Chapter 34: Nursing Management: Coronary Artery Disease and Acute Coronary Syndrome

Chapter 34: Nursing Management: Coronary Artery Disease and Acute Coronary
Syndrome

Complete Chapter Questions With Answers

Sample Questions Are Posted Below

MULTIPLE CHOICE
1. When developing a health teaching plan for a 60-year-old man with the following risk
factors for coronary artery disease (CAD), the nurse should focus on the
a. family history of coronary artery disease.
b. increased risk associated with the patient’s gender.
c. high incidence of cardiovascular disease in older people.
d. elevation of the patient’s serum low density lipoprotein (LDL) level.
ANS: D
Because family history, gender, and age are nonmodifiable risk factors, the nurse should
focus on the patient’s LDL level. Decreases in LDL will help reduce the patient’s risk for
developing CAD.
DIF: Cognitive Level: Application REF: 767 TOP: Nursing Process:
Planning
MSC: NCLEX: Health Promotion and Maintenance
2. To assist the patient with coronary artery disease (CAD) in making appropriate dietary
changes, which of these nursing interventions will be most effective?
a. Instruct the patient that a diet containing no saturated fat and minimal sodium will
be necessary.
b. Emphasize the increased risk for cardiac problems unless the patient makes the
dietary changes.
c. Assist the patient to modify favorite high-fat recipes by using monosaturated oils
when possible.
d. Provide the patient with a list of low-sodium, low-cholesterol foods that should be
included in the diet.
ANS: C
Lifestyle changes are more likely to be successful when consideration is given to the
patient’s values and 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.
DIF: Cognitive Level: Application REF: 767-768
TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity
Test Bank 34-2
3. Which information collected by the nurse who is admitting a patient with chest pain
suggests that the pain is caused by an acute myocardial infarction (AMI)?
a. The pain increases with deep breathing.
b. The pain has persisted longer than 30 minutes.
c. The pain worsens when the patient raises the arms.
d. The pain is relieved after the patient takes nitroglycerin.
ANS: B
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.
DIF: Cognitive Level: Application REF: 779
TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity
4. Which information given by a patient admitted with chronic stable angina will help the
nurse confirm this diagnosis?
a. The patient rates the pain at a level 3 to 5 (0 to 10 scale).
b. The patient states that the pain “wakes me up at night.”
c. The patient says that the frequency of the pain has increased over the last few
weeks.
d. The patient states that the pain is resolved after taking one sublingual nitroglycerin
tablet.
ANS: D
Chronic stable angina is typically relieved by rest or nitroglycerin administration. The
level of pain is not a consistent indicator of the type of angina. Pain occurring at rest or
with increased frequency is typical of unstable angina.
DIF: Cognitive Level: Comprehension REF: 771-776
TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity