Myocardial Infarction By Rnpedia

35 Questions | By Rnpedia | Last updated: Mar 28, 2018 | Total Attempts: 709

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Myocardial Infarction occurs when blood flow to the heart either stops or decreases causing damage to that heart muscle. If you are a student of medicine in need of this type of insight, this is the quiz for you.

Questions and Answers

1.

Tissue plasminogen activator (t-PA) 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.
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.
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.
4.

Which of the following is the most common symptom of myocardial infarction?
- A.
  
  Chest pain
- B.
  
  Dyspnea
- C.
  
  Edema
- D.
  
  Palpitations
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
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.
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 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
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.
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
10.

Jose, who had a myocardial infarction 2 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
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
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
13.

Dr. Marquez orders a continuous intravenous nitroglycerin infusion for the client suffering from myocardial infarction. Which of the following is the most 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
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
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.
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.
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
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.
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.
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. A 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.
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 the:
- A.
  
  Adverse effects of spironolactone (Aldactone)
- B.
  
  Adverse effects of digoxin (Lanoxin)
- C.
  
  Therapeutic effects of propranolol (Indiral)
- D.
  
  Therapeutic effects of furosemide (Lasix)
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
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 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.
24.

On the evening shift, the triage nurse evaluates several clients who were brought to the emergency department. Which in 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
25.

After a myocardial infarction, a client is placed on a sodium restricted diet. When the nurse is 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