Acute Coronary Syndromes: Diagnosis, Management, and Prehospital Care, Exams of Nursing

Download Acute Coronary Syndromes: Diagnosis, Management, and Prehospital Care and more Exams Nursing in PDF only on Docsity!

[ALS - Red Cross] Acute Coronary Syndromes

[Pre-Assessment - 2022]

After screening for potential contraindications, which medications should be administered as initial therapies to the patient with suspected ACS? Correct Answer: 1. Nitroglycerin

2. Aspirin What findings on ECG suggest non-ST-segment elevation ACS (NSTE-ACS)? Correct Answer:
3. ST-segment depression
4. Transient T-wave elevation
5. T-wave inversion Which findings on a 12-lead ECG would be expected in a patient with high-risk non-ST-segment elevation acute coronary syndromes (NSTE-ACS)? Correct Answer: 1. T-wave inversion in two or more contiguous leads
6. ST-segment depression in two or more contiguous leads New ST-segment elevation on a 12-lead ECG suggests __________. Correct Answer: Myocardial infarction When auscultating lung sounds in a patient with left ventricular dysfunction, you will hear _______________________. Correct Answer: crackles Which descriptions of chest pain would be associated with ACS? Correct Answer: 1. Pain that comes and goes
7. Pain that is unrelieved with changes in position
8. Pain that radiates to one or both arms
9. Pain lasting longer than 3 to 5 minutes Patients with low- to intermediate-risk NSTE-ACS may show which changes on an ECG? Correct Answer: 1. No changes
10. Nondiagnostic T-wave changes
11. Nondiagnostic ST-segment changes Which signs and symptoms can indicate myocardial infarction? Correct Answer: 1. Retrosternal chest pain
12. Loss of consciousness
13. Nausea and vomiting
14. Fatigue and weakness In addition to myocardial infarction, which are life-threatening causes of chest pain? Correct Answer: 1. Ruptured esophagus
15. Aortic dissection
16. Pneumothorax
17. Pulmonary embolism

When a patient presents with possible ACS, a 12-or 15-lead ECG should be obtained and interpreted within ______. Correct Answer: 10 minutes What is the dose of nitroglycerin (sublingual tablet or spray) to be administered to a patient suspected of having an acute coronary syndrome? Correct Answer: 0.4 mg every 5 minutes Which conditions contribute to the pathophysiology of ACS? Correct Answer: 1. Vasospasm

2. Development of an occlusive intracoronary thrombus
3. Transient platelet aggregation
4. Plaque erosion What is the ideal time frame for performing percutaneous coronary intervention (PCI) in a patient with STEMI? Correct Answer: Within 1.5 to 2 hours of the patient's arrival at the facility Advance notification of the receiving facility by prehospital providers can improve outcomes for patients with STEMI. Correct Answer: True What diagnostic test is typically obtained at presentation to rule out other causes of acute chest pain and to identify pulmonary congestion? Correct Answer: Chest radiography Cardiac troponin levels should be measured at initial presentation and then ___________ hours later. Correct Answer: 3- What finding on ECG is diagnostic for ST-segment elevation myocardial infarction (STEMI) in a man 40 years or older? Correct Answer: New ST-segment elevation of at least 0.2 mV (≥ 2 mm) at the J point in leads V2 and V For a patient experiencing STEMI, management focuses on early reperfusion therapy with: Correct Answer: 1. Percutaneous coronary intervention (PCI).
5. Fibrinolytic therapy. Intravenous nitroglycerin is used to improve pulmonary edema or hypertension. It should be titrated to maintain a systolic blood pressure that is __________% less than the baseline pressure in patients with blood pressure in the normal range. Correct Answer: wrong: 15, 5 What changes on an ECG suggest ischemia? Correct Answer: 1. ST-segment depression
6. T-wave inversion Which conditions are contraindications to therapy with β-blockers in patients with ACS? Correct Answer: 1. Risk for cardiogenic shock
7. Recent myocardial infarction
8. Low cardiac output
9. Acute heart failure

Physical examination findings in patients with ACS may include which conditions? Correct Answer: 1. Crackles

2. Hypotension
3. Pulmonary edema A patient presents to the emergency department with signs and symptoms suggestive of ACS. The 12-lead ECG shows T-wave inversion of less than 2 mm. To which clinical category would you assign this patient? Correct Answer: Low- or intermediate-risk NSTE-ACS Which interventions are appropriate as part of the primary assessment of a patient with suspected ACS? Correct Answer: 1. Order a 12-lead ECG.
4. Establish pulse oximetry.
5. Obtain vascular access.
6. Establish cardiac monitoring. Which conditions are included in the category of non-ST-segment elevation acute coronary syndromes (NSTE-ACS)? Correct Answer: 1. Non-ST-segment elevation myocardial infarction (NSTEMI)
7. Unstable angina (UA)