Cardiac Nurse Education (66-70)

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66. The nurse is preparing to initiate an intravenous nitroglycerin drip on a client with acute myocardial infarction. In the absence of an invasive (arterial) monitoring line, the nurse prepares to have which piece of equipment for use at the bedside?

a) defibrillator
b) pulse oximeter
c) central venous pressure (CVP) tray
d) noninvasive blood pressure monitor

67. A client is in ventricular tachycardia and the physician orders intravenous (IV) lidocaine (xylocaine). The nurse plans to dilute the concentrated solution of lidocaine with:

a) lactated ringer's
b) normal saline 0.9%
c) 5% dextrose in water
d) normal saline 0.45%

68. A client who recently experienced a myocardial infarction is scheduled to have a percutaneous transluminal coronary angioplasty (PTCA). The nurse plans to teach the client that, during this procedure, a balloon-tipped catheter will:

a) inflate a meshlike device that will spring open
b) be used to compress the plaque against the coronary blood vessel wall
c) cut away the plaque from the coronary vessel wall using a cutting blade
d) be positioned in coronary artery to take pressure measurements in the vessel

69. A nurse is planning care for the client with heart failure. The nurse asks the dietary department to remove which item from all meal trays before delivering them to the client?

a) 1% milk
b) margarine
c) salt packets
d) decaffeinated tea


70. A client has just been admitted to the emergency department with chest pain. Serum enzyme levels are drawn, and the results indicate an elevated serum creatinine kinase (CK)-MB isoenzyme, troponin T, and troponin I. The nurse concludes that these results are compatible with:

a) stable angina
b) unstable angina
c) prinzmetal's angina
d) new-onset myocardial infarction (MI)







Cardiac Nurse Education
Answers and Rationale

66) D

- Nitroglycerin dilates both arteries and veins, causing peripheral blood pooling, thus reducing preload, afterload, and myocardial workload. This action accounts for the primary side effect of nitroglycerin, which is hypotension. In the absence of an arterial monitoring line, the nurse should have a noninvasive blood pressure monitor for use at the bedside.

67) C

- Lidocaine for IV administration is dispensed in concentrated and dilute formulations. The concentrated formulation must be diluted with 5% dextrose in water.

68) B

- In PTCA, a balloon-tipped catheter is used to compress the plaque against the coronary blood vessel wall. Option C describes coronary atherectomy, option A describes placement of a coronary stent, and option D describes part of the process used in cardiac catheterization.

69) C

- Sodium restriction reduces water retention and improves cardiac efficiency. A standard dietary modification for the client with heart failure is sodium restriction.

70) D

- Creatine kinase (CK)-MB isoenzyme is a sensitive indicator of myocardial damage. Levels begin to rise 3 to 6 hours after the onset of chest pain, peak at approximately 24 hours, and return to normal in about 3 days. Troponin is a regulatory protein found in striated muscle (skeletal and myocardial). Increased amounts of troponins are released into the bloodstream when an infarction causes damage to the myocardium. Therefore, the client's results are compatible with new-onset MI. Options A, B, and C all refer to angina. These levels would not be elevated in angina.



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Cardiac Nurse Education (1-5)


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Cardiac Nurse Education (71-75)