SOLVED

 Question 11 A patient with diabetes is surprised to learn that he has been having angina when the only problem he has been experiencing is a “bit of fatigue and shortness of breath.” How should the nurse explain to this patient? 1. Shortness of breath is the first symptom of angina. 2. There is no classic symptom of angina. 3. Slight fatigue is usually the first symptom of angina. 4. Persons with diabetes may experience pain differently. Question 12 A female patient presents to the emergency department with complaint of chest pain. Which findings would raise the nurse’s suspicion that the chest pain is of cardiac origin? 1. The patient has 2+ edema in her ankles. 2. The patient has bilateral xanthomas. 3. The chest pain is described as a “burning” in the center of the chest that is worse when supine. 4. The patient has an S3 heart sound. 5. The patient has a dull humming sound just below the xiphoid process. Question 13 Which assessment finding would indicate to the nurse that the patient has an altered blood supply to the right coronary artery affecting the posterior wall of the myocardium? 1. cTnT of 0.0 mcg/L 2. CK-MB of 4% 3. ST segment depression in V1 and V2 4. Peaked T waves in aVF Question 14 A patient is admitted with chest pain of approximately 2 hours in duration. The CK level was 8 U/L. Which additional order should the nurse expect in order for assessment of this patient to be adequate? 1. Repeat CK level in 48 hours 2. CTnT level 3. CK-MB in the a.m. 4. LDL and HDL levels Question 15 A patient, admitted with chest pain, has a baseline cTnT level of 1.1 mcg/L. Which explanation would the nurse provide the patient for redrawing this level in 6 hours? 1. “Trends in this value will help us determine your diagnosis.” 2. “If this level goes down we know your pain medication is working.” 3. “Hopefully we will see this level rise as an indicator that your oxygen therapy has been effective.” 4. “If this level does not increase, we will need to increase the rate of your intravenous fluid replacement.” Question 16 A patient has presented for a scheduled exercise stress test. Which patient comments should the nurse communicate immediately to the health care provider performing the test? 1. “I did tell you that I am allergic to iodine didn’t I?” 2. “I’m pretty hungry since I didn’t eat breakfast.” 3. “I had a cup of tea this morning instead of coffee.” 4. “I took my propranolol early this morning when I first woke up.” 5. “I am determined to quit smoking. I haven’t had a cigarette for 2 days.” Question 17 At the conclusion of a stress echocardiogram it was determined that the patient has dyskinesis. The nurse would reinforce which explanation of this finding? 1. The patient’s heart moves too slowly. 2. The patient’s heart wall moves very quickly to impulses. 3. The patient’s heart wall moves opposite from normal. 4. A portion of the patient’s heart does not move at all. Question 18 A patient’s is admitted with complaint of chest pain. The electrocardiogram reveals ST segment elevation. What is the nurse’s priority intervention? 1. Give the patient 162 mg of aspirin. 2. Draw blood for serum cardiac markers. 3. Place the patient on a cardiac monitor. 4. Call for a portable chest x-ray. Question 19 During the first 24 hours after a patient has received thrombolytic therapy. What is a priority nursing intervention? 1. Monitor level of consciousness. 2. Administer pain medications. 3. Monitor for decreased output. 4. Monitor for pulmonary emboli. Question 20 A patient with acute coronary syndrome has received thrombolytic therapy. The nurse would monitor and report which findings that indicate this therapy was successful? 1. Respiratory rate of 18 per minute 2. Resolution of ST segment elevation 3. Resolution of chest pain 4. Occurrence of premature ventricular complexes 5. Occurrence of a headache