Sherpath - Coronary Artery Disease & Acute Coronary Syndrome Flashcards
(25 cards)
Which abnormality in the lipid profile would the nurse expect to find when assessing a client who may have coronary artery disease?
a. Increased high-density lipoprotein and low density lipoprotein levels.
b. Decreased high-density lipoprotein and low-density lipoprotein levels.
c. Decreased low-density lipoprotein and increased high-denisuty lipoprotein levels.
d. Decreased high-density lipoproteins and increased low-density lipoprotein levels.
d. Decreased high-density lipoproteins and increased low-density lipoprotein levels.
• HDL = High-Density Lipoprotein = “Happy” cholesterol = takes cholesterol to the liver to be destroyed = you want this high
• LDL = Low-Density Lipoprotein = “Lousy” cholesterol = dumps cholesterol in your blood vessels = you want this low
So, “density” in lipoproteins refers to how much protein versus fat (lipid) is crammed into that little cholesterol-carrying spaceship.
Let’s break this down like I’m babysitting a goldfish:
• High-Density Lipoproteins (HDL): These have more protein and less fat, making them denser (science!). They’re like responsible adults in the bloodstream, scooping up excess cholesterol and dragging it to the liver to be destroyed. Very cleanup-crew energy.
• Low-Density Lipoproteins (LDL): These have more fat and less protein, so they’re fluffier and lighter. Unfortunately, they’re also lazy and dump cholesterol on your artery walls like teenagers leaving trash in a parking lot. This leads to plaque buildup, aka “Let’s clog some arteries, baby.”
Which assessment finding is the highest priority and would be reported to the primary health care provider immediately for a client who has been administered the tissue-type plasminogen activator (TPA) alteplase for an acute myocardial infection?
a. Anorexia
b. Hematuria
c. Oral Temperature of 38 degrees celsius
d. Occasional premature ventricular contractions
b. Hematuria
What is alteplase?
It’s a clot buster—used in emergencies like heart attacks (MI), strokes, or massive clots that need to be gone yesterday.
But here’s the fine print: it doesn’t just dissolve bad clots—it’ll happily bust any clot. Including the ones your body needs to stop bleeding.
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• b. Hematuria (blood in the urine)? YES. Big fat yes. This screams internal bleeding, which is a major risk of alteplase and must be reported immediately before they start leaking from more places. ⸻
Bottom line:
Hematuria = potential bleeding emergency in someone on a thrombolytic drug.
It might look like pee, but it’s your clue that the patient’s plumbing is failing.
Which information is important for the nurse to include in the discharge teaching related to elimination after a client has experienced a myocardial infarction?
a. “Avoid straining during bowel movement.’
b. “Avoid passing stools after having food.”
c. “Avoid passing stools more than once a day.”
d. “Take medicine for constipation.”
a. “Avoid straining during bowel movement.’
This is important discharge teaching for a client who has experienced a myocardial infarction (MI) because straining during bowel movements (called the Valsalva maneuver) can cause a sudden increase in intrathoracic pressure, which may reduce cardiac output and can lead to dysrhythmias or even cardiac arrest in someone with a vulnerable heart.
Key teaching points for post-MI patients include:
• Avoid constipation and straining—often managed with stool softeners, fluids, and dietary fiber.
• Avoid heavy lifting and strenuous activity during the recovery period.
• Report any chest pain, shortness of breath, or palpitations promptly
Which nursing intervention is most important for a client during the first several days after a myocardial infarction?
a. Determining the client’s ability to tolerate a regular diet.
b. Instructing the client on how to utilize a bedside commode.
c. Assisting the client in turning, coughing, and deep breathing.
d. Encouraging the client to perform active range-of-motion exercises.
b. Instructing the client on how to utilize a bedside commode.
Why? Because after a myocardial infarction (aka a heart attack), you don’t want the patient:
1. Straining on the toilet, which activates the Valsalva maneuver, which:
2. Triggers vagal tone, which:
3. Can cause bradycardia, decreased cardiac output, or even dysrhythmias, which:
4. Could send them right back into a cardiac episode—because who doesn’t love an encore?
The bedside commode allows the patient to eliminate without the effort of hiking to the bathroom or doing interpretive dance moves to get on and off the toilet. Less physical stress = safer recovery.
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Yes, you’re right — they can still strain on a bedside commode. It’s not magic. It doesn’t come with a “no Valsalva maneuver” forcefield. But here’s the nuance, my overachieving friend:
Why the bedside commode is still a big deal:
• It reduces physical exertion compared to walking to the bathroom and navigating toilet logistics like a Cirque du Soleil routine.
• The nurse can teach strategies to minimize straining:
• Stool softeners (hello, docusate sodium).
• Proper positioning (lean forward, feet flat, knees up—basic potty ergonomics).
• No holding breath while bearing down like they’re giving birth to a watermelon.
• It’s also about supervision and safety—you’re keeping them in a controlled space where you can monitor how their fragile heart handles basic activities like pooping. Glamorous, I know
Which condition would the nurse recognize that the client with diabetes mellitus may be experiencing when they report shortness of breath, neck pain, and hypoglycemic symptoms and their BP is 130/86, HR-102 bpm, R-24, and BG-7.5 mmol/L.
a. Myocardial infarction
b. Late-stage diabetic ketoacidosis
c. Early-onset diabetic ketoacidosis
d. Hyperosmolar hyperglycemic nonketotic syndrome
a. Myocardial infarction
The nurse, reviewing a client’s laboratory results, recognizes which result as most indicative of myocardial infarction?
a. Increased myoglobin
b. Decreased C-reactive protein
c. Increased creatine kinase
d. Increased white blood cell count
c. Increased creatine kinase
Creatine kinase (CK) is an enzyme chilling inside your cells, especially muscle cells. And guess what your heart is made of? That’s right—muscle. So when your cardiac muscle gets injured (like, say, because it’s not getting blood and is dying dramatically), those cells break open and CK spills into the bloodstream like tea at a family reunion.
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CK has different types (because of course it does):
• CK-MM – mostly in skeletal muscle
• CK-BB – mostly in the brain (very extra)
• CK-MB – specific to cardiac muscle
So when we say increased creatine kinase, what we really care about is CK-MB, the subtype that goes, “Hey! Your heart’s in trouble!”
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Why it matters in an MI:
• A heart attack = cardiac muscle dies due to lack of oxygen.
• Dying muscle cells rupture, releasing CK-MB.
• Levels start to rise within 3–6 hours, peak around 12–24 hours, and go back to normal after 2–3 days.
• So it’s like a short-lived but very telling scream from your heart cells.
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Bonus:
Nowadays, troponin is the real gold standard lab value for diagnosing MI—because it’s more specific and sensitive than CK-MB.
Which medication class does clopidogrel belong to?
a. Vitamin K antagonist
b. Nonsteroidal anit-inflammatory drugs
c. Opioid analgesic
d. Antiplatelet
d. Antiplatelet
Yes, this is one of those “please don’t let this medication sneak into your breast milk” situations. Amantadine has been shown to pass into breast milk and could potentially cause toxicity in nursing infants, because babies aren’t really equipped to metabolize neuroactive compounds designed for, say, people who can do their own taxes.
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Let’s roast the wrong options for clarity:
• a. Less CNS toxicity than rimantadine?
Nope. Amantadine is actually more likely to cause CNS side effects like dizziness, insomnia, hallucinations, and the occasional “I forgot where I put my brain.” Rimantadine is the more chill cousin.
• b. Commonly used to treat Influenza A and B?
Noooope. It only works on Influenza A, and even that’s barely a thing anymore because most strains are resistant now. B isn’t even on its guest list.
• d. Longer half-life than rimantadine?
False again. Rimantadine actually has the longer half-life, because it enjoys overstaying its welcome in your system
Which serum cholesterol levels increase the risk of coronary artery disease?
a. Decreased triglycerides
b. Elevated high-density lipoproteins
c. Elevated low-density lipoproteins
d. Decreased very-low-density lipoproteins
c. Elevated low-density lipoproteins
In which way would the resumption of sexual activity be discussed with a client recovering from myocardial infarction.
a. Delegated to the health care provider.
b. Discussed along with other physical activities
c. Avoided because it is embarrassing to the client.
d. Accomplished by providing the client with written material
b. Discussed along with other physical activities
Which statement by the client who was diagnosed recently with coronary artery disease indicates that the client understand dietary modification that need to be implemented after discharge home?
a. “I will not eat bacon or any pork products”
b. “I will eat only fried eggs instead of boiled eggs”
c. “I may continue to enjoy french fries with hot dogs.”
d. “I will drink no more than one glass of whole milk per day.”
a. “I will not eat bacon or any pork products”
Why bacon and pork get the axe (sadly):
Bacon and pork products = high in saturated fats + often processed + loaded with sodium
Which = everything your coronary arteries hate with a fiery passion.
Saturated fats increase LDL cholesterol (aka the “bad guy”), which is basically like spreading cement in your arteries. Not ideal when you already have coronary artery disease
Which goal would the nurse use to plan care to help prevent cardiovascular disease progression in a female client who has type 1 diabetes mellitus and has chronic stable angina tha tis controlled with rest increased insulin requirements over the last few months?
a. Exercise almost every day
b. Avoid saturated fat intake
c. Limit calories to daily limit
d. Keep Hgb A1C less than 7%
d. Keep Hgb A1C less than 7%
Which factor is true of ischemia related to angina?
a. It generally lasts longer than 15-20 minutes
b. It will be relieved by rest and/or nitroglycerin
c. It indicates that irreversible myocardial damage is occurring.
d. It is frequently associated with vomiting and extreme fatigue.
b. It will be relieved by rest and/or nitroglycerin
Which serum cardiac marker would the nurse review to determine if a myocardial infarction occured 10 days ago?
a. Troponin
b. Myoglobin
c. Homocysteine
d. Creatine kinase
a. Troponin
Which statement by the client indicates an adequate understanding about ways to decraese risk factors for coronary artery disease?
a. “I will add weight lifting to my exercise program.”
b. “I will change my diet to increase my intake of saturated fats.”
c. “I need to switch to smokeless tobacco instead of smoking cigarettes.”
d. “I will change my lifestyle to reduce activities that increase my stress.”
d. “I will change my lifestyle to reduce activities that increase my stress.”
When teaching a client about modifying risk related to serum lipid levels, which action would the nurse teach to help lower the risk of coronary artery disease?
a. Decrease low-density and high-density lipoprotein levels.
b. Increase low-density and high density lipoprotein levels.
c. Increase low-density lipoproteins and decrease high-density lipoprotein levels.
d. Increase high-density lipoproteins and decrease low-density lipoprotein levels.
d. Increase high-density lipoproteins and decrease low-density lipoprotein levels.
When analyzing a client’s electrocardiogram strip, the nurse recognizes which finding most diagnostic of myocardial infarction?
a. Prolonged PR interval
b. Presence of a U wave
c. QRS abnormalities
d. Heightened T wave
c. QRS abnormalities
Which client statement indicates a need for further teaching regarding nitroglycerin sublingual spray for the treatment of chronic stable angina?
a. “possible adverse effects include a warm feeling, headache, or light-headedness.”
b. “I must inhale the nitroglycerin spray then hold my breath for 10 seconds.”
c. “I will ensure the medication is easily accessible at all times.”
d. “The sublingual tablets will expire 6 months from the time the bottle is opened.”
b. “I must inhale the nitroglycerin spray then hold my breath for 10 seconds.”
Which diagnosis would the nurse anticipate for a client with severe, prolonged angina that is not immediately reversible?
a. Unstable angina
b. Acute coronary syndrome
c. ST-segment elevation myocardial infarction (STEMI)
d. Non-ST-segment elevation myocardial infarction (NSTEMI).
b. Acute coronary syndrome
Which important information would the nurse give to the client regarding sexual activity who has a history of angina and is being treated with nitrates and beta blockers?
a. “You cannot have sexual intercourse while taking these medicines.”
b. “You cannot take medicines like sildenafil.”
c. “Stop taking beta blockers because they cause impotence.”
d. “Stop taking nitrates when planning to have sexual intercourse.”
b. “You cannot take medicines like sildenafil.”
Which assessment data would indicate that the client has stable angina?
a. The client developed chest pain while sitting and watching television.
b. Pain developed when the client was jogging and subsided now.
c. The client developed chest pain shortly after going to bed.
d. Pain starts approximately the same time every day without regard to activity level.
b. “You cannot take medicines like sildenafil.”
Which findings associated with myocardial ischemia could be obtained by cardiac catheterization for a client with unstable angina?
a. ST segment depression
b. Cardiac enlargement
c. Abnormal cardiac wall motion
d. 70% block in right coronary artery
d. 70% block in right coronary artery
After teaching a client with chronic stable angina about nitroglycerin, which client statement indicates a need for further teaching?
a. “I will replace my nitroglycerin supply every 6 months.”
b. “I can take up to 5 tablets every 3 minutes for relief of my chest pain.”
c. “I will take acetaminophen to treat the headache caused by nitroglycerin.”
d. “I will take the nitroglycerin 10 minutes before a planned activity that usually causes chest pain.”
b. “I can take up to 5 tablets every 3 minutes for relief of my chest pain.”
The nurse reviews a client’s medical history and identifies which findings as the most important risk factors for coronary artery disease?
a. Age, family history, hypertension, smoking, and stress.
b. Diabetes, high cholesterol, personality type, and smoking
c. Diabetes, high cholesterol, hypertension, obesity, and smoking
d. Alcohol consumption, diabetes, high cholesterol, obesity, and stress.
c. Diabetes, high cholesterol, hypertension, obesity, and smoking
Which reason is best to explain the findings of an 80% block in the left circumflex artery and 70% block in the right coronary artery with no symptoms of coronary ischemia in an older adult client?
a. Lowering of low-density lipoprotein levels in the body.
b. Pulmonary artery supplies oxygenated blood to the heart.
c. Formation of collateral in the coronary circulation
d. Increased production of C-reactive proteins in the liver.
c. Formation of collateral in the coronary circulation
