Chapter 28 Management Of Patients With Coronary Vascular Disorders

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Chapter 28  Management Of Patients With Coronary Vascular Disorders

 

 

Complete Chapter Questions And Answers
 

Sample Questions

 

Multiple Choice

1. The nurse is caring for a patient who has been diagnosed with an elevated cholesterol level. The nurse is aware that plaque on the inner lumen of arteries is composed chiefly of what?
A) Lipids and fibrous tissue
B) WBCs

C) Lipoproteins
D) High-density cholesterol

Ans: A
Chapter: 28
Client Needs: D-4
Cognitive Level: Comprehension
Difficulty: Easy
Integrated Process: Nursing Process
Objective: 1
Page and Header: 756, Coronary Atherosclerosis

Feedback: As T-lymphocytes and monocytes infiltrate to ingest lipids on the arterial wall and then die, a fibrous tissue develops. This causes plaques to form on the inner lumen of arterial walls.

2. A patient comes to the walk-in clinic complaining of chest pain on exertion. The patient is diagnosed with angina pectoris. The patient asks what causes angina. The nurse informs the patient that most often angina is caused by what?
A) Smoking

B) Inadequate cardiac output
C) Infarction of the myocardium D) Coronary arteriosclerosis

Ans: D
Chapter: 28
Client Needs: D-4
Cognitive Level: Application
Difficulty: Moderate
Integrated Process: Teaching/Learning Objective: 2
Page and Header: 757, Coronary Atherosclerosis

Feedback: In most cases, angina pectoris is due to arteriosclerosis, particularly in older patients. Smoking, hypertension, high cholesterol levels, and diabetes mellitus are all associated with coronary arteriosclerosis.

3. You are caring for an adult patient who had symptoms of unstable angina during admission to the hospital. The most appropriate nursing diagnosis for the discomfort associated with angina is what?
A) Deficient knowledge about underlying disease and methods for avoiding complications
B) Anxiety related to fear of death
C) Ineffective cardiopulmonary tissue perfusion secondary to CAD, as evidenced by chest pain D) Noncompliance related to failure to accept necessary lifestyle changes

Ans: C
Chapter: 28
Client Needs: D-4
Cognitive Level: Application Difficulty: Moderate
Integrated Process: Nursing Process Objective: 3
Page and Header: 766, Angina Pectoris

Feedback: Ineffective cardiopulmonary tissue perfusion describes the symptoms of discomfort associated with angina. Deficient knowledge describes the patient awareness of disease process

and treatment. Anxiety identifies psychological effects of angina, while noncompliance is related to a patient’s resistance to changing behaviors/patterns necessary to treat and manage the disease.

4. The triage nurse in the emergency department assesses a 66-year-old male patient who presents to the emergency department with complaints of midsternal chest pain that has lasted for the last 5 hours. The nurse is aware that because of the length of time the patient has been experiencing symptoms, if they are due to a MI, what has happened to the myocardium?
A) May have developed an increased area of infarction
B) Will probably not have more damage than if he came in immediately
C) Can have restoration of the area of dead cells with proper treatment
D) Has been damaged already, so immediate treatment is no longer necessary

Ans: A
Chapter: 28
Client Needs: D-4
Cognitive Level: Application
Difficulty: Difficult
Integrated Process: Nursing Process
Objective: 4
Page and Header: 768, Acute Coronary Syndrome and Myocardial Infarction

Feedback: When the patient experiences lack of oxygen to myocardium cells during a MI, the sooner treatment is initiated the more likely the treatment will prevent or minimize myocardial tissue necrosis. Despite the length of time the symptoms have been present, treatment needs to be initiated immediately to minimize further damage.

5. Family members bring a patient to the emergency department with pale cool skin, midsternal chest pain unrelieved with rest, and a history of CAD. What is the nurse aware of?
A) The symptoms indicate angina and should be treated as such.
B) The symptoms indicate anxiety and should be treated as such.

C) The symptoms indicate an acute coronary episode and should be treated as such. D) Treatment should be held until an ECG is completed.

Ans: C
Chapter: 28
Client Needs: D-4
Cognitive Level: Application Difficulty: Moderate
Integrated Process: Nursing Process Objective: 5

Page and Header: 768, Acute Coronary Syndrome and Myocardial Infarction

Feedback: Angina and MI have similar symptoms and are considered the same process but are on different points along a continuum. Acute coronary syndrome may be used to represent these diagnoses. Treatment should be initiated immediately regardless of diagnosis.

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