MEDICAL SURGERY NURSING , LATEST EDITION 2025/2026 QUESTIONS AND CORRECT ANSWERS RATED 100%

MEDICAL SURGERY NURSING , LATEST EDITION 2025/2026 QUESTIONS AND CORRECT ANSWERS RATED 100% Nursing Management: Coronary Artery Disease and Acute Coronary Syndrome MULTIPLE CHOICE 1. When developing a health teaching plan for a 65-year-old patient with all these risk factors for coronary artery disease (CAD), the nurse will focus on the a. family history of heart disease. b. increased risk associated with the patient’s ethnicity. c. high incidence of cardiovascular disease in older people. d. low activity level the patient reports. Correct Answer: D Rationale: Because family history, ethnicity, and age are nonmodifiable risk factors, the nurse should focus on the patient’s activity level. An increase in activity will help reduce the patient’s risk for developing CAD. 2. To assist the patient with CAD to make the appropriate dietary changes, which of these nursing interventions will be most effective? a. Assist the patient to modify favorite high-fat recipes by using monosaturated oils when possible. b. Provide the patient with a list of low-sodium, low-cholesterol foods that should be included in the diet. c. Instruct the patient that a diet containing no saturated fat and minimal sodium will be necessary. d. Emphasize the increased risk for cardiac problems unless the patient makes the dietary changes. Correct Answer: A Rationale: Lifestyle changes are more likely to be successful when consideration is given to patient’s preferences. The highest percentage of calories from fat should come from monosaturated fats. Although low-sodium and low-cholesterol foods are appropriate, providing the patient with a list alone is not likely to be successful in making dietary changes. Removing saturated fat from the diet completely is not a realistic expectation; up to 7% of calories in the therapeutic lifestyle changes (TLC) diet can come from saturated fat. Telling the patient about the increased risk without assisting further with strategies for dietary change is unlikely to be successful. 3. The nurse is admitting a patient who is complaining of chest pain to the emergency department (ED). Which information collected by the nurse suggests that the pain is caused by an acute myocardial infarction (AMI)? a. The pain worsens when the patient raises the arms. b. The pain increases with deep breathing. c. The pain is relieved after the patient takes nitroglycerin. d. The pain has persisted longer than 30 minutes. Correct Answer: D Rationale: Chest pain that lasts for 20 minutes or more is characteristic of AMI. Changes in pain that occur with raising the arms or with deep breathing are more typical of pericarditis or musculoskeletal pain. Stable angina is usually relieved when the patient takes nitroglycerin. 4. A patient is admitted to the ED after an episode of severe chest pain, and the physician schedules the patient for coronary angiography and possible percutaneous coronary intervention (PCI). The nurse prepares the patient for the procedure by explaining that it is used to a. determine whether there are any structural defects in the chambers of the heart. b. locate any coronary artery obstructions and administer thrombolytic agents. c. measure the amount of blood being pumped from the heart with each contraction. d. visualize any coronary artery blockages and dilate any obstructed arteries. Correct Answer: D Rationale: Visualization of the coronary arteries and possible balloon dilation are scheduled for this patient. Thrombolytic therapy is an alternative treatment if the patient is experiencing acute coronary syndrome (ACS) but is not the ordered therapy for this patient. Although angiography might help to detect structural defects or changes in cardiac output, it is not the reason for the procedure in this patient with symptoms of CAD. 5. Which information given by a patient admitted with chronic stable angina will help the nurse confirm this diagnosis? a. The patient rates the pain at a level 3 to 5 (0–10 scale). b. The patient states that the pain “wakes me up at night.” c. The patient indicates that the pain is resolved after taking one sublingual nitroglycerin tablet. d. The patient says that the frequency of the pain has increased over the last few weeks. Correct Answer: C Rationale: Chronic 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. 6. Which electrocardiographic (ECG) change will be of most concern to the nurse when admitting a patient with chest pain? a. Sinus tachycardia b. Inverted T wave c. ST-segment elevation d. Frequent PACs Correct Answer: C Rationale: The patient is likely to be experiencing an ST-segment–elevation myocardial infarction (STEMI) and immediate therapy with PCI or fibrinolytic medications is indicated to minimize the amount of myocardial damage. The other ECG changes also suggest a need for therapy, but not as rapidly. 7. When caring for a patient with ACS who has returned to the coronary care unit after having a PCI, the nurse obtains these assessment data. Which data indicate the need for immediate intervention by the nurse? a. Heart rate 100 beats/min b. Chest pain level 8 on a 10-point scale c. Blood pressure (BP) 104/56 mm Hg d. Pedal pulses 2+ Correct Answer: B Rationale: The patient’s chest pain may indicate that restenosis of the coronary artery is occurring and requires immediate actions, such as administration of oxygen and nitroglycerin, by the nurse. The other information indicates a need for ongoing assessments by the nurse. 8. In developing a teaching plan for a patient who has stable angina and is started on sublingual nitroglycerin (Nitrostat), the nurse identifies an expected patient outcome of a. stating that nitroglycerin is to be taken only if chest pain develops. b. listing the side effects of nitroglycerin as gastric upset and dry mouth. c. identifying the need to call the emergency medical services (EMS) if chest pain persists 5 minutes after taking nitroglycerin. d. recognizes that taking the nitroglycerin is important to decrease the ongoing atherosclerosis of the coronary arteries. Correct Answer: C Rationale: The EMS system should be activated when chest pain or other symptoms are not completely relieved 5 minutes after taking nitroglycerin. Nitroglycerin can be taken to prevent chest pain or other symptoms from developing. Gastric upset and dry mouth are not expected side effects of nitroglycerin. Nitroglycerin does not impact the underlying pathophysiology of coronary artery atherosclerosis.