Med-Surg Success Book: Angina &
Myocardial Infarction Practice
Questions 2026
13. Which cardiac enzyme would the nurse expect to elevate first in a client diagnosed with a myocardial
infarction?
1. Creatine kinase (CK-MB).
2. Lactate dehydrogenase (LDH).
3. Troponin.
4. White blood cells (WBCs). - ANSWER ✔✨---3. Troponin is the enzyme that elevates within 1 to 2
hours.
1. CPK-MB elevates in 12 to 24 hours.
2. LDH elevates in 24 to 36 hours.
4. WBCs elevate as a result of necrotic tissue, but this is not a cardiac enzyme.
TEST-TAKING HINT: The test taker should be aware of the words "cardiac enzyme," which would
eliminate option "4" as a possible answerwer. The word in the stem is "first." This question requires the
test taker to have knowledge of laboratory values.
, 14. Along with persistent, crushing chest pain, which signs/symptoms would make the nurse suspect
that the client is experiencing a myocardial infarction?
1. Midepigastric pain and pyrosis.
2. Diaphoresis and cool clammy skin.
3. Intermittent claudication and pallor.
4. Jugular vein distention and dependent edema. - ANSWER ✔✨---2. Diaphoresis (sweating) is a
systemic reaction to the MI. The body vasoconstricts to shunt blood from the periphery to the trunk of
the body; this, in turn, leads to cold, clammy skin.
1. Midepigastric pain would support a diagnosis of peptic ulcer disease; pyrosis is belching.
3. Intermittent claudication is leg pain secondary to decreased oxygen to the muscle, and pallor is
paleness of the skin as a result of decreased blood supply. Neither is an early sign of MI.
4. Jugular vein distension (JVD) and dependent edema are signs/symptoms of congestive heart failure,
not of MI.
TEST-TAKING HINT: The stem already addresses chest pain; therefore, the test taker could eliminate
option "1" as a possible answerwer. Intermittent claudication, option "3," is the classic sign of arterial
occlusive disease, and JVD is very specific to congestive heart failure. The nurse must be able to identify
at least two or three signs/symptoms of disease processes.
15. The client diagnosed with rule-out myocardial infarction is experiencing chest pain while walking to
the bathroom. Which action should the nurse implement first?
1. Administer sublingual nitroglycerin.
2. Obtain a STAT electrocardiogram.
3. Have the client sit down immediately.
4. Assess the client's vital signs. - ANSWER ✔✨---3. Stopping all activity will decrease the need of
the myocardium for oxygen and may help decrease the chest pain.
1. The nurse must assume the chest pain is secondary to decreased oxygen to the myocardium and
administer a sublingual nitroglycerin tablet, which is a coronary vasodilator, but this is not the first
action.
Myocardial Infarction Practice
Questions 2026
13. Which cardiac enzyme would the nurse expect to elevate first in a client diagnosed with a myocardial
infarction?
1. Creatine kinase (CK-MB).
2. Lactate dehydrogenase (LDH).
3. Troponin.
4. White blood cells (WBCs). - ANSWER ✔✨---3. Troponin is the enzyme that elevates within 1 to 2
hours.
1. CPK-MB elevates in 12 to 24 hours.
2. LDH elevates in 24 to 36 hours.
4. WBCs elevate as a result of necrotic tissue, but this is not a cardiac enzyme.
TEST-TAKING HINT: The test taker should be aware of the words "cardiac enzyme," which would
eliminate option "4" as a possible answerwer. The word in the stem is "first." This question requires the
test taker to have knowledge of laboratory values.
, 14. Along with persistent, crushing chest pain, which signs/symptoms would make the nurse suspect
that the client is experiencing a myocardial infarction?
1. Midepigastric pain and pyrosis.
2. Diaphoresis and cool clammy skin.
3. Intermittent claudication and pallor.
4. Jugular vein distention and dependent edema. - ANSWER ✔✨---2. Diaphoresis (sweating) is a
systemic reaction to the MI. The body vasoconstricts to shunt blood from the periphery to the trunk of
the body; this, in turn, leads to cold, clammy skin.
1. Midepigastric pain would support a diagnosis of peptic ulcer disease; pyrosis is belching.
3. Intermittent claudication is leg pain secondary to decreased oxygen to the muscle, and pallor is
paleness of the skin as a result of decreased blood supply. Neither is an early sign of MI.
4. Jugular vein distension (JVD) and dependent edema are signs/symptoms of congestive heart failure,
not of MI.
TEST-TAKING HINT: The stem already addresses chest pain; therefore, the test taker could eliminate
option "1" as a possible answerwer. Intermittent claudication, option "3," is the classic sign of arterial
occlusive disease, and JVD is very specific to congestive heart failure. The nurse must be able to identify
at least two or three signs/symptoms of disease processes.
15. The client diagnosed with rule-out myocardial infarction is experiencing chest pain while walking to
the bathroom. Which action should the nurse implement first?
1. Administer sublingual nitroglycerin.
2. Obtain a STAT electrocardiogram.
3. Have the client sit down immediately.
4. Assess the client's vital signs. - ANSWER ✔✨---3. Stopping all activity will decrease the need of
the myocardium for oxygen and may help decrease the chest pain.
1. The nurse must assume the chest pain is secondary to decreased oxygen to the myocardium and
administer a sublingual nitroglycerin tablet, which is a coronary vasodilator, but this is not the first
action.
