CAD NCLEX PRACTICE QUESTIONS LATEST UPDATE 2024/2025 WITH 100% VERIFIED ANSWERS, Exams of Health sciences

Download CAD NCLEX PRACTICE QUESTIONS LATEST UPDATE 2024/2025 WITH 100% VERIFIED ANSWERS and more Exams Health sciences in PDF only on Docsity! CAD NCLEX PRACTICE QUESTIONS LATEST UPDATE 2024/2025 WITH 100% VERIFIED ANSWERS Which client reaction should the nurse expect during a coronary artery spasm? Acute reduction in level of consciousness Gradual increase in peripheral edema Gradual increase in systolic blood pressure Sudden onset of acute chest pain Sudden onset of acute chest pain The nurse should expect a sudden onset of acute chest pain from a coronary artery spasm, which is characteristic of Prinzmetal angina, in which there is an acute reduction in coronary blood flow. An acute reduction in level of consciousness indicates neurologic involvement. A gradual increase in peripheral edema is a sign of heart failure. A gradual increase in systolic blood pressure can have multiple causes. A client who has a strong family history of coronary artery disease asks the nurse, "How can I decrease my chances of developing problems with my arteries?" Which response by the nurse is appropriate? (Select all that apply.) "Keeping your blood pressure within normal levels will decrease the risk of injury to your arteries." "A diet high in fruits, vegetables, and unsaturated fatty acids may help protect your arteries." "You can reduce your risk by making some changes in your lifestyle, such as moderate exercise." "As long as your cholesterol is normal, your arteries will remain clear." "There is little you can do except take medication to prevent coronary artery disease." "Keeping your blood pressure within normal levels will decrease the risk of injury to your arteries." "A diet high in fruits, vegetables, and unsaturated fatty acids may help protect your arteries." "You can reduce your risk by making some changes in your lifestyle, such as moderate exercise." The causes of atherosclerosis are not known, but research has shown a connection with modifiable risk factors such as cholesterol, triglycerides, lack of exercise, smoking, obesity, blood pressure, diet, stress, and diabetes. Elevated cholesterol is only one of the factors that can contribute to the development of plaque in the arteries. Excessive pressures within the arterial system can cause injury to the arterial endothelium. Endothelial damage promotes platelet adhesion and aggregation and attracts leukocytes to the area. Risk factors such as age, gender, and heredity cannot be modified. The exact cause is unclear, but it is believed that fruits, vegetables, whole grains, and unsaturated fatty acids have nutrients that help protect the arteries from injury. The nurse is assessing a client who has a possible myocardial infarction (MI). Which finding is consistent with this diagnosis? (Select all that apply.) Vomiting ST segment depression Q wave changes Anxiety Tachypnea Vomiting Q wave changes Anxiety Tachypnea Clinical manifestations of a myocardial infarction (MI) include tachypnea, anxiety, vomiting, and electrocardiogram (ECG) changes in the Q wave. A client experiencing an MI would experience ST segment elevation, not depression. The nurse is caring for a client with a history of atherosclerosis. The client has chest pain that occurs with physical exertion or stress and is relieved with sublingual nitroglycerin. Which disorder should the nurse recognize the client is most likely experiencing? Prinzmetal angina Acute coronary syndrome Myocardial infarction Diabetes affects the tissue that lines the blood vessels, making way for diseases like atherosclerosis. Family history of CAD is a strong indicator for the development of heart-related problems. Stopping smoking will increase high-density lipoprotein (HDL) levels and help prevent the development of coronary artery disease (CAD). Walk for 30 minutes five or six times a week to lower LDL and triglycerides and to raise HDL levels. Stopping smoking will increase high-density lipoprotein (HDL) levels and help prevent the development of coronary artery disease (CAD). Stopping smoking and walking for 30 minutes several times a week represents modifiable risk factors for CAD. Clients can make lifestyle changes in these areas to decrease their risk for developing CAD. Smoking cessation improves HDL levels and lowers LDL levels and also improves the viscosity of blood, so clients should be encouraged to quit smoking. Regular physical exercise lowers very low-density lipoprotein (VLDL), LDL, and triglyceride levels, and it raises HDL levels. Clients are encouraged to participate in 30 minutes of exercise five or six times a week. While understanding about menopause and its associated symptoms is important, it is not information that can be used to effectively change the risk of CAD. Family history is not modifiable and cannot help with needed lifestyle changes. Although understanding the effects of diabetes is also important, it is not an effect of lifestyle change to decrease the risk of CAD. The school nurse is a guest speaker in a high school health class talking about coronary artery disease (CAD). Which statement by the nurse is most beneficial to include in the presentation? "If you eat healthy foods you can keep the levels of fat in your bloodstream low, which will minimize your risk of CAD." "It is much better to learn to prevent CAD, rather than to pay for the related treatments and surgeries." "CAD is the leading cause of death in both men and women, which means that all of you are at risk." "Some of the things that you can do now to minimize your risk of CAD are avoid fatty food, be active, and do not smoke." "Some of the things that you can do now to minimize your risk of CAD are avoid fatty food, be active, and do not smoke." In this case, it is important for the nurse to highlight the changes that are most easily achievable by the high school audience. Although excess lipids in the bloodstream can contribute to the development of CAD, it is not enough to say that eating healthy foods will keep lipid levels low. Further, high school students are unlikely to be convinced by the cost of CAD care. Telling students that they are all at risk is also unlikely to motivate them to be proactive in avoiding CAD. By warning high school students about their predispositions to the disease and advising them of the modifications they can make to avoid it, the audience is much more likely to be receptive to the information. The nurse is teaching a client with coronary artery disease about the therapeutic lifestyle changes (TLC) diet. Which client statement indicates that more teaching is needed? "I will miss having avocado slices on toast for breakfast." "I will be able to have a glass of red wine with dinner." "I will switch from whole milk to 2% milk." "I will use olive oil to cook with instead of butter." "I will miss having avocado slices on toast for breakfast." Even though 25-35% of a person's daily calorie consumption should come from fat, the TLC diet recommends monounsaturated fats as a person's source of fat. These are found in nuts, olive oil, avocado, and canola oil. Avocados are high in monounsaturated fat, so the client does not have to give up avocados. Switching to lower-fat milk is indicated for this client, as is using olive oil to cook instead of butter. There is research that indicates a benefit to consuming moderate alcohol on the TLC diet. The nurse is planning to teach a client about coronary angiography. Which information should the nurse include? (Select all that apply.) There will be a flushing sensation while the dye is injected during the procedure. You will not be able to eat or drink for several hours after the procedure. You will need to remain in bed with your leg straight after the procedure. Pulses on your feet will need to be checked frequently after the procedure. Pressure will be applied to the insertion site after the procedure. There will be a flushing sensation while the dye is injected during the procedure. You will need to remain in bed with your leg straight after the procedure. Pulses on your feet will need to be checked frequently after the procedure. Pressure will be applied to the insertion site after the procedure. A coronary angiogram, obtained through a procedure known as cardiac catheterization, is a radiographic study of the circulation of the coronary arteries. The client will be on bedrest for up to 8 hours after the procedure with his leg straight, and pedal pulses will be checked every 15 minutes following the procedure. There will be a flushing sensation while the dye is injected during the procedure. After the procedure, the client will have pressure applied to the insertion site when the sheath is removed. Food and drink are allowed as tolerated. The nurse suspects that a client is having a myocardial infarction (MI). Which diagnostic test should the nurse anticipate will be ordered? Troponin Brain natriuretic peptide (BNP) Complete blood count (CBC) Ankle-brachial blood pressure index (ABI) Troponin When the healthcare provider believes that a client has experienced a myocardial infarction (MI), diagnostic tests will include cardiac markers, including a troponin test, which measures the levels of troponin T or troponin I proteins in the blood. These proteins are released when the heart muscle has been damaged. Additional tests would include a CPK and CK-MB and an electrocardiogram (ECG). A CBC and BNP will not be useful to confirm the diagnosis of an MI. An ABI tests for peripheral vascular disease that may predict coronary artery disease (CAD), so it is not relevant to the diagnosis of an MI. The nurse is teaching a client about best practices in managing symptoms of coronary artery disease. Which client statement suggests that the nurse's teaching has been successful? "I will take salicylic acid every day to increase blood flow to my heart." "I will stop taking Lipitor every day in order to decrease my cholesterol." "Ibuprofen will help to increase blood flow to my heart." "I should take a pain reliever every day for my chest pain." "I will take salicylic acid every day to increase blood flow to my heart." To increase the client's blood flow, one goal is to prevent the aggregation of platelets in the arteries. Salicylic acid (aspirin) is a pharmacologic measure to control the aggregation. Statins such as atorvastatin (Lipitor) are used to decrease cholesterol and would be a part of the client's protocol unless the client "It's normal to feel anxious after what you have been through." "What specific questions can I answer about your recovery?" "Tell me more about what you are worried about." "Your body language is telling me something is wrong." "What specific questions can I answer about your recovery?" "Tell me more about what you are worried about." It is important for the nurse to encourage self-care; the client's confidence increases as his dependence on others decreases. Encouraging questions helps provide information and relieve fears when the client may have been reluctant to ask. Telling the client how that his feelings are normal is dismissing how he feels. Acknowledge the client's feelings and encourage expression of those feelings and fears. It is imperative the nurse be able to identify the client's fear using both verbal and nonverbal clues. A female client is undergoing diagnostic testing for coronary heart disease. The nurse should assess for which symptoms that are indicative of heart disease? (Select all that apply.) Headache Insomnia Chronic fatigue Indigestion Abdominal fullness Chronic fatigue Indigestion Abdominal fullness Women may not have chest pain but may feel discomfort or indigestion. They often present with a triad of symptoms -indigestion or feeling of abdominal fullness, feeling of chronic fatigue despite adequate rest, and feeling unable to catch their breath. Insomnia and headache are not indicative of heart disease. The nurse is monitoring a client who is undergoing an exercise stress test on a treadmill. Which assessment finding requires the most rapid action by the nurse? ST segment elevation on the electrocardiogram (ECG) monitor Blood pressure increase from 134/68 to 150/80 mmHg Pulse change from 80 to 92 beats per minute Client complaint of feeling tired ST segment elevation on the electrocardiogram (ECG) monitor ECG changes such as ST segment elevation are associated with a myocardial infarction (MI), indicating that the myocardium is not getting adequate oxygen delivery and that the exercise test should be terminated immediately. Increases in both blood pressure and heart rate are normal responses to aerobic exercise. Tiredness is also normal.