Question 1

A nurse is discussing fibrinolytic therapy for the acute phase of STEMI management with a group of nursing students. Which statement by a student indicates understanding of this therapy?

Accepted Answer

A)   "Fibrinolytics are effective when the first dose is given up to 24 hours after symptom onset."
B)   "Fibrinolytics should be given once cardiac troponins reveal the presence of STEMI."
C)   "Fibrinolytics should be used with caution in patients with a history of cerebrovascular accident."
D)   "Patients should receive either an anticoagulant or an antiplatelet agent with a fibrinolytic drug."E) None of the above
F) C) and D) C

Question 2

A patient arrives in the emergency department complaining of chest pain that has lasted longer than 1 hour and is unrelieved by nitroglycerin. The patient's electrocardiogram reveals elevation of the ST segment. Initial cardiac troponin levels are negative. The patient is receiving oxygen via nasal cannula. Which drug should be given immediately?

Accepted Answer

A)   Aspirin 325 mg chewable
B)   Beta blocker given IV
C)   Ibuprofen 400 mg orally
D)   Morphine intravenouslyE) None of the above
F) B) and C)

Question 3

A patient diagnosed with STEMI is about to undergo a primary percutaneous coronary intervention (PCI) . Which combination of pharmacotherapeutic agents will be given to augment this procedure?

Accepted Answer

A)   Beta blocker and nitroglycerin
B)   Abciximab and a fibrinolytic drug
C)   Angiotensin-converting enzyme (AC
E)   inhibitor and aspirin
D)   Heparin, aspirin, and clopidogrelE) A) and C)
F) A) and B)

Question 4

A patient is admitted to the coronary care unit from the emergency department after initial management of STEMI. A primary percutaneous coronary intervention has been performed. The nurse notes an initial heart rate of 56 beats per minute and a blood pressure of 120/80 mm Hg. The patient has a history of stroke and a previous myocardial infarction. Which order will the nurse question?

Accepted Answer

A)   Aspirin
B)   Beta blocker
C)   Clopidogrel
D)   HeparinE) A) and B)
F) A) and C)

Question 5

A nurse is giving aspirin to a patient during acute management of STEMI. The patient asks why a chewable tablet is given. Which response by the nurse is correct?

Accepted Answer

A)   "Aspirin is absorbed more quickly when it is chewed."
B)   "Chewing aspirin prevents it from being metabolized by the liver."
C)   "Chewing aspirin prevents stomach irritation."
D)   "More of the drug is absorbed when aspirin is chewed."E) None of the above
F) A) and D)

Question 6

A patient has undergone a PCI,and the provider orders clopidogrel to be given for 12 months,along with an ACE inhibitor and heparin. What will the nurse do?

Accepted Answer

A)   Question the need for heparin.
B)   Request an order for a beta blocker.
C)   Request an order for aspirin.
D)   Suggest ordering clopidogrel for 14 days.E) A) and B)
F) None of the above

Question 7

A patient who is receiving reperfusion therapy has a history of heparin-induced thrombosis (HIT) . The patient has a creatinine clearance of 28 mL/min. In addition to the fibrinolytic agent,which medication will the nurse expect to administer to this patient?

Accepted Answer

A)   Aspirin
B)   Bivalirudin [Angiomax]
C)   Clopidogrel [Plavix]
D)   Fondaparinux [Arixtra]E) C) and D)
F) A) and C)

Question 8

Patients with a history of myocardial infarction should take which medications indefinitely? (Select all that apply.)

Accepted Answer

A)   ACE inhibitors
B)   Alteplase
C)   Aspirin
D)   Beta blockers
E)   ClopidogrelF) A) and C)
G) None of the above

Question 9

A nurse is evaluating a patient admitted to the emergency department with an evolving STEMI for possible administration of thrombolytic therapy. Which information,identified during history taking,would contraindicate this type of therapy?

Accepted Answer

A)   The patient just completed her last menstrual cycle.
B)   The patient states that the chest pain started 1 hour ago.
C)   The patient has a history of a small cerebral aneurysm.
D)   The patient has hypertension that is well controlled by diuretic therapy.E) C) and D)
F) A) and C) C

Question 10

A patient in the emergency department has severe chest pain. The nurse administers morphine intravenously. The patient asks the nurse why morphine is given. Which response by the nurse is correct?

Accepted Answer

A)   "Morphine helps by reducing anxiety and relieving pain."
B)   "Morphine helps by reducing pain and dissolving clots."
C)   "Morphine helps by relieving pain and lowering blood pressure."
D)   "Morphine helps by relieving pain and reducing the cardiac oxygen demand."E) A) and D)
F) C) and D)

Question 11

A patient who is recovering from a STEMI 3 months prior is in the clinic for a follow-up evaluation. The patient is taking 81 mg of aspirin,a beta blocker,and an ACE inhibitor daily and uses nitroglycerine as needed for angina. The patient's BMI is 24.5 kg/m²,and serum LDL is 150 mg/dL. The patient has a blood pressure of 135/80 mm Hg. What will the nurse expect the provider to order for this patient?

Accepted Answer

A)   An antihypertensive medication
B)   Counseling about a weight loss diet
C)   Discontinuing the ACE inhibitor
D)   High-dose statin therapyE) B) and C)
F) All of the above

Question 12

A patient has undergone a primary percutaneous coronary intervention with a stent placement. The provider has ordered a daily dose of 81 mg of aspirin and clopidogrel. The patient asks the nurse how long the medications must be taken. What will the nurse tell this patient about the medication regimen?

Accepted Answer

A)   This drug regimen will continue indefinitely.
B)   The clopidogrel will be discontinued in one year and the aspirin will be given indefinitely.
C)   The aspirin will be discontinued in one year and the clopidogrel will be given indefinitely.
D)   Both drugs will be discontinued in one year.E) None of the above
F) B) and D) B

Exam 53: Management of ST-Elevation Myocardial Infarction

A nurse is discussing fibrinolytic therapy for the acute phase of STEMI management with a group of nursing students. Which statement by a student indicates understanding of this therapy?

Correct Answer
verified
C

Correct Answer
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A patient diagnosed with STEMI is about to undergo a primary percutaneous coronary intervention (PCI) . Which combination of pharmacotherapeutic agents will be given to augment this procedure?

Correct Answer
verified

Correct Answer
verified

A nurse is giving aspirin to a patient during acute management of STEMI. The patient asks why a chewable tablet is given. Which response by the nurse is correct?

Correct Answer
verified

A patient has undergone a PCI,and the provider orders clopidogrel to be given for 12 months,along with an ACE inhibitor and heparin. What will the nurse do?

Correct Answer
verified

A patient who is receiving reperfusion therapy has a history of heparin-induced thrombosis (HIT) . The patient has a creatinine clearance of 28 mL/min. In addition to the fibrinolytic agent,which medication will the nurse expect to administer to this patient?

Correct Answer
verified

Patients with a history of myocardial infarction should take which medications indefinitely? (Select all that apply.)

Correct Answer
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A nurse is evaluating a patient admitted to the emergency department with an evolving STEMI for possible administration of thrombolytic therapy. Which information,identified during history taking,would contraindicate this type of therapy?

Correct Answer
verified
C

A patient in the emergency department has severe chest pain. The nurse administers morphine intravenously. The patient asks the nurse why morphine is given. Which response by the nurse is correct?

Correct Answer
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Correct Answer
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Correct Answer
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B

Exam 53: Management of ST-Elevation Myocardial Infarction

A nurse is discussing fibrinolytic therapy for the acute phase of STEMI management with a group of nursing students. Which statement by a student indicates understanding of this therapy?

Correct AnswerverifiedC

Correct AnswerverifiedShow Answer

A patient diagnosed with STEMI is about to undergo a primary percutaneous coronary intervention (PCI) . Which combination of pharmacotherapeutic agents will be given to augment this procedure?

Correct AnswerverifiedShow Answer

Correct AnswerverifiedShow Answer

A nurse is giving aspirin to a patient during acute management of STEMI. The patient asks why a chewable tablet is given. Which response by the nurse is correct?

Correct AnswerverifiedShow Answer

A patient has undergone a PCI,and the provider orders clopidogrel to be given for 12 months,along with an ACE inhibitor and heparin. What will the nurse do?

Correct AnswerverifiedShow Answer

A patient who is receiving reperfusion therapy has a history of heparin-induced thrombosis (HIT) . The patient has a creatinine clearance of 28 mL/min. In addition to the fibrinolytic agent,which medication will the nurse expect to administer to this patient?

Correct AnswerverifiedShow Answer

Patients with a history of myocardial infarction should take which medications indefinitely? (Select all that apply.)

Correct AnswerverifiedShow Answer

A nurse is evaluating a patient admitted to the emergency department with an evolving STEMI for possible administration of thrombolytic therapy. Which information,identified during history taking,would contraindicate this type of therapy?

Correct AnswerverifiedC

A patient in the emergency department has severe chest pain. The nurse administers morphine intravenously. The patient asks the nurse why morphine is given. Which response by the nurse is correct?

Correct AnswerverifiedShow Answer

Correct AnswerverifiedShow Answer

Correct AnswerverifiedB

Correct Answer
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C

Correct Answer
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Correct Answer
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Correct Answer
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Correct Answer
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Correct Answer
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Correct Answer
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Correct Answer
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Correct Answer
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C

Correct Answer
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Correct Answer
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Correct Answer
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B