Myocardial Infarction MCQs Quiz With Answers

The most common symptom of an MI is chest pain, resulting from deprivation of oxygen to the heart. Dyspnea is the second most common symptom, related to an increase in the metabolic needs of the body during an MI. Edema is a later sign of heart failure, often seen after an MI. Palpitations may result from reduced cardiac output, producing arrhythmias.

This client should receive the highest priority because his symptoms are suggestive of a myocardial infarction (heart attack), which is a life-threatening condition that requires immediate intervention. The severe chest pain radiating to the jaw, along with diaphoresis, are classic signs of a heart attack. While the other clients may require medical attention, their conditions are not as immediately life-threatening as the man with chest pain. The elderly woman with loss of appetite and fatigue may be experiencing a range of issues, but her symptoms are not indicative of an acute emergency. The football player with an ankle injury may require evaluation and treatment, but it is not a life-threatening condition. The child with nausea and vomiting should be assessed, but this is a common symptom in children and may not necessarily indicate a severe medical issue. In triage situations, it is crucial to quickly identify clients with potentially life-threatening conditions and prioritize their care to ensure the best possible outcomes.

Exercise is important for all hospitalized patients to prevent deep vein thrombosis. Muscular contraction promotes venous return and prevents hemostasis in the lower extremities. This exercise is not sufficiently vigorous to increase physical fitness, nor is it intended to prevent bedsores or constipation.

An early finding in the electrocardiogram (EKG) of a client with an infarcted myocardium (heart muscle damage due to a heart attack) would be elevated ST segments. The ST segment on an EKG represents the time between the end of the QRS complex (ventricular depolarization) and the beginning of the T wave (ventricular repolarization). When the heart muscle is damaged, the normal electrical activity is disrupted, which can cause the ST segment to become elevated. Elevated ST segments are a significant indicator of an acute myocardial infarction, and they usually appear within hours of the onset of symptoms. The other options – disappearance of Q waves, absence of P wave, and flattened T waves – are not typically early findings in a client with an infarcted myocardium.

A history of cerebral hemorrhage is a contraindication to tPA because it may increase the risk of bleeding. TPA acts by dissolving the clot blocking the coronary artery and works best when administered within 6 hours of onset of symptoms. Prior MI is not a contraindication to tPA. Patients receiving tPA should be observed for changes in blood pressure, as tPA may cause hypotension.

In prioritizing client care, the nurse should first assess the client who is experiencing symptoms that may indicate a potentially life-threatening complication. In this case, the 44-year-old client with a myocardial infarction complaining of nausea should be seen first, as nausea can be a symptom of an impending cardiac event or a side effect of the medications used to treat MI. While the other clients may require attention, their situations do not necessarily indicate immediate life-threatening complications. The post-operative appendectomy client with pain, the client with an infiltrated IV, and the post-operative hysterectomy client with a saturated dressing can be assessed and managed after addressing the potentially more critical situation of the MI client.

Nausea and loss of appetite are common adverse effects of digoxin (Lanoxin), a medication often used to treat heart conditions such as atrial fibrillation and heart failure. Digoxin helps improve the heart's pumping efficiency and can be prescribed following a myocardial infarction to improve cardiac function. However, it can cause gastrointestinal side effects, including nausea, vomiting, and loss of appetite. The other options are less likely to cause these symptoms. Spironolactone (Aldactone) is a diuretic that can cause gastrointestinal side effects, but nausea and loss of appetite are not among its most common adverse effects. Propranolol (Inderal) is a beta-blocker that may cause nausea, but loss of appetite is not a typical side effect. Furosemide (Lasix) is a diuretic that can cause electrolyte imbalances and dehydration, but it is not commonly associated with nausea and loss of appetite. It is important for the nurse to monitor the client's symptoms and communicate any concerns to the healthcare provider, as adjustments to the medication regimen may be necessary to manage adverse effects.

High pulmonary artery wedge pressures are diagnostic for left-sided heart failure. With leftsided heart failure, pulmonary edema can develop causing pulmonary crackles. In leftsided heart failure, hypotension may result and urine output will decline. Dry mucous membranes aren’t directly associated with elevated pulmonary artery wedge pressures.

Pain associated with angina is relieved by rest. Answer B is incorrect because it is not a true statement. Answer Pain associated with angina is confined to the chest area is incorrect because pain associated with angina can be referred to the jaw, the left arm, and the back. Pain associated with myocardial infarction is referred to the left arm is incorrect because pain from a myocardial infarction can be referred to areas other than the left arm.

Given Helen's background in the maternity unit, it would be most appropriate to assign her to a client with a myocardial infarction who is currently free from pain and dysrhythmias. Although this client has a cardiac condition, they are currently stable, and their care would primarily involve monitoring and routine assessments, which should be within Helen's scope of practice as a nurse. The other clients have more complex and unstable conditions that require specialized knowledge and experience in critical care nursing. A client with a dopamine drip IV and vital signs monitored every 5 minutes, a client with respiratory distress following a tracheotomy, and a client with intermittent capture after a pacemaker insertion may require more advanced assessment skills and interventions that Helen may not be familiar with, given her background in maternity nursing. It is important to ensure that nurses are assigned to clients based on their level of expertise and competence, to provide safe and effective patient care.

Valsalva's maneuver involves holding one's breath and bearing down, which increases intrathoracic pressure and can have harmful effects on the cardiovascular system, particularly after a myocardial infarction. To help prevent Valsalva's maneuver, the client should be instructed to avoid holding their breath during activity. Assuming a side-lying position, clenching teeth while moving in bed, and drinking fluids through a straw do not directly contribute to preventing Valsalva's maneuver. Instead, the nurse should encourage the client to practice deep breathing and relaxation techniques, move slowly and deliberately during activities, and use proper body mechanics to minimize strain and the risk of triggering Valsalva's maneuver.

Morphine is administered to clients who have experienced a myocardial infarction (heart attack) for two primary reasons: to relieve pain and to prevent shock. Morphine is a potent opioid analgesic that helps alleviate the severe chest pain associated with a heart attack, making the client more comfortable. Additionally, morphine helps to prevent cardiogenic shock, a severe complication of a heart attack, by reducing the heart's workload and stabilizing hemodynamics. While morphine may have secondary effects such as reducing anxiety and restlessness or mildly dilating blood vessels, its primary purposes in this context are to manage pain and prevent shock. Morphine does not directly prevent fibrillation of the heart, though it may contribute to overall hemodynamic stability.

Percutaneous Transluminal Coronary Angioplasty (PTCA) is a minimally invasive procedure used to open blocked coronary arteries and restore blood flow to the heart. To be most effective, PTCA should be performed within 60 minutes of the patient's arrival at the emergency department following a diagnosis of myocardial infarction. This time frame is referred to as the "door-to-balloon" time and is a critical factor in reducing mortality and improving outcomes in patients with acute myocardial infarction. Performing PTCA within this time frame helps minimize damage to the heart muscle by quickly restoring blood flow to the affected area. Waiting longer than 60 minutes can result in increased risk of complications and a less favorable prognosis for the patient.

Fever causes an increase in the body’s metabolism, which results in an increase in oxygen consumption and demand. This need for oxygen increases the heart rate, which is reflected in the increased pulse rate. Increased BP, chest pain and shortness of breath are not typically noted in fever.

The nurse should first ask the client if he has concerns about his care. This is important because the client's request to see his chart may be driven by concerns or questions about his condition or treatment. By addressing his concerns, the nurse can provide the client with the information and reassurance he needs, potentially alleviating the need for him to view his chart. It also demonstrates the nurse's willingness to listen and engage in open communication with the client, which is an important aspect of patient-centered care.

Administering stool softeners every day will prevent straining on defecation which causes the Valsalva maneuver. If constipation occurs then laxatives would be necessary to prevent straining. If straining on defecation produced the valsalva maneuver and rhythm disturbances resulted then antidysrhythmics would be appropriate.

When caring for a client with Alzheimer's disease, it is important to establish and maintain a routine. A consistent routine can help reduce confusion and disorientation, which are common symptoms of Alzheimer's disease. By providing a predictable daily schedule, the client can better anticipate activities and adapt to their environment. This can help reduce anxiety, improve cooperation, and promote a sense of security. While providing a stimulating environment and performing activities of daily living for the client may also be beneficial, establishing a routine is a critical aspect of caring for a client with Alzheimer's disease. Trying to reason with the client may not be effective due to the cognitive impairments associated with the disease, and it is more important to focus on empathetic communication and understanding the client's needs.

In a hospitalized patient on prolonged bed rest, he most likely cause of sudden onset shortness of breath and chest pain is pulmonary embolism. Pregnancy and prolonged inactivity both increase the risk of clot formation in the deep veins of the legs. These clots can then break loose and travel to the lungs. Myocardial infarction and atherosclerosis are unlikely in a 27-year-old woman, as is congestive heart failure due to fluid overload. There is no reason to suspect an anxiety disorder in this patient. Though anxiety is a possible cause of her symptoms, the seriousness of pulmonary embolism demands that it be considered first.

In a comatose client who has overdosed on barbiturates, respiratory failure is a significant concern. Barbiturates are central nervous system depressants that can cause respiratory depression, leading to shallow breathing, decreased respiratory rate, and potentially respiratory arrest. As the client is comatose, their ability to maintain a patent airway and adequate breathing may be compromised, increasing the risk of respiratory failure. While epilepsy, myocardial infarction, and renal failure may be concerns in some cases, they are not the most immediate or likely complications in a barbiturate overdose. Nurse Trish should prioritize monitoring the client's respiratory status, ensuring a patent airway, and providing respiratory support as needed to prevent respiratory failure and its associated complications.

During the second day of hospitalization following a myocardial infarction, an expected outcome for the client would be the ability to perform self-care activities without experiencing pain. This is a positive indication of the client's recovery and suggests that their condition is stabilizing. While it is important for clients to recognize the risk factors of myocardial infarction and participate in cardiac rehabilitation programs, these are more likely to be long-term goals rather than expected outcomes during the early stages of hospitalization. Severe chest pain would not be an expected outcome, as it indicates ongoing cardiac distress and should be addressed immediately.

Having established, by stimulating the client, that the client is unconscious rather than sleep, the nurse should immediately call for help. This may be done by dialing the operator from the client’s phone and giving the hospital code for cardiac arrest and the client’s room number to the operator, of if the phone is not available, by pulling the emergency call button. Noting the time is important baseline information for cardiac arrest procedure.

This meal plan is the most appropriate for a client on a sodium-restricted diet after a myocardial infarction. Broiled fish, baked potato, canned beets, and fresh fruit are all low-sodium options that provide essential nutrients. Milk is also a suitable choice as it is naturally low in sodium. The other meal plans contain foods that may be higher in sodium, such as canned salmon, biscuits, bologna, and processed juice. When following a sodium-restricted diet, it is important to focus on fresh or frozen whole foods, as well as low-sodium prepared foods, to minimize sodium intake and promote overall heart health. In addition to suggesting appropriate meal plans, the nurse should also provide education on reading food labels, avoiding high-sodium seasonings and condiments, and incorporating a variety of low-sodium foods to maintain a balanced and satisfying diet.

Morphine is administered to a client with myocardial infarction primarily to decrease oxygen demand on the client's heart. Myocardial infarction, also known as a heart attack, occurs when the blood flow to the heart is reduced or blocked, causing damage to the heart muscle. Morphine helps by dilating the blood vessels, which reduces the workload on the heart and decreases the demand for oxygen. While morphine can also have secondary effects such as sedation, pain relief, and anxiety reduction, the main purpose in this context is to alleviate the strain on the heart and minimize further damage to the cardiac muscle.

"When you can climb 2 flights of stairs without problems, it is generally safe." There is a risk of cardiac rupture at the point of the myocardial infarction for about 6 weeks. Scar tissue should form about that time. Waiting until the client can tolerate climbing stairs is the usual advice given by health care providers.

In a client with COPD, an ineffective cough impedes secretion removal. This, in turn, causes mucus plugging, which leads to localized airway obstruction — a known cause of atelectasis. An ineffective cough doesn’t cause pleural effusion (fluid accumulation in the pleural space). Pulmonary edema usually results from left-sided heart failure, not an ineffective cough. Although many noncardiac conditions may cause pulmonary edema, an ineffective cough isn’t one of them. Oxygen toxicity results from prolonged administration of high oxygen concentrations, not an ineffective cough.

This provides the opportunity for the client to verbalize feelings underlying behavior and helpful in relieving anxiety. Anxiety can be a stressor which can activate the sympathoadrenal response causing the release of catecholamines that can increase cardiac contractility and workload that can further increase myocardial oxygen demand.

Air hunger, also known as dyspnea, is a common symptom of pulmonary edema. Patients may feel like they cannot get enough air, and their breathing may become rapid and shallow. Pulmonary edema occurs when fluid accumulates in the lungs, making it difficult for oxygen to be absorbed into the bloodstream. This can lead to a sensation of breathlessness or difficulty breathing. Slow, deep respirations, stridor, and bradycardia are not typical symptoms of pulmonary edema. Instead, patients with pulmonary edema may exhibit signs such as tachypnea (rapid breathing), tachycardia (rapid heart rate), and cyanosis (bluish discoloration of the skin due to low oxygen levels). The nurse should closely monitor the patient for these symptoms and notify the healthcare provider if the patient's respiratory status worsens. Treatment for pulmonary edema may include medications to remove excess fluid, supplemental oxygen, and other supportive measures to improve respiratory function.

Cardiogenic shock severely impairs the pumping function of the heart muscle, causing diminished blood flow to the organs of the body. This results in diminished brain function and confusion, as well as hypotension, tachycardia, and weak pulse. Cardiogenic shock is a serious complication of myocardial infarction with a high mortality rate.

When administering a continuous intravenous nitroglycerin infusion, it is crucial to use an infusion pump to ensure accurate and controlled dosing. Nitroglycerin is a potent vasodilator used in the treatment of myocardial infarction to help reduce chest pain and improve blood flow to the heart. Due to its potency, careful titration and precise dosing are necessary to avoid adverse effects, such as hypotension or headaches. While monitoring urine output, blood pressure, and serum potassium levels may be important aspects of nursing care for a client with a myocardial infarction, obtaining an infusion pump specifically addresses the administration of the nitroglycerin infusion, which is the focus of this question.

The elevated body temperature observed in this client can be attributed to the inflammatory response triggered by the myocardial infarction. When the heart muscle is damaged, the body's immune system initiates an inflammatory response to repair the injured tissue. This process involves the release of various chemicals and immune cells, which can cause an increase in body temperature, a condition known as fever. Fever is a common systemic response to inflammation and infection. The other options do not accurately explain the presenting adaptations seen in this client. For instance, the chest pain that radiates to the neck, jaw, and shoulders is more likely due to the activation of nerve fibers in the heart, rather than the release of catecholamines at the site of infarction. Diaphoresis (excessive sweating) and decreased blood pressure are often the result of autonomic nervous system activation in response to pain, rather than being directly caused by parasympathetic reflexes or constriction of blood vessels.

The 83-year-old patient has no complicating factors at the moment. Providing care for stable and uncomplicated patients is within the LPN’s educational preparation and scope of practice, with the care always being provided under the supervision and direction of the RN. The RN should assess the newly post-operative patient and the new admission. The patient who is preparing for discharge after MI may need some complex teaching. Focus: Delegation/supervision, assignment

The nurse should prioritize visiting the client with Raynaud's disease first. Raynaud's disease is a condition that affects blood flow to the extremities, leading to reduced blood circulation in response to cold or stress. It can result in color changes, numbness, and pain in the fingers or toes. In some cases, this condition may require immediate attention to assess and address circulation issues.

An automatic internal cardioverter-defibrillator delivers an electric shock to the heart to terminate episodes of ventricular tachycardia and ventricular fibrillation. This is necessary in a patient with significant ventricular symptoms, such as tachycardia resulting in syncope. A patient with myocardial infarction that resolved with no permanent cardiac damage would not be a candidate. A patient recovering well from coronary bypass would not need the device. Atrial tachycardia is less serious and is treated conservatively with medication and cardioversion as a last resort.

Atrial fibrillation (AFib) is a heart condition characterized by irregular and often rapid heartbeats. In AFib, the heart's upper chambers (atria) do not beat effectively, leading to stagnant blood flow and an increased risk of blood clot (thrombus) formation. These clots can travel to the brain, causing a stroke, or to other parts of the body, causing organ damage or pulmonary embolism. While the other options are potential complications of AFib, thrombus formation is the most immediate and significant danger.