Acute Coronary Syndrome Midterm Exam Questions 100% Well Answered.
During the 48 hours after a myocardial infarction (MI), a nurse should assign the highest priority to monitoring the patient for what complication?
Dysrhythmias Anxiety and fear Metabolic acidosis Medication side effects - Answer Dysrhythmias
The nurse must be most alert for dysrhythmias, which may signal another MI or impending complications. The nurse should also be alert for increased anxiety, which may cause pain and lead to a secondary infarction. Anxiety and fear are highly likely but secondary in importance to monitoring the patient for dysrhythmias. Metabolic acidosis and reactions to new medications are not likely but should still be included as part of overall assessment of the patient.
The nurse monitors a patient for complications of myocardial infarction. The nurse auscultates a new murmur at the cardiac apex. Which treatment strategies are appropriate for inclusion in the patient's care plan? Select all that apply.
Antiplatelets Short-term corticosteroids Cardiac surgery with mitral valve repair Intraaortic balloon pump (IABP) therapy Nonsteroidal antiinflammatory agents (NSAIDs) - Answer Cardiac surgery with mitral valve repair
Intraaortic balloon pump (IABP) therapy
Papillary muscle dysfunction is a complication of myocardial infarction and should be suspected if a new murmur at the cardiac apex is detected. It may occur if the infarcted area includes or is near the papillary
muscle that attaches the mitral valve. The patient should be treated with nitroprusside, intraaortic balloon pump (IABP) therapy, or cardiac surgery with mitral valve repair to reduce the afterload of the heart. Antiplatelets, such as aspirin and nonsteroidal antiinflammatory agents, help treat acute pericarditis. Short-acting corticosteroids are effective in the treatment of Dressler syndrome.
The nurse assesses a patient who has been administered the tissue-type plasminogen activator alteplase
for an acute myocardial infarction. Which assessment finding is the highest priority and should be reported to the primary health care provider immediately?
Anorexia Hematuria Oral temperature of 100.4° F (38° C) Occasional premature ventricular contractions - Answer Hematuria
Alteplase is a proteolytic enzyme that digests threads and other substances in the blood, including clotting factors, thereby causing hypercoagulability of the blood and possibly bleeding, which is evidenced by blood in the urine. Anorexia and increased temperature are not issues directly related to this drug. Alteplase may cause premature ventricular contractions, which should be monitored, but this is usually not a problem because the drug has a short half-life. Text Reference - p. 752 A patient is scheduled for a coronary artery bypass graft (CABG) surgery. The nurse reviews the surgical plan and notes that the type of graft that will be used is prone to future stenosis and graft occlusion. Therefore the nurse anticipates postoperative use of antiplatelet and statin therapy to improve graft patency. Which type of graft will be used for the surgery?
Radial artery graft Saphenous vein graft Gastroepiploic artery graft Internal mammary artery graft - Answer Saphenous vein graft
Coronary artery bypass graft surgery (CABG) involves the replacement of conduits that transport blood between the aorta and the coronary artery. A patient with a saphenous vein graft may develop intimal hyperplasia, which contributes to stenosis and graft occlusions. This patient should receive antiplatelet therapy and statins after surgery to improve vein graft patency. A patient with radial artery CABG should receive calcium channel blockers and long-acting nitrates to control coronary spasms. A patient with gastroepiploic artery CABG generally has a high graft patency rate; the chances of graft-related problems are very rare. A patient with CABG of the internal mammary artery has an average graft patency of more than 90 percent, even after 10 years. A patient with high graft patency rates may not require any medication to maintain the patency of the graft.
A patient reports heaviness and burning sensation in the substernal and retrosternal region. Assessment findings include a fasting blood glucose of 190 mg/dL and blood pressure of 145/90 mm Hg. The nurse recognizes that which other finding indicates sympathetic nervous system stimulation?
Jugular venous distention Abnormal S 3 and S 4 sounds Ashen, clammy, and cool skin
During the 48 hours after a myocardial infarction (MI), a nurse should assign the highest priority to monitoring the patient for what complication?
Dysrhythmias Anxiety and fear Metabolic acidosis Medication side effects - Answer Dysrhythmias
The nurse must be most alert for dysrhythmias, which may signal another MI or impending complications. The nurse should also be alert for increased anxiety, which may cause pain and lead to a secondary infarction. Anxiety and fear are highly likely but secondary in importance to monitoring the patient for dysrhythmias. Metabolic acidosis and reactions to new medications are not likely but should still be included as part of overall assessment of the patient.
The nurse monitors a patient for complications of myocardial infarction. The nurse auscultates a new murmur at the cardiac apex. Which treatment strategies are appropriate for inclusion in the patient's care plan? Select all that apply.
Antiplatelets Short-term corticosteroids Cardiac surgery with mitral valve repair Intraaortic balloon pump (IABP) therapy Nonsteroidal antiinflammatory agents (NSAIDs) - Answer Cardiac surgery with mitral valve repair
Intraaortic balloon pump (IABP) therapy
Papillary muscle dysfunction is a complication of myocardial infarction and should be suspected if a new murmur at the cardiac apex is detected. It may occur if the infarcted area includes or is near the papillary
muscle that attaches the mitral valve. The patient should be treated with nitroprusside, intraaortic balloon pump (IABP) therapy, or cardiac surgery with mitral valve repair to reduce the afterload of the heart. Antiplatelets, such as aspirin and nonsteroidal antiinflammatory agents, help treat acute pericarditis. Short-acting corticosteroids are effective in the treatment of Dressler syndrome.
The nurse assesses a patient who has been administered the tissue-type plasminogen activator alteplase
for an acute myocardial infarction. Which assessment finding is the highest priority and should be reported to the primary health care provider immediately?
Anorexia Hematuria Oral temperature of 100.4° F (38° C) Occasional premature ventricular contractions - Answer Hematuria
Alteplase is a proteolytic enzyme that digests threads and other substances in the blood, including clotting factors, thereby causing hypercoagulability of the blood and possibly bleeding, which is evidenced by blood in the urine. Anorexia and increased temperature are not issues directly related to this drug. Alteplase may cause premature ventricular contractions, which should be monitored, but this is usually not a problem because the drug has a short half-life. Text Reference - p. 752 A patient is scheduled for a coronary artery bypass graft (CABG) surgery. The nurse reviews the surgical plan and notes that the type of graft that will be used is prone to future stenosis and graft occlusion. Therefore the nurse anticipates postoperative use of antiplatelet and statin therapy to improve graft patency. Which type of graft will be used for the surgery?
Radial artery graft Saphenous vein graft Gastroepiploic artery graft Internal mammary artery graft - Answer Saphenous vein graft
Coronary artery bypass graft surgery (CABG) involves the replacement of conduits that transport blood between the aorta and the coronary artery. A patient with a saphenous vein graft may develop intimal hyperplasia, which contributes to stenosis and graft occlusions. This patient should receive antiplatelet therapy and statins after surgery to improve vein graft patency. A patient with radial artery CABG should receive calcium channel blockers and long-acting nitrates to control coronary spasms. A patient with gastroepiploic artery CABG generally has a high graft patency rate; the chances of graft-related problems are very rare. A patient with CABG of the internal mammary artery has an average graft patency of more than 90 percent, even after 10 years. A patient with high graft patency rates may not require any medication to maintain the patency of the graft.
A patient reports heaviness and burning sensation in the substernal and retrosternal region. Assessment findings include a fasting blood glucose of 190 mg/dL and blood pressure of 145/90 mm Hg. The nurse recognizes that which other finding indicates sympathetic nervous system stimulation?
Jugular venous distention Abnormal S 3 and S 4 sounds Ashen, clammy, and cool skin
