NUFT 341 COMPREHENSIVE EXAM ACTUAL QUESTIONS
AND SOLUTIONS GRADED A+
✔✔After having a myocardial infarction (MI) and successful percutaneous
coronary intervention, the patient states, "It was just a little chest pain. As
soon as I get out of here, I'm going for my vacation as planned." Which reply
would be most appropriate for the nurse to make?
a. "What do you think caused your chest pain?"
b. "Where are you planning to go for your vacation?"
c. "Sometimes plans need to change after a heart attack."
d. "Recovery from a heart attack takes at least a few weeks." - ✔✔A. "What do you think
caused your chest pain?"
When the patient is experiencing denial, the nurse should assist the patient in testing
reality until the patient has progressed beyond this step of the emotional adjustment to
MI. Asking the patient about vacation plans reinforces the patient's plan, which is not
appropriate in the immediate post-
MI period. Reminding the patient in denial about the MI is likely to make the patient
angry and lead to distrust of the nursing staff.
✔✔The nurse is evaluating the effectiveness of preoperative teaching with a
patient scheduled for coronary artery bypass graft (CABG) surgery using the
internal mammary artery. Which patient statement indicates that additional
teaching is needed?
a. "They will circulate my blood with a machine during surgery."
b. "I will have incisions in my leg where they will remove the vein."
c. "Theywill use an artery near my heart to go around the area that is
blocked."
d. "I will need to take aspirin every day after the surgery to keep the graft
open." - ✔✔B. "I will have incisions in my leg where they will remove the vein."
When the internal mammary artery is used, there is no need to have a saphenous vein
removed from the leg. The other statements by the patient are accurate and indicate
that the teaching has been effective.
✔✔A patient who is recovering from an acute myocardial infarction (AMI)
asks the nurse about safely resuming sexual intercourse. Which response by
the nurse provides the most useful information for the patient?
a. "Most patients are able to enjoy intercourse without any complications."
b. "Sexual activity uses about as much energy as climbing two flights of
stairs."
c. "The doctor will provide sexual guidelines when your heart is strong
enough."
d. "Holding and cuddling are good ways to maintain intimacy after a heart
,attack." - ✔✔B. "Sexual activity uses about as much energy as climbing two flights of
stairs."
Sexual activity places about as much physical stress on the cardiovascular system as
moderate-energy activities, such as climbing two flights of stairs. The other responses
are general statements that may be accurate, but do not provide useful guidelines for
judging the physical safety of the activity.
✔✔A patient with hyperlipidemia has a new order for colesevelam (Welchol).
Which action would the nurse take?
a. Administer the medication at the patient's usual bedtime.
b. Have the patient take the colesevelam 1 hour before breakfast.
c. Give the patient's other medications 3 hours after colesevelam.
d. Have the patient take the dose at the same time as the prescribed aspirin. - ✔✔C.
Give the patient's other medications 3 hours after colesevelam.
The bile acid sequestrants interfere with the absorption of many other drugs and giving
other medications at the same time should be avoided. Taking an aspirin concurrently
with the colesevelam may increase the incidence of
gastrointestinal side effects such as heartburn. For maximum effect, colesevelam
should be administered with meals.
✔✔The nurse is caring for a patient who was admitted to the coronary care
unit following an acute myocardial infarction (AMI) and percutaneous
coronary intervention the previous day. Which information would the nurse
plan to provide today?
a. Typical emotional responses to AMI
b. When cardiac rehabilitation will begin
c. Pathophysiology of coronary arterydisease
d. Information regarding discharge medications - ✔✔B. When cardiac rehabilitation will
begin
Early after an AMI, the patient will want to know when resumption of usual activities can
be expected. At this time, the patient's anxiety level or denial will interfere with good
understanding of complex information such as the
pathophysiology of coronary artery disease. Teaching about discharge medications
should be done closer to discharge. The nurse should support the patient by decreasing
anxiety with information rather than discussing the typical emotional responses to
myocardial infarction.
✔✔A patient who has recently started taking pravastatin (Pravachol) and
niacin reports several new symptoms to the nurse. Which information is most
important to communicate to the health care provider?
a. Generalized muscle aches and pains
b. Dizziness with rapid position changes
c. Nausea when taking the drugs before meals
, d. Flushing and pruritus after taking the drugs - ✔✔A. Generalized muscle aches and
pains
Muscle aches and pains may indicate myopathy and rhabdomyolysis, which have
caused acute kidney injury and death in some patients who have taken the statin
medications. These symptoms indicate that the pravastatin may need to be
discontinued. The other symptoms are common side effects when taking niacin, and
although the nurse should follow-up with the health care provider, they do not indicate
that a change in medication is needed.
✔✔A patient who is being admitted to the emergency department with
intermittent chest pain gives the following list of daily medications to the
nurse. Which medication has the most immediate implications for the
patient's care?
a. Sildenafil (Viagra)
b. Furosemide (Lasix)
c. Warfarin (Coumadin)
d. Diltiazem (Cardizem) - ✔✔A. Sildenafil (Viagra)
The nurse will need to avoid giving nitrates to the patient because nitrate administration
is contraindicated in patients who are using sildenafil because of the risk of severe
hypotension caused by vasodilation. The other home
medications should be documented and reported to the health care provider but do not
have as immediate an impact on decisions about the patient's treatment.
✔✔Which assessment finding in a patient who has had coronary artery
bypass grafting using a right radial artery graft is most important for the
nurse to communicate to the health care provider?
a. Complaints of incisional chest pain
b. Pallor and weakness of the right hand
c. Fine crackles heard at both lung bases
d. Redness on both sides of the sternal incision - ✔✔B. Pallor and weakness of the right
hand
The changes in the right hand indicate compromised blood flow, which requires
immediate evaluation and actions, such as prescribed calcium channel blockers or
surgery. The other changes are expected or require nursing interventions
✔✔The nurse is caring for a patient who has just arrived on the telemetry
unit after having cardiac catheterization. Which task could the nurse
delegate to a licensed practical/vocational nurse (LPN/VN)?
a. Teach the patient about the postprocedure plan of care.
b. Give the scheduled aspirin and lipid-lowering medication.
c. Perform the initial assessment of the catheter insertion site.
AND SOLUTIONS GRADED A+
✔✔After having a myocardial infarction (MI) and successful percutaneous
coronary intervention, the patient states, "It was just a little chest pain. As
soon as I get out of here, I'm going for my vacation as planned." Which reply
would be most appropriate for the nurse to make?
a. "What do you think caused your chest pain?"
b. "Where are you planning to go for your vacation?"
c. "Sometimes plans need to change after a heart attack."
d. "Recovery from a heart attack takes at least a few weeks." - ✔✔A. "What do you think
caused your chest pain?"
When the patient is experiencing denial, the nurse should assist the patient in testing
reality until the patient has progressed beyond this step of the emotional adjustment to
MI. Asking the patient about vacation plans reinforces the patient's plan, which is not
appropriate in the immediate post-
MI period. Reminding the patient in denial about the MI is likely to make the patient
angry and lead to distrust of the nursing staff.
✔✔The nurse is evaluating the effectiveness of preoperative teaching with a
patient scheduled for coronary artery bypass graft (CABG) surgery using the
internal mammary artery. Which patient statement indicates that additional
teaching is needed?
a. "They will circulate my blood with a machine during surgery."
b. "I will have incisions in my leg where they will remove the vein."
c. "Theywill use an artery near my heart to go around the area that is
blocked."
d. "I will need to take aspirin every day after the surgery to keep the graft
open." - ✔✔B. "I will have incisions in my leg where they will remove the vein."
When the internal mammary artery is used, there is no need to have a saphenous vein
removed from the leg. The other statements by the patient are accurate and indicate
that the teaching has been effective.
✔✔A patient who is recovering from an acute myocardial infarction (AMI)
asks the nurse about safely resuming sexual intercourse. Which response by
the nurse provides the most useful information for the patient?
a. "Most patients are able to enjoy intercourse without any complications."
b. "Sexual activity uses about as much energy as climbing two flights of
stairs."
c. "The doctor will provide sexual guidelines when your heart is strong
enough."
d. "Holding and cuddling are good ways to maintain intimacy after a heart
,attack." - ✔✔B. "Sexual activity uses about as much energy as climbing two flights of
stairs."
Sexual activity places about as much physical stress on the cardiovascular system as
moderate-energy activities, such as climbing two flights of stairs. The other responses
are general statements that may be accurate, but do not provide useful guidelines for
judging the physical safety of the activity.
✔✔A patient with hyperlipidemia has a new order for colesevelam (Welchol).
Which action would the nurse take?
a. Administer the medication at the patient's usual bedtime.
b. Have the patient take the colesevelam 1 hour before breakfast.
c. Give the patient's other medications 3 hours after colesevelam.
d. Have the patient take the dose at the same time as the prescribed aspirin. - ✔✔C.
Give the patient's other medications 3 hours after colesevelam.
The bile acid sequestrants interfere with the absorption of many other drugs and giving
other medications at the same time should be avoided. Taking an aspirin concurrently
with the colesevelam may increase the incidence of
gastrointestinal side effects such as heartburn. For maximum effect, colesevelam
should be administered with meals.
✔✔The nurse is caring for a patient who was admitted to the coronary care
unit following an acute myocardial infarction (AMI) and percutaneous
coronary intervention the previous day. Which information would the nurse
plan to provide today?
a. Typical emotional responses to AMI
b. When cardiac rehabilitation will begin
c. Pathophysiology of coronary arterydisease
d. Information regarding discharge medications - ✔✔B. When cardiac rehabilitation will
begin
Early after an AMI, the patient will want to know when resumption of usual activities can
be expected. At this time, the patient's anxiety level or denial will interfere with good
understanding of complex information such as the
pathophysiology of coronary artery disease. Teaching about discharge medications
should be done closer to discharge. The nurse should support the patient by decreasing
anxiety with information rather than discussing the typical emotional responses to
myocardial infarction.
✔✔A patient who has recently started taking pravastatin (Pravachol) and
niacin reports several new symptoms to the nurse. Which information is most
important to communicate to the health care provider?
a. Generalized muscle aches and pains
b. Dizziness with rapid position changes
c. Nausea when taking the drugs before meals
, d. Flushing and pruritus after taking the drugs - ✔✔A. Generalized muscle aches and
pains
Muscle aches and pains may indicate myopathy and rhabdomyolysis, which have
caused acute kidney injury and death in some patients who have taken the statin
medications. These symptoms indicate that the pravastatin may need to be
discontinued. The other symptoms are common side effects when taking niacin, and
although the nurse should follow-up with the health care provider, they do not indicate
that a change in medication is needed.
✔✔A patient who is being admitted to the emergency department with
intermittent chest pain gives the following list of daily medications to the
nurse. Which medication has the most immediate implications for the
patient's care?
a. Sildenafil (Viagra)
b. Furosemide (Lasix)
c. Warfarin (Coumadin)
d. Diltiazem (Cardizem) - ✔✔A. Sildenafil (Viagra)
The nurse will need to avoid giving nitrates to the patient because nitrate administration
is contraindicated in patients who are using sildenafil because of the risk of severe
hypotension caused by vasodilation. The other home
medications should be documented and reported to the health care provider but do not
have as immediate an impact on decisions about the patient's treatment.
✔✔Which assessment finding in a patient who has had coronary artery
bypass grafting using a right radial artery graft is most important for the
nurse to communicate to the health care provider?
a. Complaints of incisional chest pain
b. Pallor and weakness of the right hand
c. Fine crackles heard at both lung bases
d. Redness on both sides of the sternal incision - ✔✔B. Pallor and weakness of the right
hand
The changes in the right hand indicate compromised blood flow, which requires
immediate evaluation and actions, such as prescribed calcium channel blockers or
surgery. The other changes are expected or require nursing interventions
✔✔The nurse is caring for a patient who has just arrived on the telemetry
unit after having cardiac catheterization. Which task could the nurse
delegate to a licensed practical/vocational nurse (LPN/VN)?
a. Teach the patient about the postprocedure plan of care.
b. Give the scheduled aspirin and lipid-lowering medication.
c. Perform the initial assessment of the catheter insertion site.
