Alterations in Cardiovascular System NCLEX Questions and Answers 2024

After an anterior-wall myocardial infarction (MI), which problem is indicated by auscultation of crackles in the lungs? A. Left-sided heart failure B. Pulmonic valve malfunction C. Right-sided heart failure D. Tricuspid valve malfunction - A. Left-sided heart failure The left ventricle is responsible for most of the cardiac output. An anterior-wall MI may result in a decrease in left ventricular function. When the left ventricle doesn't function properly, resulting in left-sided heart failure, fluid accumulates in the interstitial and alveolar spaces in the lungs and causes crackles. Pulmonic and tricuspid valve malfunction causes right-sided heart failure. A client who is being evaluated for myocardial infarction (MI) asks the nurse which diagnostic tool is most commonly used to determine the location of myocardial damage. The best response by the nurse is: A. cardiac catheterization. B. cardiac enzymes. C. echocardiogram. D. electrocardiogram (ECG). - D. electrocardiogram (ECG) The ECG is the quickest, most accurate, and most widely used tool to determine the location of myocardial infarction (MI). Cardiac catheterization is an invasive study for determining coronary artery disease and may also indicate the location of myocardial damage, but the study may not be performed immediately. Cardiac enzymes are used to diagnose MI but can't determine the location. An echocardiogram is used most widely to view myocardial wall function after an MI has been diagnosed. What is the first intervention for the nurse to implement for a client experiencing myocardial infarction (MI)? A. Administer morphine. B. Administer oxygen. C. Administer sublingual nitroglycerin. D. Obtain an electrocardiogram(ECG). - B. Administering supplemental oxygen to the client is the first priority of care. The myocardium is deprived of oxygen during an infarction, so additional oxygen is administered to assist in oxygenation and prevent further damage. Morphine and sublingual nitroglycerin are also used to treat MI, but they're more commonly administered after the oxygen. An ECG is the most common diagnostic tool used to evaluate MI. A client who experienced a myocardial infarction (MI) tells the nurse he is fearful of dying. The most appropriate response by the nurse is: A. "Tell me about your feelings right now." B. "When the doctor arrives, everything will be fine." C. "This is a bad situation, but you'll feel better soon." D. "Please be assured we're doing everything we can to make you feel better." - A. "Tell me about your feelings right now." Validation of a client's feelings is the most appropriate response. It gives the client a feeling of comfort and safety. The other three responses give the client false hope. No one can determine if a client experiencing an MI will feel or get better, and therefore, these responses are inappropriate. What is the class of medications that protects the ischemic myocardium by blocking catecholamines and sympathetic nerve stimulation? A. Beta-adrenergic blockers B. Calcium channel blockers C. Opioids D. Nitrates - A. Beta-adrenergic blockers