ACUTE CORONARY SYNDROME NCLEX EXAM QUESTIONS AND
ANSWERS 100% PASS
1. The client with unstable angina has 1. Among people who have unsta-
received education about the acute ble angina, 10% to 30% have a my-
coronary syndrome. Which of the fol- ocardial infarction (MI) within 1 year.
lowing indicates that he understood Although angina pain is temporary,
the teaching? it reflects underlying coronary artery
1. "This is a big warning, I must mod- disease (CAD), which requires atten-
ify my lifestyle or risk having a heart tion, including lifestyle modifications.
attack in the next year." Unstable angina reflects tissue is-
2. "Angina is just a temporary inter- chemia, but infarction represents tis-
ruption of blood flow to my heart." sue necrosis. Clients with underlying
3. "I need to tell my wife I've had a CAD may need medications such as
heart attack." aspirin (ASA), lipid-lowering agents,
4. "Because this was temporary, I will antianginals, or antihypertensives.
not need to take any medications for
my heart."
2. The nurse is caring for a group of 2. Owing to the large size of the an-
clients who have sustained myocar- terior wall, the amount of tissue in-
dial infarction (MI). The nurse ob- farction may be large enough to de-
serves the client with which type of crease the force of contraction, lead-
MI most carefully for the develop- ing to heart failure. with the inferior
ment of left ventricular heart failure? wall, the client is more likely to de-
1. Inferior wall velop right ventricular MI. regarding
2. Anterior wall clients with obstruction of the circum-
3. Lateral wall flex artery may experience a lateral
4. Posterior wall wall or posterior wall MI and sinus
dysrhythmias.
3. The nurse is providing a cardiac Increasing age, especially after 70 yo
class for a women's group. The nurse Family history is a risk factor in both
emphasizes that which characteris- men and women
tics place women at high risk for Abdominal obesity: A large waist
myocardial infarction (MI)? Select all size/abdominal obesity is a risk fac-
that apply. tor for both metabolic syndrome and
Premenopausal MI.
Increasing age
Family history
Abdominal obesity
Breast cancer
,ACUTE CORONARY SYNDROME NCLEX EXAM QUESTIONS AND
ANSWERS 100% PASS
4. The nurse is teaching a group of 3. Tobacco exposure, including sec-
teens about prevention of heart dis- ondhand smoke, reduces coronary
ease. Which point should the nurse blood flow, causes vasoconstric-
emphasize? tion and endothelial dysfunction and
1. Reduce abdominal fat. thickening of the vessel wall, increas-
2. Avoid stress. es carbon monoxide, and decreas-
3. Do not smoke or chew tobacco. es oxygen. Because this is highly
4. Avoid alcoholic beverages. addicting, beginning smoking in the
teen years may lead to decades of
exposure.
5. The nurse is teaching the client that Hypercholesterolemia: Decreased
metabolic syndrome can increase high-density lipoprotein cholesterol
the risk for myocardial infarction (MI). (HDL-C) (usually with high low-den-
Which signs of metabolic syndrome sity lipoprotein cholesterol [LDL-C]),
should the nurse include in the dis- HDL-C less than 40 mg/dL for men
cussion? Select all that apply. or less than 50 mg/dL for women,
Truncal obesity or taking an anticholesterol drug is a
Hypercholesterolemia sign of metabolic syndrome.
Elevated homocysteine levels Glucose intolerance: Increased fast-
Glucose intolerance ing blood glucose (caused by dia-
Client taking losartan (Cozaar) betes, glucose intolerance, or insulin
resistance) is included in the constel-
lation of metabolic syndrome.
Client taking losartan (Cozaar):
Blood pressure greater than 130/85
or taking antihypertensive medica-
tion indicates metabolic syndrome.
6. Which of the following atypical symp- Dyspnea, Dizziness, Extreme fatigue
toms may be present in the female
client experiencing myocardial in-
farction (MI)? Select all that apply.
Sharp, inspiratory chest pain
Dyspnea
Dizziness
Extreme fatigue
Anorexia
, 7. To validate that the client has had a 4. Myoglobin, troponin, and CK-MB
myocardial infarction (MI), the nurse are the cardiac markers used to de-
assesses for positive findings on termine whether MI has occurred.
which tests? Homocysteine and C-reactive pro-
1. Creatine kinase-MB fraction tein are markers of inflammation,
(CK-MB) and alkaline phosphatase which may represent risk for MI, but
2. Homocysteine and C-reactive pro- they are not diagnostic for MI.
tein
3. Total cholesterol, low-density
lipoprotein (LDL) and high-density
lipoprotein (HDL) cholesterols
4. Myoglobin and troponin
8. When caring for a client with acute 2. The focus of pain relief is on re-
myocardial infarction, the nurse rec- ducing myocardial oxygen demand.
ognizes that prompt pain manage- Chest discomfort will increase anxi-
ment is essential for which reason? ety, but it may not affect coping. The
1. The discomfort will increase client major purpose of pain relief is to
anxiety and reduce coping. reduce myocardial oxygen demand.
2. Pain relief improves the oxygen Relief of pain is secondary to the use
supply and decreases oxygen de- of opiates or indicates that the tissue
mand. infarction is complete.
3. Relief of pain indicates that the my-
ocardial infarction is resolving.
4. Pain medication should not be
used until a definitive diagnosis has
been established.
9. When planning care for a client in the Morphine: Morphine is needed to re-
emergency department, the nurse duce oxygen demand, preload, pain,
recognizes that which interventions and anxiety.
are needed in the acute phase? Se- Oxygen: will increase available oxy-
lect all that apply. gen for the ischemic myocardium.
Morphine sulfate Nitroglycerin is used to reduce pre-
Oxygen load and chest pain.
Nitroglycerin The client is given aspirin to chew;
Naloxone acetaminophen may be used for
Acetaminophen headache related to nitroglycerin.
Verapamil (Calan, Isoptin) Owing to negative inotropic action,
ANSWERS 100% PASS
1. The client with unstable angina has 1. Among people who have unsta-
received education about the acute ble angina, 10% to 30% have a my-
coronary syndrome. Which of the fol- ocardial infarction (MI) within 1 year.
lowing indicates that he understood Although angina pain is temporary,
the teaching? it reflects underlying coronary artery
1. "This is a big warning, I must mod- disease (CAD), which requires atten-
ify my lifestyle or risk having a heart tion, including lifestyle modifications.
attack in the next year." Unstable angina reflects tissue is-
2. "Angina is just a temporary inter- chemia, but infarction represents tis-
ruption of blood flow to my heart." sue necrosis. Clients with underlying
3. "I need to tell my wife I've had a CAD may need medications such as
heart attack." aspirin (ASA), lipid-lowering agents,
4. "Because this was temporary, I will antianginals, or antihypertensives.
not need to take any medications for
my heart."
2. The nurse is caring for a group of 2. Owing to the large size of the an-
clients who have sustained myocar- terior wall, the amount of tissue in-
dial infarction (MI). The nurse ob- farction may be large enough to de-
serves the client with which type of crease the force of contraction, lead-
MI most carefully for the develop- ing to heart failure. with the inferior
ment of left ventricular heart failure? wall, the client is more likely to de-
1. Inferior wall velop right ventricular MI. regarding
2. Anterior wall clients with obstruction of the circum-
3. Lateral wall flex artery may experience a lateral
4. Posterior wall wall or posterior wall MI and sinus
dysrhythmias.
3. The nurse is providing a cardiac Increasing age, especially after 70 yo
class for a women's group. The nurse Family history is a risk factor in both
emphasizes that which characteris- men and women
tics place women at high risk for Abdominal obesity: A large waist
myocardial infarction (MI)? Select all size/abdominal obesity is a risk fac-
that apply. tor for both metabolic syndrome and
Premenopausal MI.
Increasing age
Family history
Abdominal obesity
Breast cancer
,ACUTE CORONARY SYNDROME NCLEX EXAM QUESTIONS AND
ANSWERS 100% PASS
4. The nurse is teaching a group of 3. Tobacco exposure, including sec-
teens about prevention of heart dis- ondhand smoke, reduces coronary
ease. Which point should the nurse blood flow, causes vasoconstric-
emphasize? tion and endothelial dysfunction and
1. Reduce abdominal fat. thickening of the vessel wall, increas-
2. Avoid stress. es carbon monoxide, and decreas-
3. Do not smoke or chew tobacco. es oxygen. Because this is highly
4. Avoid alcoholic beverages. addicting, beginning smoking in the
teen years may lead to decades of
exposure.
5. The nurse is teaching the client that Hypercholesterolemia: Decreased
metabolic syndrome can increase high-density lipoprotein cholesterol
the risk for myocardial infarction (MI). (HDL-C) (usually with high low-den-
Which signs of metabolic syndrome sity lipoprotein cholesterol [LDL-C]),
should the nurse include in the dis- HDL-C less than 40 mg/dL for men
cussion? Select all that apply. or less than 50 mg/dL for women,
Truncal obesity or taking an anticholesterol drug is a
Hypercholesterolemia sign of metabolic syndrome.
Elevated homocysteine levels Glucose intolerance: Increased fast-
Glucose intolerance ing blood glucose (caused by dia-
Client taking losartan (Cozaar) betes, glucose intolerance, or insulin
resistance) is included in the constel-
lation of metabolic syndrome.
Client taking losartan (Cozaar):
Blood pressure greater than 130/85
or taking antihypertensive medica-
tion indicates metabolic syndrome.
6. Which of the following atypical symp- Dyspnea, Dizziness, Extreme fatigue
toms may be present in the female
client experiencing myocardial in-
farction (MI)? Select all that apply.
Sharp, inspiratory chest pain
Dyspnea
Dizziness
Extreme fatigue
Anorexia
, 7. To validate that the client has had a 4. Myoglobin, troponin, and CK-MB
myocardial infarction (MI), the nurse are the cardiac markers used to de-
assesses for positive findings on termine whether MI has occurred.
which tests? Homocysteine and C-reactive pro-
1. Creatine kinase-MB fraction tein are markers of inflammation,
(CK-MB) and alkaline phosphatase which may represent risk for MI, but
2. Homocysteine and C-reactive pro- they are not diagnostic for MI.
tein
3. Total cholesterol, low-density
lipoprotein (LDL) and high-density
lipoprotein (HDL) cholesterols
4. Myoglobin and troponin
8. When caring for a client with acute 2. The focus of pain relief is on re-
myocardial infarction, the nurse rec- ducing myocardial oxygen demand.
ognizes that prompt pain manage- Chest discomfort will increase anxi-
ment is essential for which reason? ety, but it may not affect coping. The
1. The discomfort will increase client major purpose of pain relief is to
anxiety and reduce coping. reduce myocardial oxygen demand.
2. Pain relief improves the oxygen Relief of pain is secondary to the use
supply and decreases oxygen de- of opiates or indicates that the tissue
mand. infarction is complete.
3. Relief of pain indicates that the my-
ocardial infarction is resolving.
4. Pain medication should not be
used until a definitive diagnosis has
been established.
9. When planning care for a client in the Morphine: Morphine is needed to re-
emergency department, the nurse duce oxygen demand, preload, pain,
recognizes that which interventions and anxiety.
are needed in the acute phase? Se- Oxygen: will increase available oxy-
lect all that apply. gen for the ischemic myocardium.
Morphine sulfate Nitroglycerin is used to reduce pre-
Oxygen load and chest pain.
Nitroglycerin The client is given aspirin to chew;
Naloxone acetaminophen may be used for
Acetaminophen headache related to nitroglycerin.
Verapamil (Calan, Isoptin) Owing to negative inotropic action,
