Chapter 21: Care of Patients With Coronary Artery Disease and Cardiac Surgery

Chapter 21: Care of Patients With Coronary Artery Disease and Cardiac Surgery

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

MULTIPLE CHOICE

 

1. The nurse explains that the pain of coronary artery disease (CAD) is related to:

a.	congestion.
b.	ischemia.
c.	edema.
d.	inflammation.

 

 

ANS:  C

The pain of CAD is related to ischemia of tissues as tissues respond to encroaching necrosis.

 

DIF:    Cognitive Level: Comprehension     REF:   451 | 453        OBJ:   2 (theory)

TOP:   CAD: Pain      KEY:  Nursing Process Step: Implementation

MSC:  NCLEX: Physiological Integrity: Physiological Adaptation

 

2. The nurse explains that following a myocardial infarction (MI), the pumping efficiency of the heart is altered because there is:

a.	loss of impulse from the sinoatrial node.
b.	necrosis of the myocardium.
c.	diminished blood flow.
d.	inflammation and swelling of the myocardium.

 

 

ANS:  B

Necrosis of the myocardium is what causes the loss in pumping efficiency. There is diminished blood flow and swelling, but the cause of loss of cardiac output is that there is less muscle to contract.

 

DIF:    Cognitive Level: Application           REF:   458                OBJ:   2 (theory)

TOP:   MI: Pathophysiology                       KEY:  Nursing Process Step: Implementation

MSC:  NCLEX: Physiological Integrity: Physiological Adaptation

 

3. The patient was admitted with chest pain to rule out a myocardial infarction (MI). Which cardiac enzyme test is most indicative of an MI?

a.	Troponin
b.	Myoglobin
c.	CPK
d.	CK-MB

 

 

ANS:  A

Elevated troponin levels are most indicative of an MI as these enzymes are specific to heart muscle damage. Elevated troponin, along with elevated CK-MB are the best diagnostic lab values when determining if an MI has occurred. CPK rises with injury to other muscles as well as cardiac muscle. Myoglobin levels rise with cardiac damage but are as indicative as other enzymes.

 

DIF:    Cognitive Level: Application           REF:   459                OBJ:   5 (theory)

TOP:   MI: Cardiac Enzymes                      KEY:  Nursing Process Step: Assessment

MSC:  NCLEX: Physiological Integrity: Physiological Adaptation

 

4. The post–myocardial infarction (MI) patient is placed on a low-fat diet as well as daily simvastatin (Zocor). The nurse instructs that while on this drug, the patient should:

a.	have blood work every 2 months to check for liver damage.
b.	drink grapefruit juice daily to help metabolize the drug.
c.	take medication with a meal to diminish gastrointestinal discomfort.
d.	report any rash on the face or neck to the physician.

 

 

ANS:  A

The statins have a potential for causing liver damage. Grapefruit juice interferes with the metabolism of the drug. The drug can be taken without regard to meals and does not cause a rash.

 

DIF:    Cognitive Level: Application           REF:   453 | Clinical Cues, 454 | Table 21-1

OBJ:   2 (clinical)      TOP:   Statins: Precaution

KEY:  Nursing Process Step: Implementation

MSC:   NCLEX: Physiological Integrity: Pharmacological Therapies