Chapter 28- Management of Patients With Coronary Vascular Disorders
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Chapter 28- Management of Patients With Coronary Vascular Disorders

Course Number: NRSG 1, Spring 2012

College/University: National University of...

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Brunner: Medical-Surgical Nursing, 11th Edition Test Bank Chapter 28: Management of Patients With Coronary Vascular Disorders Multiple Choice 1. A patient is diagnosed as having elevated cholesterol level. The nurse is aware that plaque on the inner lumen of arteries is composed chiefly of: A) Lipids and fibrous tissue B) WBCs C) Lipoproteins D) High-density cholesterol Ans: A Chapter: 28 Cognitive Level:...

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Medical-Surgical Brunner: Nursing, 11th Edition Test Bank Chapter 28: Management of Patients With Coronary Vascular Disorders Multiple Choice 1. A patient is diagnosed as having elevated cholesterol level. The nurse is aware that plaque on the inner lumen of arteries is composed chiefly of: A) Lipids and fibrous tissue B) WBCs C) Lipoproteins D) High-density cholesterol Register to View AnswerChapter: 28 Cognitive Level: Comprehension Difficulty: Easy Integrated Process: Nursing Process Objective: 1 Patient Needs: D-4 Feedback: As T lymphocytes and monocytes infiltrate to ingest lipids on the arterial wall and then die, a fibrous tissue develops. This causes plaques to form on the inner lumen of arterial walls. 2. The coronary arteries are susceptible to development of arteriosclerosis because coronary arteries: A) Are smaller in diameter B) Accumulate more low-density cholesterol C) Have numerous twist and turns D) Have a decreased pulse pressure Register to View AnswerChapter: 28 Cognitive Level: Knowledge Difficulty: Easy Integrated Process: Nursing Process Objective: 1 Patient Needs: D-4 Feedback: Due to the need of the coronary arteries to supply blood to the heart, they have many twists and turns, creating more sites susceptible to developing atheroma. 3. An adult patient who experiences angina pectoris with exertion is informed by the nurse that most often angina is caused by: A) Smoking B) Inadequate cardiac output C) Infarction of the myocardium D) Coronary arteriosclerosis Register to View AnswerChapter: 28 Cognitive Level: Application Difficulty: Moderate Integrated Process: Teaching/Learning Objective: 2 Patient Needs: D-4 Feedback: In most cases, angina pectoris is due to arteriosclerosis, particularly in older patients. Smoking, hypertension, high cholesterol levels, and diabetes mellitus are all associated with coronary arteriosclerosis. 4. The nurse is teaching a 45-year-old patient about ways to lower elevated cholesterol levels. One method to lower cholesterol levels is to exercise, which: A) Increases HDL and decreases triglycerides B) Increases LDL and decreases triglycerides C) Decreases HDL and increases LDL D) Decreases both HDL and LDL Register to View AnswerChapter: 28 Cognitive Level: Application Difficulty: Moderate Integrated Teaching/Learning Objective: Process: 1 Patient Needs: B-2 Feedback: Moderate exercise increases HDL levels, which assists in lowering LDL levels. Exercise also decreases triglyceride levels. 5. A patient angina with pectoris secondary to atherosclerotic disease asks why he experiences chest pain with exertion. The nurse informs him that exertion: A) Increases the heart's oxygen demands B) Causes vasoconstriction of the heart C) Increases blood flow to the mesenteric area D) Reduces the effectiveness of medications Register to View AnswerChapter: 28 Cognitive Level: Application Difficulty: Moderate Integrated Process: Teaching/Learning Objective: 2 Patient Needs: D-4 Feedback: Physical exertion increases the myocardial oxygen demand. If the patient has arteriosclerosis of the coronary arteries, blood supply is diminished to the myocardium. 6. To relieve angina pectoris symptoms, the nurse administers nitroglycerin sublingual to the patient. Which of the following is an action of nitroglycerin? A) Decreases myocardial oxygen consumption B) Causes venous constriction C) Decreases collateral circulation in the heart D) Causes arterial constriction Register to View AnswerChapter: 28 Cognitive Level: Application Difficulty: Moderate Integrated Process: Nursing Process Objective: 2 Patient Needs: D-2 Feedback: Nitrates decrease myocardial oxygen consumption to decrease ischemia and relieve pain. The veins, and in higher doses the arteries, are also dilated. It also increases perfusion through the collateral vessels. 7. An adult patient has symptoms of unstable angina during admission to the hospital. The most appropriate nursing diagnosis for the discomfort associated with angina is: A) Deficient knowledge about underlying disease and methods for avoiding complications B) Anxiety related to fear of death C) Ineffective cardiopulmonary tissue perfusion secondary to CAD, as evidenced by chest pain D) Noncompliance related to failure to accept necessary lifestyle changes Register to View AnswerChapter: 28 Cognitive Level: Application Difficulty: Moderate Integrated Process: Nursing Process Objective: 3 Patient Needs: D-4 Feedback: Ineffective cardiopulmonary tissue perfusion explains the symptoms of discomfort associated with angina.

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