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Week 9 CON 246
Week 9 Sherpath Acute Coronary Syndrome
| Question | Answer |
|---|---|
| Which statement best describes acute coronary syndrome (ACS)? | ACS is the progression of untreated ischemia. |
| How does acute coronary syndrome cause injury to the heart? | Platelets adhere to the plaque, occluding blood flow to the myocardium. |
| What is a primary difference in the clinical manifestations of acute coronary syndrome between men and women? | Fewer women than men manifest the “classic” signs and symptoms of unstable angina or myocardial infarction. |
| The nurse is caring for a patient who returns to the unit after percutaneous coronary intervention (PCI). Which intervention is a priority on the patient’s arrival on the unit? | Monitor the ECG for heart rate and rhythm. |
| The emergency department receives a report from a paramedic who is transporting a patient with chest pain that is unrelieved by three sublingual nitroglycerin tablets. Which priority collaborative care intervention should be implemented on the patient’s a | Administration of morphine intravenously |
| The surgeon has explained the coronary artery bypass graft (CABG) procedure to a patient. Afterward the patient asks the nurse why he “just can’t get more stents.” How can the nurse explain the difference between these procedures? | Long-term benefits are expected to be better with CABG. |
| On entering a patient’s room, the nurse sees the patient clutch his chest, and he states he is in pain. Which nursing interventions are priorities? | Have the patient rate the pain on a number scale- Determine when the pain started- Ask the patient to describe his pain - Question the patient about the location of the pain. |
| The nurse is caring for a patient who arrives in the emergency department with complaints of chest pain. Which nursing intervention is a priority for this patient? | Elevate the head of bed |
| A patient diagnosed with myocardial infarction is transferred to the intensive care unit (ICU) for observation after percutaneous coronary intervention (PCI) with stent placement in the right circumflex artery. The nurse will assess for effectiveness of t | Resolution of ST-elevation changes on a 12-lead ECG - Opening of the affected coronary artery allows perfusion manifested by resolution of ST elevation on a 12-lead ECG. |
| The nurse is caring for a patient recently returning from cardiac catheterization after a severe myocardial infarction (MI). In discussing the plan of care with the patient, which statement is most appropriate to describe care for the immediate post proce | I can assist you onto the bedpan if you need help.” |
| A patient has just been diagnosed with a myocardial infarction. The patient has begun to cry and is verbalizing doubts about being able to care for her family. How would the nurse approach the patient to address these concerns? | “Can you tell me what your concerns are? I have time.” - Asking the patient to be specific about concerns gives the nurse the opportunity to assist. |
| Which statement describes how unstable angina differs from chronic stable angina? | Unstable angina has a random onset. |
| Unstable angina is considered an emergency because of which pathophysiological occurrence? | Platelet aggregation blocks the artery. |
| A patient has been diagnosed with acute coronary syndrome. Which assessment findings would the nurse expect to see? | Pain occurs at rest. - Pain may radiate to other areas. - Severe, immobilizing chest pain. |
| A male patient diagnosed with acute ST-segment-elevation myocardial infarction (STEMI) is receiving thrombolytic therapy. Which assessment finding by the nurse would require immediate intervention? | The skin is pale and cool with bilateral pedal pulses faintly palpable. |
| Which patients are more likely to require off-pump coronary artery bypass (OPCAB) surgery instead of coronary artery bypass graft (CABG) surgery? | Patient with renal complications whose urine output is 50 mL per day. - Patient with left ventricular heart failure, obesity, and poor wound healing. - Patient with history of an ischemic stroke who has difficulty using the right arm. |
| A patient comes to the emergency department with complaints of chest pain. The initial ECG shows ST-segment elevation in more than three leads. Which intervention should the nurse perform first? | Administer oxygen and nitrates |
| A patient is being discharged with prescriptions for aspirin and clopidogrel after percutaneous coronary intervention (PCI) to treat acute coronary syndrome. The patient wants to know why Which is the best response? | Aspirin and clopidogrel can prevent another clot from forming. |
| A patient is complaining of angina that has increased in intensity. The patient’s vital signs are as follows: blood pressure 94/52, heart rate 122, respiratory rate 20, Which intervention has the highest priority in the nursing management of this patient? | Notification of the health care provider |
| A patient comes to the emergency department with complaints of chest pain, and heart monitoring is initiated. The nurse notes T-wave inversion on the electrocardiogram (ECG). . Which is the nurse’s best response? | “You are having decreased blood flow to part of the heart.” |
| The Emergency Medical Service (EMS) was called to assess a person who had collapsed. The patient’s electrocardiogram (ECG) has been transmitted to the . Which results would require the patient’s immediate transport for diagnostic cardiac catheterization? | ST elevation |
| The nurse administers morphine as ordered to a patient experiencing chest pain of 9 on a scale of 10 that is unrelieved by three doses of nitroglycerin. Which assessment finding would be most concerning? | Distended neck veins |
Created by:
Brandi Sizemore
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