ACS test bank Questions With Complete Solutions
A client is receiving an infusion of tissue plasminogen activator
(t-PA). The nurse assesses the client to be disoriented to person,
place, and time. What action by the nurse is best?
a. Assess the clients pupillary responses.
b. Request a neurologic consultation.
c. Stop the infusion and call the provider.
d. Take and document a full set of vital signs.
c. Stop the infusion and call the provider.
A client received tissue plasminogen activator (t-PA) after a
myocardial infarction and now is on an intravenous infusion of
heparin. The clients spouse asks why the client needs this
medication. What response by the nurse is best?
a. The t-PA didnt dissolve the entire coronary clot.
b. The heparin keeps that artery from getting blocked again.
c. Heparin keeps the blood as thin as possible for a longer time.
d. The heparin prevents a stroke from occurring as the t-PA
wears off.
b. The heparin keeps that artery from getting blocked again.
types of PCI
-coronary angioplasty/ ateriography
-coronary stent
A client is in the hospital after suffering a myocardial infarction
and has bathroom privileges. The nurse assists the client to the
bathroom and notes the clients O2 saturation to be 95%, pulse
88 beats/min, and respiratory rate 16 breaths/min after returning
to bed. What action by the nurse is best?
, a. Administer oxygen at 2 L/min.
b. Allow continued bathroom privileges.
c. Obtain a bedside commode.
d. Suggest the client use a bedpan
b. Allow continued bathroom privileges.
A nursing student is caring for a client who had a myocardial
infarction. The student is confused because the client states
nothing is wrong and yet listens attentively while the student
provides education on lifestyle changes and healthy menu
choices. What response by the faculty member is best?
a. Continue to educate the client on possible healthy changes.
b. Emphasize complications that can occur with noncompliance.
c. Tell the client that denial is normal and will soon go away.
d. You need to make sure the client understands this illness.
a. Continue to educate the client on possible healthy changes.
normal right atrial pressure
1-8
A change in neurologic status in a client receiving t-PA could
indicate
intracranial hemorrhage
A client undergoing hemodynamic monitoring after a
myocardial infarction has a right atrial pressure of 0.5 mm Hg.
What action by the nurse is most appropriate?
a. Level the transducer at the phlebostatic axis.
b. Lay the client in the supine position.
c. Prepare to administer diuretics.
d. Prepare to administer a fluid bolus.
d. Prepare to administer a fluid bolus.
A client has hemodynamic monitoring after a myocardial
infarction. What safety precaution does the nurse implement for
this client?
A client is receiving an infusion of tissue plasminogen activator
(t-PA). The nurse assesses the client to be disoriented to person,
place, and time. What action by the nurse is best?
a. Assess the clients pupillary responses.
b. Request a neurologic consultation.
c. Stop the infusion and call the provider.
d. Take and document a full set of vital signs.
c. Stop the infusion and call the provider.
A client received tissue plasminogen activator (t-PA) after a
myocardial infarction and now is on an intravenous infusion of
heparin. The clients spouse asks why the client needs this
medication. What response by the nurse is best?
a. The t-PA didnt dissolve the entire coronary clot.
b. The heparin keeps that artery from getting blocked again.
c. Heparin keeps the blood as thin as possible for a longer time.
d. The heparin prevents a stroke from occurring as the t-PA
wears off.
b. The heparin keeps that artery from getting blocked again.
types of PCI
-coronary angioplasty/ ateriography
-coronary stent
A client is in the hospital after suffering a myocardial infarction
and has bathroom privileges. The nurse assists the client to the
bathroom and notes the clients O2 saturation to be 95%, pulse
88 beats/min, and respiratory rate 16 breaths/min after returning
to bed. What action by the nurse is best?
, a. Administer oxygen at 2 L/min.
b. Allow continued bathroom privileges.
c. Obtain a bedside commode.
d. Suggest the client use a bedpan
b. Allow continued bathroom privileges.
A nursing student is caring for a client who had a myocardial
infarction. The student is confused because the client states
nothing is wrong and yet listens attentively while the student
provides education on lifestyle changes and healthy menu
choices. What response by the faculty member is best?
a. Continue to educate the client on possible healthy changes.
b. Emphasize complications that can occur with noncompliance.
c. Tell the client that denial is normal and will soon go away.
d. You need to make sure the client understands this illness.
a. Continue to educate the client on possible healthy changes.
normal right atrial pressure
1-8
A change in neurologic status in a client receiving t-PA could
indicate
intracranial hemorrhage
A client undergoing hemodynamic monitoring after a
myocardial infarction has a right atrial pressure of 0.5 mm Hg.
What action by the nurse is most appropriate?
a. Level the transducer at the phlebostatic axis.
b. Lay the client in the supine position.
c. Prepare to administer diuretics.
d. Prepare to administer a fluid bolus.
d. Prepare to administer a fluid bolus.
A client has hemodynamic monitoring after a myocardial
infarction. What safety precaution does the nurse implement for
this client?
