Deck 16: Ischemic Heart Disease and Conduction Disorders

Question 1

A client presents with chest pain not relieved by nitroglycerin medication. A review of the client's medical record shows a history of type 2 diabetes. The client's blood pressure is 150/90 mm Hg. Which condition is the client developing?
1)Myocardial infarction
2)Angina
3)Pericarditis
4)Myocarditis

Answer 1

1

Question 2

The nurse is reviewing the results of a diagnostic test of a client who is being moved out of the intensive care unit. A cardiac troponin T level assay was performed while the client was in the intensive care unit, which indicated high levels of troponin. With which condition is the client diagnosed?
1)Angina
2)Acute myocardial infarction
3)Transient cardiac ischemia
4)Atrioventricular block

Answer 2

2

Question 3

The nurse is presenting teaching to a client with stable angina. Which information is vital for the nurse to teach and validate?
1)Get medical help if three doses of nitroglycerine does not stop the pain
2)Notify the health-care provider if the pain suddenly radiates to the arms
3)Consider angina pain that is more severe than usual to be a medical emergency
4)If pain occurs during activity, sit down and rest to see if the pain stops or continues

Answer 3

3

Question 4

A client presents reporting dyspnea and excessive diaphoresis. The nurse notices pallor. The client's electrocardiogram shows an irregular rhythm. Which additional finding indicates the client has developed a myocardial infarction?
1)Nitroglycerin relieved the pain.
2)Pain continued after three doses of nitroglycerin.
3)Aspirin relieved the pain.
4)Application of oxygen per nasal cannula relieved the pain.

Question 5

Which heart condition is most likely to increase the demand for myocardial oxygen?
1)Electroconduction disorders
2)Electrocardiogram (ECG) results of cardiac arrhythmia
3)Decreased systemic blood pressure
4)The coronary artery disease atherosclerosis

Question 6

Which condition is characterized by the deposition of immune complexes, causing inflammation and fluid accumulation in the pericardial sac?
1)Dressler's syndrome
2)Myocarditis
3)Infective endocarditis
4)Unstable angina

Question 7

A client is displaying premature ventricular contractions (PVCs) in a couplet pattern. Which is the priority assessment by the nurse?
1)Sensations of palpitation
2)Changes in electrocardiogram (ECG) pattern
3)Blood pressure
4)Oxygen saturation

Question 8

An older adult client presents with complaints of crushing pain on the left side of the chest. After the client is examined, it is found that the client has unstable angina. Which intervention to reduce the pain is appropriate for the client?
1)Administering nitroglycerin
2)Changing the position of the client
3)Encouraging the client to take deep breaths
4)Administering antianxiety medication

Question 9

The nurse in the cardiac unit is caring for a client diagnosed with ischemic heart disease related to two coronary vessel blockages. The client has a history of high low-density lipoprotein (LDL) cholesterol and diabetes mellitus. Which pre-procedure testing does the nurse expect?
1)Coronary artery calcium computerized tomography (CT) scan
2)Twelve-lead electrocardiogram
3)Blood coagulation studies
4)Cardiac ultrasonography

Question 10

The nurse is reviewing a client's cardiac rhythm in an electrocardiogram and notes that the reading shows the P wave and PR interval are absent. Which condition does the nurse interpret from this result?
1)Ventricular fibrillation
2)Premature ventricular contractions
3)Atrial fibrillation
4)First-degree atrioventricular (AV) block

Question 11

A client with a history of atherosclerosis periodically experiences angina pectoris. While shopping, the client suddenly experiences a level of pain that is more severe than with the usual angina events. Which pathophysiological change is most likely occurring?
1)A coronary vasospasm is causing the intense pain.
2)A new endothelial injury and platelet aggregation are developing.
3)Plaque from atherosclerosis has traveled in a coronary artery.
4)Increased activity is escalating the usual angina pain.

Question 12

A client whose neck vein has bulged presents with a sharp pain in the chest. The electrocardiogram shows an elevated ST segment, and the laboratory report shows an increase in the serum creatinine and blood urea nitrogen. Which condition has the client developed?
1)Myocarditis
2)Pericarditis
3)Infective endocarditis
4)Septic carditis

Question 13

A client visits the hospital with chest pain, and the vital signs are 101.5°F body temperature and 125/85 mm Hg blood pressure. The echocardiogram of the client shows valve perforation, and a new regurgitant murmur is heard during chest auscultation. Which condition has the client developed?
1)Infective endocarditis
2)Myocarditis
3)Pericarditis
4)Cardiac failure

Question 14

A nurse is caring for a client with infective endocarditis. Which is the specific nursing intervention for this client?
1)Administering nitroglycerin
2)Administering ampicillin
3)Administering urokinase
4)Administering oxygen

Question 15

A client presents with chest pain. The pain has not reduced after administering three nitroglycerine tablets within 10 minutes. Which diagnostic test does the primary health-care provider prescribe to confirm the client has developed a myocardial infarction (MI)?
1)Thallium stress test
2)Electrocardiogram
3)Cardiac troponin test
4)Intravascular angiosonography

Question 16

A client is experiencing severe chest pain unrelieved by nitroglycerine. Which diagnostic testing supports the possibility of a myocardial infarction instead of unstable angina?
1)Electrocardiogram (ECG) results exhibit a depressed ST segment
2)Coronary artery calcium computerized tomography (CT) scan shows calcification
3)An ambulatory ECG is positive for cardiac stress
4)Blood tests indicate elevation of specific enzymes

Question 17

The nurse is providing care for a client admitted for coronary disease. The client is currently being treated for manifestations of increased angina pectoris. Testing indicates that previously blocked coronary arteries at 20% are now more than 30% blocked. Which intervention does the nurse anticipate for this client?
1)Cardiac rehabilitation
2)Cholesterol-lowering drugs
3)Coronary artery bypass grafts
4)Percutaneous coronary interventions

Question 18

A client is experiencing chest pain. On examination, a scratchy sound is heard through the stethoscope. Which intervention does the nurse initiate?
1)Applying oxygen per nasal cannula
2)Planning a low-sodium diet
3)Administering glucocorticoids
4)Maintaining an hourly output

Question 19

A client reports myalgia and fever. On physical examination, an S₃ gallop rhythm was heard through the stethoscope, and the client is diagnosed with myocarditis. For which reason is the client prescribed angiotensin-converting enzyme (ACE) inhibitors?
1)To treat heart failure
2)To treat infection
3)To improve healing
4)To promote cardiac rest

Question 20

The nurse is providing care for a client in the emergency department being treated for an acute myocardial infarction. The health-care provider prescribes treatment with morphine sulfate IV push. Which is the best reason for this prescribed medication?
1)Immediately alleviates pain
2)Effectively treats anxiety
3)Affects respiratory function
4)Improves gas exchange

Question 21

Which are the clinical manifestations in clients with infective endocarditis? Select all that apply.
1)Petechiae
2)Janeway lesions
3)S₃ gallop rhythm
4)Lymphadenopathy
5)Pericardial friction rub

Question 22

The nurse is assessing a client with pericarditis. Which assessment findings indicate pericarditis? Select all that apply.
1)Flat neck veins
2)Increased blood pressure
3)Muffled or distant heart sounds
4)Pericardial friction rub
5)Dyspnea

Question 23

Which wave in the electrocardiogram represents ventricular repolarization?
1)P wave
2)Q wave
3)S wave
4)T wave

Question 24

The nurse is caring for four clients with chest pain. Which client is treated for infective endocarditis? Select all that apply.
1)The client with a dental implant
2)The client who shows elevated ST segment in the electrocardiogram reading
3)The client who has a swollen neck vein
4)The client who has a scratchy sound through the stethoscope upon examination
5)The client with a pacemaker

Question 25

Which statements regarding angina are correct? Select all that apply.
1)"Stress is the cause of the chest pain."
2)"The chest pain lasts for more than 15 minutes."
3)"Taking a rest does not relieve the chest pain."
4)"The chest pain is reduced by taking a deep breath."
5)"The chest pain is reduced by resting."