AH3 FINAL EXAM QUESTIONS AND ANSWERS
When is patient education done? - Answers :it is ongoing and frequently reinforced
What is palliative care? - Answers :comfort care, quality of life before death important,
continue pain meds, anti-pyretic meds, sedative, but d/c insulin and antibiotics
What is an advanced directive? - Answers :medical POA can override this but is a
document that explains the patients wishes, before the patient is in a medical state
where they can no longer make decisions
Where does the electrical conduction begin in the heart? - Answers :the SA node in the
right atrium with intrinsic factor of 60-100
What is the path of the electrical conduction of the heart? - Answers :The electrical
signal starts in the SA node and travels to the AV node to the bundle branches that lead
to the Purkinje fibers of the ventricles
What is the intrinsic factor of the AV node? - Answers :40-60bpm
What is the intrinsic factor of the ventricles? - Answers :20-40 bpm
What are s/sx of a myocardial infarction in men? - Answers :crushing chest pain,
radiates to arm
What are s/sx of myocardial infarction in women? - Answers :radiated pain to back, jaw,
neck; fatigue, nausea, anxiety, SOB, indigestion, diaphoresis, and dizziness
What are 3 common causes of a myocardial infarction? - Answers :plaque rupture,
thrombus, and coronary spasm
What does MONA stand for? - Answers :M: morphine
O: oxygen
N: nitro
A: aspirin
Why is morphine given for a MI? - Answers :helps with pain, relaxation, and causes
vasodilation
Why is oxygen given for a MI? - Answers :saturates the blood that is getting perused
Why is nitro given for an MI? - Answers :causes vasodilation (watch for a drop in BP)
,Why is aspirin given for an MI? - Answers :anti-platelet to prevent clotting (have the pt
chew it)
What is the difference between ischemia, injury, and infarction? - Answers :ischemia:
tissue is viable with a inverted T wave
injury: tissue might be viable with a inverted T wave and ST elevation
infarction: tissue is no longer viable with an inverted T wave, ST elevation, and
depressed Q wave
What is causes a NSTEMI? - Answers :a partial occlusion; no ST elevation and the Q
wave is not affected
What treatment is not done for a NSTEMI? - Answers :fibrinolytic because it can cause
the plaque to rupture
What is the treatment for a NSTEMI? - Answers :PCI balloon angioplasty or stent
placement
What are symptoms of left HF? - Answers :pulmonary congestion, crackles, pink frothy
sputum, SOB
What are symptoms of right HF? - Answers :ascites, JVD, dependent edema,
hepatosplenomegaly
What lab indicates heart failure? - Answers :BNP 100-400
When does a PCI have to be done by? - Answers :90 minutes after onset of chest pain
to get to lab
When should fibrinolytics be given by with a MI? - Answers :30 minutes and if being
transferred 120 minutes
What does a IABP do? - Answers :increases blood flow of oxygenated blood and
decreases afterload
What is a PTCA? - Answers :percutaneous transluminal coronary angioplasty; ballon
catheter inserted into coronary artery that is inflated intermittently
What is PTCA do? - Answers :dual anti-platelet therapy to prevent restenosis
What is an acute complication of coronary stents? - Answers :bleeding
What are late complications of coronary stents? - Answers :restenosis, late thrombosis
for dual anti-platelet therapy
, What does a VAD used for? - Answers :used for people in end stage HF and redirects
blood to decrease the work of the heart; pt is not going to have pulse or blood pressure
and will need to be on anticoagulants
Who are thrombolytics given to? - Answers :pts with recent onset of chest pain and
persistent ST elevation or bundle branch block
When do thrombolytics have to be given by? - Answers :within 12 hours of the onset of
chest pain
What type of chest pain are thrombolytics given for? stable or unstable? - Answers
:unstable
What will happen to cardiac biomarkers like troponin, CK, and CKMB if thrombolytics
are therapeutic? - Answers :rise quickly and then fall
What are signs that thrombolytics have been affective other than lab values? - Answers
:chest pain is relieved and the ST elevation returns to normal
What are some nursing considerations for thrombolytics? - Answers :the pt cannot have
any other conditions that increase the risk of bleeding and they should be given 30
minutes within the first medical contact
What is stable angina? - Answers :predictable chest pain that subsides with the use of
nitro or rest and can be exercise induced
What is unstable angina? - Answers :unpredictable chest pain that can come at any
time in the day and and does not subside with the use of nitro or rest
What is variant angina? - Answers :spasm of coronary arteries at the same time every
day
What is silent ischemia? - Answers :the heart muscle died but there were no visible
symptoms
Who is at a greater risk of silent ischemia? - Answers :diabetics and previous heart
surgery patients
How do you know silent ischemia occured? - Answers :see evidence in EKG
What is the treatment for angina? - Answers :nitro
How should nitro be taken? - Answers :the first tablet should be taken at the first onset
of chest pain, if unrelieved called 911 and take another tablet after 5 minutes and the pt
can take up to 3 doses
When is patient education done? - Answers :it is ongoing and frequently reinforced
What is palliative care? - Answers :comfort care, quality of life before death important,
continue pain meds, anti-pyretic meds, sedative, but d/c insulin and antibiotics
What is an advanced directive? - Answers :medical POA can override this but is a
document that explains the patients wishes, before the patient is in a medical state
where they can no longer make decisions
Where does the electrical conduction begin in the heart? - Answers :the SA node in the
right atrium with intrinsic factor of 60-100
What is the path of the electrical conduction of the heart? - Answers :The electrical
signal starts in the SA node and travels to the AV node to the bundle branches that lead
to the Purkinje fibers of the ventricles
What is the intrinsic factor of the AV node? - Answers :40-60bpm
What is the intrinsic factor of the ventricles? - Answers :20-40 bpm
What are s/sx of a myocardial infarction in men? - Answers :crushing chest pain,
radiates to arm
What are s/sx of myocardial infarction in women? - Answers :radiated pain to back, jaw,
neck; fatigue, nausea, anxiety, SOB, indigestion, diaphoresis, and dizziness
What are 3 common causes of a myocardial infarction? - Answers :plaque rupture,
thrombus, and coronary spasm
What does MONA stand for? - Answers :M: morphine
O: oxygen
N: nitro
A: aspirin
Why is morphine given for a MI? - Answers :helps with pain, relaxation, and causes
vasodilation
Why is oxygen given for a MI? - Answers :saturates the blood that is getting perused
Why is nitro given for an MI? - Answers :causes vasodilation (watch for a drop in BP)
,Why is aspirin given for an MI? - Answers :anti-platelet to prevent clotting (have the pt
chew it)
What is the difference between ischemia, injury, and infarction? - Answers :ischemia:
tissue is viable with a inverted T wave
injury: tissue might be viable with a inverted T wave and ST elevation
infarction: tissue is no longer viable with an inverted T wave, ST elevation, and
depressed Q wave
What is causes a NSTEMI? - Answers :a partial occlusion; no ST elevation and the Q
wave is not affected
What treatment is not done for a NSTEMI? - Answers :fibrinolytic because it can cause
the plaque to rupture
What is the treatment for a NSTEMI? - Answers :PCI balloon angioplasty or stent
placement
What are symptoms of left HF? - Answers :pulmonary congestion, crackles, pink frothy
sputum, SOB
What are symptoms of right HF? - Answers :ascites, JVD, dependent edema,
hepatosplenomegaly
What lab indicates heart failure? - Answers :BNP 100-400
When does a PCI have to be done by? - Answers :90 minutes after onset of chest pain
to get to lab
When should fibrinolytics be given by with a MI? - Answers :30 minutes and if being
transferred 120 minutes
What does a IABP do? - Answers :increases blood flow of oxygenated blood and
decreases afterload
What is a PTCA? - Answers :percutaneous transluminal coronary angioplasty; ballon
catheter inserted into coronary artery that is inflated intermittently
What is PTCA do? - Answers :dual anti-platelet therapy to prevent restenosis
What is an acute complication of coronary stents? - Answers :bleeding
What are late complications of coronary stents? - Answers :restenosis, late thrombosis
for dual anti-platelet therapy
, What does a VAD used for? - Answers :used for people in end stage HF and redirects
blood to decrease the work of the heart; pt is not going to have pulse or blood pressure
and will need to be on anticoagulants
Who are thrombolytics given to? - Answers :pts with recent onset of chest pain and
persistent ST elevation or bundle branch block
When do thrombolytics have to be given by? - Answers :within 12 hours of the onset of
chest pain
What type of chest pain are thrombolytics given for? stable or unstable? - Answers
:unstable
What will happen to cardiac biomarkers like troponin, CK, and CKMB if thrombolytics
are therapeutic? - Answers :rise quickly and then fall
What are signs that thrombolytics have been affective other than lab values? - Answers
:chest pain is relieved and the ST elevation returns to normal
What are some nursing considerations for thrombolytics? - Answers :the pt cannot have
any other conditions that increase the risk of bleeding and they should be given 30
minutes within the first medical contact
What is stable angina? - Answers :predictable chest pain that subsides with the use of
nitro or rest and can be exercise induced
What is unstable angina? - Answers :unpredictable chest pain that can come at any
time in the day and and does not subside with the use of nitro or rest
What is variant angina? - Answers :spasm of coronary arteries at the same time every
day
What is silent ischemia? - Answers :the heart muscle died but there were no visible
symptoms
Who is at a greater risk of silent ischemia? - Answers :diabetics and previous heart
surgery patients
How do you know silent ischemia occured? - Answers :see evidence in EKG
What is the treatment for angina? - Answers :nitro
How should nitro be taken? - Answers :the first tablet should be taken at the first onset
of chest pain, if unrelieved called 911 and take another tablet after 5 minutes and the pt
can take up to 3 doses
