Myocardial Infarction MCQs Quiz With Answers
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Do you understand myocardial infarction and all the emergencies related to it? To check your understanding, try this myocardial infarction MCQs with answers. Otherwise and commonly known as a heart attack, Myocardial Infarction, abbreviated as MI, is when the blood decreases in the heart and stops. How much do you know about this cardiac condition? Take this quiz to find out. Here, you can test your knowledge as well as learn new things about this situation. Do share the quiz with other medical people so that they can test their knowledge also.
Myocardial Infarction Questions and Answers
- 1.
Tissue plasminogen activator (tPA) is considered for treatment of a patient who arrives in the emergency department following onset of symptoms of myocardial infarction. Which of the following is a contraindication for treatment with t-PA?
- A.
Worsening chest pain that began earlier in the evening.
- B.
History of cerebral hemorrhage.
- C.
History of prior myocardial infarction.
- D.
Hypertension.
Correct Answer
B. History of cerebral hemorrhage.Explanation
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.Rate this question:
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- 2.
Following myocardial infarction, a hospitalized patient is encouraged to practice frequent leg exercises and ambulate in the hallway as directed by his physician. Which of the following choices reflects the purpose of exercise for this patient?
- A.
Increases fitness and prevents future heart attacks.
- B.
Prevents bedsores.
- C.
Prevents DVT (deep vein thrombosis).
- D.
Prevent constipations.
Correct Answer
C. Prevents DVT (deep vein thrombosis).Explanation
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.Rate this question:
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- 3.
A patient arrives in the emergency department with symptoms of myocardial infarction, progressing to cardiogenic shock. Which of the following symptoms should the nurse expect the patient to exhibit with cardiogenic shock?
- A.
Hypertension.
- B.
Bradycardia.
- C.
Bounding pulse.
- D.
Confusion.
Correct Answer
D. Confusion.Explanation
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.Rate this question:
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- 4.
Which of the following is the most common symptom of myocardial infarction?
- A.
Chest pain
- B.
Dyspnea
- C.
Edema
- D.
Palpitations
Correct Answer
A. Chest painExplanation
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.Rate this question:
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- 5.
What is the primary reason for administering morphine to a client with myocardial infarction?
- A.
To sedate the client
- B.
To decrease the client's pain
- C.
To decrease the client's anxiety
- D.
To decrease oxygen demand on the client's heart
Correct Answer
D. To decrease oxygen demand on the client's heartExplanation
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.Rate this question:
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- 6.
A male client with chronic obstructive pulmonary disease (COPD) is recovering from a myocardial infarction. Because the client is extremely weak and can’t produce an effective cough, the nurse should monitor closely for:
- A.
Pleural effusion.
- B.
Pulmonary edema.
- C.
Atelectasis.
- D.
Oxygen toxicity.
Correct Answer
C. Atelectasis.Explanation
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.Rate this question:
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- 7.
A client with a history of an anterior wall myocardial infarction is being transferred from the coronary care unit (CCU) to the cardiac stepdown unit (CSU). While giving a report to the CSU nurse, the CCU nurse says, “His pulmonary artery wedge pressures have been in the high normal range.” The CSU nurse should be especially observant for:
- A.
Hypertension
- B.
High urine output
- C.
Dry mucous membranes
- D.
Pulmonary crackles
Correct Answer
D. Pulmonary cracklesExplanation
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.Rate this question:
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- 8.
Alzheimer’s disease is the secondary diagnosis of a client admitted with myocardial infarction. Which nursing intervention should appear on this client’s plan of care?
- A.
Perform activities of daily living for the client to decease frustration.
- B.
Provide a stimulating environment.
- C.
Establish and maintain a routine.
- D.
Try to reason with the client as much as possible.
Correct Answer
C. Establish and maintain a routine.Explanation
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.Rate this question:
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- 9.
An early finding in the EKG of a client with an infarcted mycardium would be:
- A.
Disappearance of Q waves
- B.
Elevated ST segments
- C.
Absence of P wave
- D.
Flattened T waves
Correct Answer
B. Elevated ST segmentsExplanation
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.Rate this question:
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- 10.
Jose, who had a myocardial infarction two days earlier, has been complaining to the nurse about issues related to his hospital stay. The best initial nursing response would be to:
- A.
Allow him to release his feelings and then leave him alone to allow him to regain his composure
- B.
Refocus the conversation on his fears, frustrations and anger about his condition
- C.
Explain how his being upset dangerously disturbs his need for rest
- D.
Attempt to explain the purpose of different hospital routines
Correct Answer
B. Refocus the conversation on his fears, frustrations and anger about his conditionExplanation
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.Rate this question:
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- 11.
Twenty four hours after admission for an Acute MI, Jose’s temperature is noted at 39.3 C. The nurse monitors him for other adaptations related to the pyrexia, including:
- A.
Shortness of breath
- B.
Chest pain
- C.
Elevated blood pressure
- D.
Increased pulse rate
Correct Answer
D. Increased pulse rateExplanation
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.Rate this question:
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- 12.
Patrick who is hospitalized following a myocardial infarction, asks the nurse why he is taking morphine. The nurse explains that morphine:
- A.
Decrease anxiety and restlessness
- B.
Prevents shock and relieves pain
- C.
Dilates coronary blood vessels
- D.
Helps prevent fibrillation of the heart
Correct Answer
B. Prevents shock and relieves painExplanation
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.Rate this question:
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- 13.
Dr. Marquez orders a continuous intravenous nitroglycerin infusion for the client suffering from myocardial infarction. Which of the following is the essential nursing action?
- A.
Monitoring urine output frequently
- B.
Monitoring blood pressure every 4 hours
- C.
Obtaining serum potassium levels daily
- D.
Obtaining infusion pump for the medication
Correct Answer
D. Obtaining infusion pump for the medicationExplanation
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.Rate this question:
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- 14.
During the second day of hospitalization of the client after a Myocardial Infarction. Which of the following is an expected outcome?
- A.
Able to perform self-care activities without pain
- B.
Severe chest pain
- C.
Can recognize the risk factors of Myocardial Infarction
- D.
Can participate in cardiac rehabilitation walking program
Correct Answer
A. Able to perform self-care activities without painExplanation
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.Rate this question:
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- 15.
A 42-year-old client admitted with an acute myocardial infarction asks to see his chart. What should the nurse do first?
- A.
Allow the client to view his chart
- B.
Contact the supervisor and physician for approval
- C.
Ask the client if he has concerns about his care
- D.
Tell the client that he isn't permitted to view his chart.
Correct Answer
C. Ask the client if he has concerns about his careExplanation
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.Rate this question:
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- 16.
Nurse Betty is assigned to the following clients. The client that the nurse would see first after endorsement?
- A.
A 34 year-old post operative appendectomy client of five hours who is complaining of pain.
- B.
A 44 year-old myocardial infarction (MI) client who is complaining of nausea.
- C.
A 26 year-old client admitted for dehydration whose intravenous (IV) has infiltrated.
- D.
A 63 year-old post operative’s abdominal hysterectomy client of three days whose incisional dressing is saturated with serosanguinous fluid.
Correct Answer
B. A 44 year-old myocardial infarction (MI) client who is complaining of nausea.Explanation
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.Rate this question:
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- 17.
In order to be effective, Percutaneous Transluminal Coronary Angioplasty (PTCA) must be performed within what time frame, beginning with arrival at the emergency department after diagnosis of myocardial infarction?
- A.
60 minutes
- B.
30 minutes
- C.
9 days
- D.
6-12 months
Correct Answer
A. 60 minutesExplanation
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.Rate this question:
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- 18.
Mr. Duffy is admitted to the CCU with a diagnosis of R/O MI. He presented in the ER with a typical description of pain associated with an MI and is now cold and clammy, pale, and dyspneic. He has an IV of D5W running and is complaining of chest pain. Oxygen therapy has not been started, and he is not on the monitor. He is frightened. During the first three days that Mr. Duffy is in the CCU, a number of diagnostic blood tests are obtained. Which of the following patterns of cardiac enzyme elevation are most common following an MI?
- A.
SGOT, CK, and LDH are all elevated immediately.
- B.
SGOT rises 4-6 hours after infarction with CK and LDH rising slowly 24 hours later.
- C.
CK peaks first (12-24 hours), followed by the SGOT (peaks in 24-36 hours) and then the LDH (peaks 3-4 days).
- D.
CK peaks first and remains elevated for 1 to 2 weeks.
Correct Answer
C. CK peaks first (12-24 hours), followed by the SGOT (peaks in 24-36 hours) and then the LDH (peaks 3-4 days).Explanation
Following a myocardial infarction, cardiac enzymes are released into the bloodstream as a result of heart muscle damage. The pattern of enzyme elevation can help confirm the diagnosis and provide insight into the timing of the infarction. The most common pattern of enzyme elevation is as follows:Creatine kinase (CK) rises within 4-6 hours after the onset of chest pain, peaks within 12-24 hours, and returns to normal within 2-3 days.Aspartate aminotransferase (AST, formerly known as SGOT) rises within 6-8 hours, peaks within 24-36 hours, and returns to normal within 3-4 days.Lactate dehydrogenase (LDH) rises within 8-12 hours, peaks within 3-4 days, and returns to normal within 7-10 days.It is important to note that the pattern of enzyme elevation can vary depending on the individual patient and the extent of heart muscle damage. Other cardiac markers, such as troponin, may also be used in conjunction with these enzymes to diagnose and assess the severity of a myocardial infarction.Rate this question:
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- 19.
Which statement best describes the difference between the pain of angina and the pain of myocardial infarction?
- A.
Pain associated with angina is relieved by rest.
- B.
Pain associated with myocardial infarction is always more severe.
- C.
Pain associated with angina is confined to the chest area.
- D.
Pain associated with myocardial infarction is referred to the left arm.
Correct Answer
A. Pain associated with angina is relieved by rest.Explanation
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.Rate this question:
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- 20.
A 55-year-old client is admitted with chest pain that radiates to the neck, jaw, and shoulders that occurs at rest, with high body temperature, weak with generalized sweating, and with decreased blood pressure. Myocardial infarction is diagnosed. The nurse knows that the most accurate explanation for one of these presenting adaptations is:
- A.
Catecholamines released at the site of the infarction causes intermittent localized pain.
- B.
Parasympathetic reflexes from the infarcted myocardium causes diaphoresis.
- C.
Constriction of central and peripheral blood vessels causes a decrease in blood pressure.
- D.
Inflammation in the myocardium causes a rise in the systemic body temperature.
Correct Answer
D. Inflammation in the myocardium causes a rise in the systemic body temperature.Explanation
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.Rate this question:
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- 21.
The client with an acute myocardial infarction is hospitalized for almost one week. The client experiences nausea and loss of appetite. The nurse caring for the client recognizes that these symptoms may indicate.
- A.
Adverse effects of spironolactone (Aldactone)
- B.
Adverse effects of digoxin (Lanoxin)
- C.
Therapeutic effects of propranolol (Indiral)
- D.
Therapeutic effects of furosemide (Lasix)
Correct Answer
B. Adverse effects of digoxin (Lanoxin)Explanation
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.Rate this question:
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- 22.
The nurse should visit which of the following clients first?
- A.
The client with diabetes with a blood glucose of 95mg/dL
- B.
The client with hypertension being maintained on Lisinopril
- C.
The client with hypertension being maintained on Lisinopril
- D.
The client with Raynaud’s disease
Correct Answer
D. The client with Raynaud’s diseaseExplanation
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.Rate this question:
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- 23.
Nurse Patricia finds a female client who is post-myocardial infarction (MI) slumped on the side rails of the bed and unresponsive to shaking or shouting. Which is the nurse's next action?
- A.
Call for help and note the time.
- B.
Clear the airway
- C.
Give two sharp thumps to the precordium, and check the pulse.
- D.
Administer two quick blows.
Correct Answer
A. Call for help and note the time.Explanation
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.Rate this question:
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- 24.
On the evening shift, the triage nurse evaluates several clients who were brought to the emergency department. Which of the following clients should receive highest priority?
- A.
An elderly woman complaining of a loss of appetite and fatigue for the past week
- B.
A football player limping and complaining of pain and swelling in the right ankle
- C.
A 50-year-old man, diaphoretic and complaining of severe chest pain radiating to his jaw
- D.
A mother with a 5-year-old boy who says her son has been complaining of nausea and vomited once since noon
Correct Answer
C. A 50-year-old man, diaphoretic and complaining of severe chest pain radiating to his jawExplanation
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.Rate this question:
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- 25.
After a myocardial infarction, a client is placed on a sodium-restricted diet. When is the nurse teaching the client about the diet, which meal plan would be the most appropriate to suggest?
- A.
3 oz. broiled fish, 1 baked potato, ½ cup canned beets, 1 orange, and milk
- B.
3 oz. canned salmon, fresh broccoli, 1 biscuit, tea, and 1 apple
- C.
A bologna sandwich, fresh eggplant, 2 oz fresh fruit, tea, and apple juice
- D.
3 oz. turkey, 1 fresh sweet potato, 1/2 cup fresh green beans, milk, and 1 orange
Correct Answer
D. 3 oz. turkey, 1 fresh sweet potato, 1/2 cup fresh green beans, milk, and 1 orangeExplanation
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.Rate this question:
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- 26.
A patient admitted to the hospital with myocardial infarction develops severe pulmonary edema. Which of the following symptoms should the nurse expect the patient to exhibit?
- A.
Slow, deep respirations.
- B.
Stridor.
- C.
Bradycardia.
- D.
Air hunger.
Correct Answer
D. Air hunger.Explanation
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.Rate this question:
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- 27.
A nurse caring for several patients in the cardiac unit is told that one is scheduled for implantation of an automatic internal cardioverter-defibrillator. Which of the following patients is most likely to have this procedure?
- A.
A patient admitted for myocardial infarction without cardiac muscle damage.
- B.
A post-operative coronary bypass patient, recovering on schedule.
- C.
A patient with a history of ventricular tachycardia and syncopal episodes.
- D.
A patient with a history of atrial tachycardia and fatigue.
Correct Answer
A. A patient admitted for myocardial infarction without cardiac muscle damage.Explanation
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.Rate this question:
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- 28.
Which patient’s nursing care would be most appropriate for the charge nurse to assign to the LPN under the supervision of the RN team leader?
- A.
A 51-year-old patient with bilateral adrenalectomy just returned from the post-anesthesia care unit
- B.
An 83-year-old patient with type 2 diabetes and chronic obstructive pulmonary disease
- C.
A 38-year-old patient with myocardial infarction who is preparing for discharge
- D.
A 72-year-old patient admitted from long-term care with mental status changes
Correct Answer
B. An 83-year-old patient with type 2 diabetes and chronic obstructive pulmonary diseaseExplanation
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, assignmentRate this question:
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- 29.
The nurse is giving discharge teaching to a client seven days post-myocardial infarction. He asks the nurse why he must wait six weeks before having sexual intercourse. What is the best response by the nurse to this question?
- A.
"You need to regain your strength before attempting such exertion."
- B.
"When you can climb 2 flights of stairs without problems, it is generally safe.”
- C.
"Have a glass of wine to relax you, then you can try to have sex."
- D.
"If you can maintain an active walking program, you will have less risk."
Correct Answer
B. "When you can climb 2 flights of stairs without problems, it is generally safe.”Explanation
"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.Rate this question:
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- 30.
A 23-year-old patient in the 27th week of pregnancy has been hospitalized on complete bed rest for 6 days. She experiences sudden shortness of breath, accompanied by chest pain. Which of the following conditions is the most likely cause of her symptoms?
- A.
Myocardial infarction due to a history of atherosclerosis.
- B.
Pulmonary embolism due to deep vein thrombosis (DVT).
- C.
Anxiety attack due to worries about her baby's health.
- D.
Congestive heart failure due to fluid overload.
Correct Answer
B. Pulmonary embolism due to deep vein thrombosis (DVT).Explanation
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.Rate this question:
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- 31.
Helen, a nurse from the maternity unit, is floated to the critical care unit because of a staff shortage on the evening shift. Which client would be appropriate to assign to this nurse? A client with:
- A.
Dopamine drip IV with vital signs monitored every 5 minutes
- B.
A myocardial infarction that is free from pain and dysrhythmias
- C.
A tracheotomy of 24 hours in some respiratory distress
- D.
A pacemaker inserted this morning with intermittent capture
Correct Answer
B. A myocardial infarction that is free from pain and dysrhythmiasExplanation
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.Rate this question:
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- 32.
To prevent a Valsalva maneuver in a client recovering from an acute myocardial infarction, the nurse would
- A.
Assist the client to use the bedside commode
- B.
Administer stool softeners every day as ordered
- C.
Administer antidysrhythmics prn as ordered
- D.
Maintain the client on strict bed rest
Correct Answer
B. Administer stool softeners every day as orderedExplanation
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.Rate this question:
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- 33.
A female client is brought by ambulance to the hospital emergency room after taking an overdose of barbiturates and is comatose. Nurse Trish would be especially alert for which of the following?
- A.
Epilepsy
- B.
Myocardial Infarction
- C.
Renal failure
- D.
Respiratory failure
Correct Answer
D. Respiratory failureExplanation
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.Rate this question:
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- 34.
Nursing measures for the client who has had an MI include helping the client avoid activity that results in Valsalva’s maneuver. Valsalva’s maneuver may cause cardiac dysrhythmias, increased venous pressure, increased intrathoracic pressure, and thrombi dislodgement. Which of the following actions would help prevent Valsalva’s maneuver? Have the client:
- A.
Assume a side-lying position
- B.
Clench her teeth while moving in bed
- C.
Drink fluids through a straw
- D.
Avoid holding her breath during activity
Correct Answer
D. Avoid holding her breath during activityExplanation
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.Rate this question:
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- 35.
The greatest danger of uncorrected atrial fibrillation for a male patient will be which of the following:
- A.
Pulmonary embolism
- B.
Cardiac arrest
- C.
Thrombus formation
- D.
Myocardial infarction
Correct Answer
C. Thrombus formationExplanation
Uncorrected atrial fibrillation in a male patient can lead to the greatest danger of thrombus formation. Atrial fibrillation causes the atria to quiver instead of contracting properly, which can result in blood pooling in the atria. This stagnant blood can form clots or thrombi. If a clot dislodges and travels to the brain, it can cause a stroke. Therefore, thrombus formation is the greatest danger associated with uncorrected atrial fibrillation in a male patient.Rate this question:
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Mar 13, 2024Quiz Edited by
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May 03, 2015Quiz Created by
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