly presents with prolonged
pressure, squeezing, or heaviness in the chest that may radiate to the arm,
shoulder, back, neck, or jaw.
3. Which cardiac biomarker is considered highly specific for myocardial injury?
A. Myoglobin
B. Creatine kinase
C. Cardiac troponin
D. Lactate
Answer: C. Cardiac troponin
Rationale: Cardiac troponin is highly sensitive and specific for myocardial injury
and is a primary biomarker used when evaluating suspected myocardial
infarction.
4. A client with suspected myocardial infarction reports chest pain and dyspnea.
Which position is generally most appropriate?
A. Supine with the legs elevated
B. Prone
C. Semi-Fowler position
D. Trendelenburg position
Answer: C. Semi-Fowler position
Rationale: Semi-Fowler positioning can improve lung expansion and reduce the
work of breathing while the client is experiencing chest discomfort and possible
cardiac dysfunction.
5. Which electrocardiographic finding is most associated with an ST-elevation
myocardial infarction?
,A. ST-segment elevation in contiguous leads
B. Prolonged PR interval only
C. Widened QRS without other changes
D. Isolated sinus bradycardia
Answer: A. ST-segment elevation in contiguous leads
Rationale: ST-segment elevation in anatomically related or contiguous
electrocardiographic leads can indicate acute coronary artery occlusion and
requires rapid reperfusion assessment.
6. What is the primary pathophysiologic event in most acute myocardial
infarctions?
A. Complete destruction of all cardiac valves
B. Acute interruption of coronary blood flow causing myocardial ischemia and
injury
C. Increased blood flow through the coronary arteries
D. Excessive production of red blood cells
Answer: B. Acute interruption of coronary blood flow causing myocardial
ischemia and injury
Rationale: Most myocardial infarctions result from acute coronary artery
obstruction, commonly involving rupture of an atherosclerotic plaque followed
by thrombus formation.
7. Which medication is commonly administered early to a client with suspected
acute myocardial infarction when not contraindicated?
A. Aspirin
B. Warfarin
C. Digoxin
D. Furosemide
Answer: A. Aspirin
, Rationale: Aspirin inhibits platelet aggregation and is an important early
treatment for suspected acute coronary syndrome unless contraindications such
as significant allergy or active bleeding are present.
8. The nurse is teaching a client about aspirin therapy after myocardial
infarction. Which explanation is most accurate?
A. It dissolves existing coronary plaques immediately.
B. It decreases platelet aggregation and helps prevent additional thrombus
formation.
C. It directly increases cardiac contractility.
D. It permanently lowers blood pressure after one dose.
Answer: B. It decreases platelet aggregation and helps prevent additional
thrombus formation.
Rationale: Aspirin inhibits platelet aggregation, reducing the likelihood of
further thrombus formation and recurrent ischemic events.
9. Which client finding requires immediate intervention following a myocardial
infarction?
A. Mild fatigue
B. Occasional anxiety
C. New-onset ventricular fibrillation
D. Decreased appetite
Answer: C. New-onset ventricular fibrillation
Rationale: Ventricular fibrillation is a life-threatening dysrhythmia that results in
ineffective cardiac output and requires immediate resuscitation and
defibrillation according to appropriate protocols.
10. Which complication is a major cause of early death following acute
myocardial infarction?
A. Ventricular dysrhythmia
B. Constipation
Nursing 354 Myocardial Infarction
Practice Exam Questions And Correct
Answers (Verified Answers) Plus
Rationales 2026 Q&A Instant Download
___________________________________________________________________
1. A client arrives in the emergency department reporting crushing substernal
chest pain that began 30 minutes ago. Which action should the nurse prioritize?
A. Obtain a 12-lead electrocardiogram
B. Administer a stool softener
C. Encourage ambulation
D. Provide a high-fat snack
Answer: A. Obtain a 12-lead electrocardiogram
Rationale: A 12-lead electrocardiogram should be obtained promptly in a client
with suspected myocardial infarction because it can identify ischemic changes
and ST-segment elevation and helps guide urgent treatment.
2. Which assessment finding is most characteristic of an acute myocardial
infarction?
A. Intermittent mild chest discomfort relieved by rest
B. Severe or persistent chest pressure that may radiate to the arm or jaw
,C. Pain occurring only after eating spicy foods
D. Brief chest discomfort lasting several seconds
Answer: B. Severe or persistent chest pressure that may radiate to the arm or
jaw
Rationale: Acute myocardial infarction commonly presents with prolonged
pressure, squeezing, or heaviness in the chest that may radiate to the arm,
shoulder, back, neck, or jaw.
3. Which cardiac biomarker is considered highly specific for myocardial injury?
A. Myoglobin
B. Creatine kinase
C. Cardiac troponin
D. Lactate
Answer: C. Cardiac troponin
Rationale: Cardiac troponin is highly sensitive and specific for myocardial injury
and is a primary biomarker used when evaluating suspected myocardial
infarction.
4. A client with suspected myocardial infarction reports chest pain and dyspnea.
Which position is generally most appropriate?
A. Supine with the legs elevated
B. Prone
C. Semi-Fowler position
D. Trendelenburg position
Answer: C. Semi-Fowler position
Rationale: Semi-Fowler positioning can improve lung expansion and reduce the
work of breathing while the client is experiencing chest discomfort and possible
cardiac dysfunction.
5. Which electrocardiographic finding is most associated with an ST-elevation
myocardial infarction?
,A. ST-segment elevation in contiguous leads
B. Prolonged PR interval only
C. Widened QRS without other changes
D. Isolated sinus bradycardia
Answer: A. ST-segment elevation in contiguous leads
Rationale: ST-segment elevation in anatomically related or contiguous
electrocardiographic leads can indicate acute coronary artery occlusion and
requires rapid reperfusion assessment.
6. What is the primary pathophysiologic event in most acute myocardial
infarctions?
A. Complete destruction of all cardiac valves
B. Acute interruption of coronary blood flow causing myocardial ischemia and
injury
C. Increased blood flow through the coronary arteries
D. Excessive production of red blood cells
Answer: B. Acute interruption of coronary blood flow causing myocardial
ischemia and injury
Rationale: Most myocardial infarctions result from acute coronary artery
obstruction, commonly involving rupture of an atherosclerotic plaque followed
by thrombus formation.
7. Which medication is commonly administered early to a client with suspected
acute myocardial infarction when not contraindicated?
A. Aspirin
B. Warfarin
C. Digoxin
D. Furosemide
Answer: A. Aspirin
, Rationale: Aspirin inhibits platelet aggregation and is an important early
treatment for suspected acute coronary syndrome unless contraindications such
as significant allergy or active bleeding are present.
8. The nurse is teaching a client about aspirin therapy after myocardial
infarction. Which explanation is most accurate?
A. It dissolves existing coronary plaques immediately.
B. It decreases platelet aggregation and helps prevent additional thrombus
formation.
C. It directly increases cardiac contractility.
D. It permanently lowers blood pressure after one dose.
Answer: B. It decreases platelet aggregation and helps prevent additional
thrombus formation.
Rationale: Aspirin inhibits platelet aggregation, reducing the likelihood of
further thrombus formation and recurrent ischemic events.
9. Which client finding requires immediate intervention following a myocardial
infarction?
A. Mild fatigue
B. Occasional anxiety
C. New-onset ventricular fibrillation
D. Decreased appetite
Answer: C. New-onset ventricular fibrillation
Rationale: Ventricular fibrillation is a life-threatening dysrhythmia that results in
ineffective cardiac output and requires immediate resuscitation and
defibrillation according to appropriate protocols.
10. Which complication is a major cause of early death following acute
myocardial infarction?
A. Ventricular dysrhythmia
B. Constipation
