Download CAD NCLEX Study Guide Exam and more Exams Nursing in PDF only on Docsity! CAD NCLEX Practice Questions CAD NCLEX Study Guide Exam Practice Questions and Answers 2024. 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 - Answer: Sudden onset of acute chest pain CAD NCLEX Practice Questions 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." - Answer: "Keeping your blood pressure within normal levels will decrease the risk of injury to your arteries." CAD NCLEX Practice Questions Myocardial infarction Stable angina - Answer: Stable angina Stable angina is a predictable form of angina, which usually occurs when the work of the heart is increased by physical exertion, exposure to cold, or stress. Prinzmetal (variant) angina occurs unpredictably and often at night. The client is currently experiencing a predictable form of angina. Clinical manifestations of myocardial infarction include pain that is less predictable, more prolonged, and unrelieved by sublingual nitroglycerin. Clinical manifestations of acute coronary syndrome include pain that is more severe and longer than previously experienced. The pain is not predictable and is unrelieved by sublingual nitroglycerin. A client has constant crushing chest pain rated at 9 out of 10 that began 30 minutes ago and is increasing in intensity. The nurse should recognize the client is at risk for which disorder? Atherosclerosis Coronary artery disease (CAD) Stable angina Myocardial infarction (MI) - Answer: Myocardial infarction (MI) CAD NCLEX Practice Questions Stable angina is the predictable form of chest pain that occurs when the heart is exerted or is exposed to cold or stress. In this case, the angina is unstable, and therefore the client is at increased risk for MI. Atherosclerosis is a long-term illness that would not cause the increasing pain and intensity described by the client. CAD is the cause of chest pain but is not a disorder that develops as a result of it. The nurse is teaching a client about coronary artery disease (CAD). Which response by the client indicates the need for further teaching? "The increased levels of high-density lipoproteins decrease the risk of atherosclerosis." "It decreases quality of life but does not increase a person's risk of death." "Damage to the linings of my arteries can cause clots and blockage." "It is a leading cause of death for men and women in the United States." - Answer: "It decreases quality of life but does not increase a person's risk of death." Coronary artery disease is a leading cause of death for men and women in the United States. A lack of oxygenated blood to the coronary arteries will decrease a client's ability to function and increase their risk of death. High-density lipoproteins attract cholesterol, returning it from peripheral tissues to the liver. CAD NCLEX Practice Questions Endothelial damage causes the body to send platelets to seal the area and leukocytes to fight inflammation. These protective mechanisms also contribute to the formation of fibrous plaque. Fibrous plaque protrudes into the arterial lumen and invades the muscular media layer of the vessel as well as the inner wall of the intima. This results in a decreased ability of the vessel to dilate. The nurse is providing discharge teaching about a cardiac diet to a client following a myocardial infarction. Which client statement indicates that the nurse's teaching has been successful? (Select all that apply.) "I am going to have a roast beef sandwich for lunch." "As soon as I get out of here, I'm going to my favorite steakhouse to celebrate!" "I don't like vegetable oil spread, so I will seek a different healthy butter alternative." "I will continue cooking my food in coconut oil because of its many health benefits." "I am happy that I won't have to give up my almond butter sandwiches!" - Answer: "I am going to have a roast beef sandwich for lunch." "I don't like vegetable oil spread, so I will seek a different healthy butter alternative." CAD NCLEX Practice Questions 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." - Answer: "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 CAD NCLEX Practice Questions 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." - Answer: "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. CAD NCLEX Practice Questions 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. - Answer: 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 CAD NCLEX Practice Questions Respiratory rate changes from 14 to 26 breaths per minute. Blood pressure changes from 120/60 to 218/68 mmHg. Heart rate is consistent at 77 beats/min during exercise. - Answer: Heart rate is consistent at 77 beats/min during exercise. If the client's heart rate changes by more than 20 beats over the resting heart rate, this indicates that the client should stop and rest. Because the client's heart rate only increased moderately from the resting heart rate, there is no need to stop. After an acute myocardial infarction (AMI), a client's level of exercise should be increased as tolerated. The increases in the blood pressure and breathing rate, and the decrease in O2 saturation are normal during exercise, but excessive changes could mean that the client is not tolerating the activity. A client diagnosed with atherosclerosis asks the nurse, "What can I do to improve my condition?" Which response by the nurse is best? "You should eat a diet with a minimum of 40% fat." "You should decrease your smoking by one pack per day." "You should exercise five or six times a week for 30 minutes." CAD NCLEX Practice Questions "You should take statins as prescribed by your healthcare provider." - Answer: "You should exercise five or six times a week for 30 minutes." Conservative treatment would include regular physical exercise such as walking at a brisk pace. Fat should be no more than 35% of the daily diet. The Pritikin diet has a beneficial effect on coronary heart disease and recommends less than 10% fat. Smoking should be totally eliminated, usually through a cessation program or the use of assistive drugs such as nicotine patches. By controlling cholesterol, the client can help control coronary artery disease (CAD), but this will begin with lifestyle changes before medication such as statins are added. The nurse is assessing a client who started a statin medication. Which finding is most concerning? Generalized muscular tenderness and pain Nausea when taking the medicine before a meal Small skin rash on the right arm Dizziness when changing positions quickly - Answer: Generalized muscular tenderness and pain Muscular tenderness and pain might indicate myopathy and rhabdomyolysis, which can cause acute kidney injury and death in some clients. These symptoms CAD NCLEX Practice Questions indicate to the nurse that the statin may need to be discontinued. The rash and nausea are common side effects of taking statins, and although the nurse should follow up with the healthcare provider, they do not indicate that a change in medication is needed. Dizziness is not a side effect of statins. The nurse is caring for a mildly obese older adult client with coronary artery disease. Which action should the nurse take to encourage additional physical activity in this client? Teaching the client to warm up, stretch, and cool down before and after all physical activities Asking the client what kind of exercise or activities she likes to do Telling the client that moderate exercise can lead to 2 pounds of weight loss per week Telling the client that older adults should exercise no more than 15 minutes at a time - Answer: Asking the client what kind of exercise or activities she likes to do Clients are more likely to be motivated to increase physical activities that they already like to do, so the nurse should ask about their preferences. The benefits of weight loss should be emphasized instead of how much weight will be lost, especially in an older, obese client. Older adults should get 30 minutes of