Lewis: Medical-Surgical Nursing, 7th Edition
Test Bank
Chapter 34: Nursing Management: Coronary Artery Disease and Acute Coronary
Syndrome
MULTIPLE
... [Show More] CHOICE
1. When developing a health teaching plan for a 65-year-old patient with all these risk
factors for coronary artery disease (CAD), the nurse will focus on the
a. family history of heart disease.
b. increased risk associated with the patient’s ethnicity.
c. high incidence of cardiovascular disease in older people.
d. low activity level the patient reports.
Correct Answer: D
Rationale: Because family history, ethnicity, and age are nonmodifiable risk factors, the nurse
should focus on the patient’s activity level. An increase in activity will help reduce the patient’s
risk for developing CAD.
Cognitive Level: Application Text Reference: pp. 790-792
Nursing Process: Planning
NCLEX: Health Promotion and Maintenance
2. To assist the patient with CAD to make the appropriate dietary changes, which of these
nursing interventions will be most effective?
a. Assist the patient to modify favorite high-fat recipes by using monosaturated
oils when possible.
b. Provide the patient with a list of low-sodium, low-cholesterol foods that should be
included in the diet.
c. Instruct the patient that a diet containing no saturated fat and minimal sodium will
be necessary.
d. Emphasize the increased risk for cardiac problems unless the patient makes the
dietary changes.
Correct Answer: A
Rationale: Lifestyle changes are more likely to be successful when consideration is given to
patient’s preferences. The highest percentage of calories from fat should come from
monosaturated fats. Although low-sodium and low-cholesterol foods are appropriate, providing
the patient with a list alone is not likely to be successful in making dietary changes. Removing
saturated fat from the diet completely is not a realistic expectation; up to 7% of calories in the
therapeutic lifestyle changes (TLC) diet can come from saturated fat. Telling the patient about
the increased risk without assisting further with strategies for dietary change is unlikely to be
successful.
Cognitive Level: Application Text Reference: pp. 792-793
Nursing Process: Implementation
NCLEX: Health Promotion and Maintenance
3. The nurse is admitting a patient who is complaining of chest pain to the emergency
department (ED). Which information collected by the nurse suggests that the pain is
caused by an acute myocardial infarction (AMI)?
a. The pain worsens when the patient raises the arms.
b. The pain increases with deep breathing.
c. The pain is relieved after the patient takes nitroglycerin.
d. The pain has persisted longer than 30 minutes.
Correct Answer: D
Rationale: Chest pain that lasts for 20 minutes or more is characteristic of AMI. Changes in pain
that occur with raising the arms or with deep breathing are more typical of pericarditis or
musculoskeletal pain. Stable angina is usually relieved when the patient takes nitroglycerin.
Cognitive Level: Application Text Reference: p. 803
Nursing Process: Assessment NCLEX: Physiological Integrity
4. A patient is admitted to the ED after an episode of severe chest pain, and the physician
schedules the patient for coronary angiography and possible percutaneous coronary
intervention (PCI). The nurse prepares the patient for the procedure by explaining that
it is used to
a. determine whether there are any structural defects in the chambers of the heart.
b. locate any coronary artery obstructions and administer thrombolytic agents.
c. measure the amount of blood being pumped from the heart with each contraction.
d. visualize any coronary artery blockages and dilate any obstructed arteries.
Correct Answer: D
Rationale: Visualization of the coronary arteries and possible balloon dilation are scheduled for
this patient. Thrombolytic therapy is an alternative treatment if the patient is experiencing acute
coronary syndrome (ACS) but is not the ordered therapy for this patient. Although angiography
might help to detect structural defects or changes in cardiac output, it is not the reason for the
procedure in this patient with symptoms of CAD.
Cognitive Level: Application Text Reference: p. 807
Nursing Process: Implementation NCLEX: Physiological Integrity [Show Less]