NUFT 341 EVALUATION EXAM ACTUAL QUESTIONS
AND SOLUTIONS GRADED A+
✔✔The nurse obtains the following data when assessing a patient who
experienced an ST-segment-elevation myocardial infarction (STEMI) 2 days
previously. Which information is most important to report to the health care
provider?
a. The troponin level is elevated.
b. The patient denies having a heart attack.
c. Bilateral crackles in the mid-lower lobes.
d. Occasional premature atrial contractions (PACs) - ✔✔C. Bilateral crackles in the mid-
lower lobes.
The crackles indicate that the patient may be developing heart failure, a possible
complication of myocardial infarction (MI). The health care provider may need to order
medications such as diuretics or angiotensin-converting enzyme inhibitors for the
patient. Elevation in troponin level at this time is
expected. PACs are not life-threatening dysrhythmias. Denial is a common response in
the immediate period after the MI.
✔✔A patient had a non-ST-segment-elevation myocardial infarction (NSTEMI)
3 days ago. Which nursing intervention is appropriate for the registered
nurse (RN) to delegate to an experienced licensed practical/vocational nurse
(LPN/VN)?
a. Reinforcement of teaching about the prescribed medications
b. Evaluation of the patient's response to walking in the hallway
c. Completion of the referral form for a home health nurse follow-up
d. Education of the patient about the pathophysiology of heart disease - ✔✔A.
Reinforcement of teaching about the prescribed medications
LPN/VN education and scope of practice include reinforcing education that has
previously been done by the RN. Evaluating the patient's response to exercise after a
NSTEMI requires more education and should be done by the
RN. Teaching and discharge planning and referral are skills that require RN education
and scope of practice.
✔✔A patient who has chest pain is admitted to the emergency department
(ED), and all of the following items are prescribed. Which one would the
nurse arrange to be completed first?
a. Chest x-ray
b. Troponin level
c. Electrocardiogram (ECG)
d. Insertion of a peripheral IV - ✔✔C. Electrocardiogram (ECG)
, The priority for the patient is to determine whether an acute myocardial infarction (AMI)
is occurring so that the appropriate therapy can begin as quickly as possible. ECG
changes occur very rapidly after coronary artery occlusion, and an ECG should be
obtained as soon as possible. Troponin
levels will increase after about 3 hours. Data from the chest x-ray may impact the
patient's care but are not helpful in determining whether the patient is experiencing a
myocardial infarction. Peripheral IV access will be needed but not before the ECG.
✔✔After receiving change-of-shift report about the following four patients on
the cardiac care unit, which patient would the nurse assess first?
a. A 39-year-old patient with pericarditis who is complaining of sharp,
stabbing chest pain
b. A 56-year-old patient with variant angina who is scheduled to
receive nifedipine (Procardia)
c. A 65-year-old patient who had a myocardial infarction (MI) 4 days ago and
is anxious about today's planned discharge
d. A 59-year-old patient with unstable angina who has just returned after a
percutaneous coronary intervention (PCI). - ✔✔D. A 59-year-old patient with unstable
angina who has just returned after a percutaneous coronary intervention (PCI).
After PCI, the patient is at risk for hemorrhage from the arterial access site. The nurse
should assess the patient's blood pressure, pulses, and the access site immediately.
The other patients should also be assessed as quickly as possible, but assessment of
this patient has the highest priority
✔✔To improve the physical activity level for a 68-year-old patient who is
mildly obese, which action would the nurse plan to take?
a. Stress that weight loss is a major benefit of increased exercise.
b. Determine what kind of physical activities the patient usually enjoys.
c. Tell the patient that older adults should exercise for no more than 20
minutes at a time.
d. Teach the patient to include a short warm-up period at the beginning of
physical activity. - ✔✔B. Determine what kind of physical activities the patient usually
enjoys.
Because patients are more likely to continue physical activities that they already enjoy,
the nurse will plan to ask the patient about preferred activities. The goal for older adults
is 30 minutes of moderate activity on most days. Older adults should plan for a longer
warm-up period. Benefits of
exercises, such as improved activity tolerance, should be emphasized rather than
aiming for significant weight loss in older mildly obese adults
✔✔Which patient at the cardiovascular clinic requires the most immediate
action by the nurse?
a. Patient with type 2 diabetes whose current blood glucose level is 145
mg/dL
AND SOLUTIONS GRADED A+
✔✔The nurse obtains the following data when assessing a patient who
experienced an ST-segment-elevation myocardial infarction (STEMI) 2 days
previously. Which information is most important to report to the health care
provider?
a. The troponin level is elevated.
b. The patient denies having a heart attack.
c. Bilateral crackles in the mid-lower lobes.
d. Occasional premature atrial contractions (PACs) - ✔✔C. Bilateral crackles in the mid-
lower lobes.
The crackles indicate that the patient may be developing heart failure, a possible
complication of myocardial infarction (MI). The health care provider may need to order
medications such as diuretics or angiotensin-converting enzyme inhibitors for the
patient. Elevation in troponin level at this time is
expected. PACs are not life-threatening dysrhythmias. Denial is a common response in
the immediate period after the MI.
✔✔A patient had a non-ST-segment-elevation myocardial infarction (NSTEMI)
3 days ago. Which nursing intervention is appropriate for the registered
nurse (RN) to delegate to an experienced licensed practical/vocational nurse
(LPN/VN)?
a. Reinforcement of teaching about the prescribed medications
b. Evaluation of the patient's response to walking in the hallway
c. Completion of the referral form for a home health nurse follow-up
d. Education of the patient about the pathophysiology of heart disease - ✔✔A.
Reinforcement of teaching about the prescribed medications
LPN/VN education and scope of practice include reinforcing education that has
previously been done by the RN. Evaluating the patient's response to exercise after a
NSTEMI requires more education and should be done by the
RN. Teaching and discharge planning and referral are skills that require RN education
and scope of practice.
✔✔A patient who has chest pain is admitted to the emergency department
(ED), and all of the following items are prescribed. Which one would the
nurse arrange to be completed first?
a. Chest x-ray
b. Troponin level
c. Electrocardiogram (ECG)
d. Insertion of a peripheral IV - ✔✔C. Electrocardiogram (ECG)
, The priority for the patient is to determine whether an acute myocardial infarction (AMI)
is occurring so that the appropriate therapy can begin as quickly as possible. ECG
changes occur very rapidly after coronary artery occlusion, and an ECG should be
obtained as soon as possible. Troponin
levels will increase after about 3 hours. Data from the chest x-ray may impact the
patient's care but are not helpful in determining whether the patient is experiencing a
myocardial infarction. Peripheral IV access will be needed but not before the ECG.
✔✔After receiving change-of-shift report about the following four patients on
the cardiac care unit, which patient would the nurse assess first?
a. A 39-year-old patient with pericarditis who is complaining of sharp,
stabbing chest pain
b. A 56-year-old patient with variant angina who is scheduled to
receive nifedipine (Procardia)
c. A 65-year-old patient who had a myocardial infarction (MI) 4 days ago and
is anxious about today's planned discharge
d. A 59-year-old patient with unstable angina who has just returned after a
percutaneous coronary intervention (PCI). - ✔✔D. A 59-year-old patient with unstable
angina who has just returned after a percutaneous coronary intervention (PCI).
After PCI, the patient is at risk for hemorrhage from the arterial access site. The nurse
should assess the patient's blood pressure, pulses, and the access site immediately.
The other patients should also be assessed as quickly as possible, but assessment of
this patient has the highest priority
✔✔To improve the physical activity level for a 68-year-old patient who is
mildly obese, which action would the nurse plan to take?
a. Stress that weight loss is a major benefit of increased exercise.
b. Determine what kind of physical activities the patient usually enjoys.
c. Tell the patient that older adults should exercise for no more than 20
minutes at a time.
d. Teach the patient to include a short warm-up period at the beginning of
physical activity. - ✔✔B. Determine what kind of physical activities the patient usually
enjoys.
Because patients are more likely to continue physical activities that they already enjoy,
the nurse will plan to ask the patient about preferred activities. The goal for older adults
is 30 minutes of moderate activity on most days. Older adults should plan for a longer
warm-up period. Benefits of
exercises, such as improved activity tolerance, should be emphasized rather than
aiming for significant weight loss in older mildly obese adults
✔✔Which patient at the cardiovascular clinic requires the most immediate
action by the nurse?
a. Patient with type 2 diabetes whose current blood glucose level is 145
mg/dL
