CAD Perfusion Practice Questions

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Questions and Answers

Which of the following is NOT a symptom of peripheral arterial disease?

  • Pain with activity
  • Pedal edema (correct)
  • Diminished pedal pulses
  • Loss of color/pale

Which of the following are risk factors for coronary artery disease (CAD)? (Select all that apply)

  • Elevated HDL
  • Elevated CRP (C reactive protein) (correct)
  • Total cholesterol <200
  • Smoking (correct)
  • History of HTN (correct)

A patient diagnosed with CAD and prescribed nitroglycerin sublingually for angina experiences chest pain. What should the patient do FIRST?

  • Sit down and wait 3–5 minutes to see if angina subsides
  • Sit down and call 911
  • Sit down and take a nitroglycerin tablet (correct)
  • Immediately drive to an emergency room

Which of the following is a potential complication of a myocardial infarction (MI)? (Select all that apply)

<p>Heart failure (A), Arrhythmias (B), Pericarditis (C), Papillary muscle rupture (E)</p> Signup and view all the answers

Which of the following is a form of revascularization for coronary artery disease?

<p>Thrombolytic therapy (B), Coronary artery bypass graft (C), Balloon angioplasty (D), Coronary stenting (E)</p> Signup and view all the answers

Which of the following are modifiable risk factors for atherosclerotic cardiovascular disease (ASCVD)? (Select all that apply)

<p>OSA (A), Smoking (C), Excess abdominal fat (E)</p> Signup and view all the answers

A patient with CAD has a heart rate of 112, blood pressure of 118/78, and respiratory rate of 24. They have a prescription for NTG and are losing weight as directed. Which of the following will best address the needs of this patient?

<p>Beta blocker (C)</p> Signup and view all the answers

A female patient presents to the ED with upper back pain, nausea, and profound fatigue. Her 12-lead EKG demonstrates ST depression in the septal leads. Which of the following is the MOST likely diagnosis? (Select all that apply)

<p>Unstable angina (B), NSTEMI (D)</p> Signup and view all the answers

A patient presents to the ED with substernal chest pain. The 12-lead EKG demonstrates ST elevation in the anterior leads. What is the most appropriate action to take?

<p>Notify the cath lab of your STEMI patient (D)</p> Signup and view all the answers

An individual develops chest pressure while exercising, and they have no history of angina. What should their FIRST action be?

<p>Sit down (D)</p> Signup and view all the answers

A nurse is teaching an orientee about cardiopulmonary bypass (CPB). Which of the following information provided by the nurse is correct?

<p>Patients must be rewarmed at the end of the procedure (D)</p> Signup and view all the answers

Which of the following are common complications of myocardial infarction (heart attack)? (Select all that apply)

<p>Heart failure (B), Arrhythmias (C), Papillary muscle rupture (acute mitral regurgitation) (E)</p> Signup and view all the answers

A patient is admitted to the ED with substernal chest pain and hypertension. The patient also reports sinus tachycardia, a pain level of 10/10, and states, "I'm going to die." The 12-lead EKG shows ST elevation. What is the MOST likely diagnosis?

<p>STEMI (C)</p> Signup and view all the answers

You instruct a patient with angina that when angina develops, they should sit down and take a sublingual nitroglycerin (NTG). Beyond the fact that NTG may drop blood pressure, why is sitting down important?

<p>Stopping activity reduces oxygen demand (D)</p> Signup and view all the answers

A patient with acute coronary syndrome (ACS) is being treated in the ED. The patient has ST depression, anxiety, neck and arm pain on the left side, diaphoresis and nausea, and negative isoenzymes. What is the MOST likely diagnosis?

<p>Unstable angina (D)</p> Signup and view all the answers

A patient presents with a partially occluding coronary artery clot, back pain, diaphoresis, exhaustion, female gender, and ST depression. What is the MOST likely diagnosis?

<p>NSTEMI (C)</p> Signup and view all the answers

A patient presents to the ED with shortness of breath and diaphoresis, commenting, "I think I must have pneumonia." The patient's history includes hypertension, peptic ulcer disease, and diabetes. The 12-lead EKG demonstrates ST depression. What does this information MOST likely indicate?

<p>Silent ischemia (B)</p> Signup and view all the answers

Which of the following is the MOST common cause of CAD?

<p>Atherosclerosis (C)</p> Signup and view all the answers

Which laboratory test is MOST useful in evaluating a patient for myocardial damage?

<p>Troponin (A)</p> Signup and view all the answers

A patient with severe CAD is scheduled for a coronary artery bypass graft (CABG). What is the primary goal of this procedure?

<p>To improve blood flow to the heart muscle (C)</p> Signup and view all the answers

Following a percutaneous coronary intervention (PCI) with stent placement, what medication is MOST important for the patient to receive to prevent stent thrombosis?

<p>Aspirin and a P2Y12 inhibitor (e.g., clopidogrel) (A)</p> Signup and view all the answers

A patient with CAD reports experiencing chest pain more frequently and with less exertion than before. This pattern is MOST consistent with which type of angina?

<p>Unstable angina (D)</p> Signup and view all the answers

What is an expected outcome of administering ACE inhibitors to patients with CAD and heart failure?

<p>Reduced sodium and water retention (B)</p> Signup and view all the answers

Which statement accurately describes the pathophysiology that results in CAD?

<p>CAD is caused by atherosclerotic plaque leading to progressive narrowing of coronary arteries. (B)</p> Signup and view all the answers

A patient is prescribed a statin medication to manage their CAD. What education is most relevant to provide?

<p>Report any unexplained muscle pain or weakness to your healthcare provider. (B)</p> Signup and view all the answers

Which of the following is a primary non-pharmacological recommendation for a patient with CAD?

<p>Engage in regular aerobic exercises such as brisk walking or cycling. (D)</p> Signup and view all the answers

What is the primary mechanism by which nitrates relieve angina symptoms?

<p>Dilating peripheral veins, which decreases cardiac preload. (B)</p> Signup and view all the answers

A patient who had a CABG surgery one week ago reports feeling depressed. Which of these answers is most appropriate?

<p>Schedule the patient with a counselor (A)</p> Signup and view all the answers

A patient has diabetes. You recommend which medicine because it decreases cardiac events and slows progression of diabetic kidney disease? Which medicine is this?

<p>SGLT2 inhibitor (C)</p> Signup and view all the answers

Which of the following medications is contraindicated with the use of nitrates?

<p>Sildenafil (C)</p> Signup and view all the answers

You have a patient who has known CAD. They are getting ready to discharge prior to their discharge, what do you recommend?

<p>Cardiac rehab (D)</p> Signup and view all the answers

What lipid levels are desirable in a patient getting ready for discharge who has CAD?

<p>All of the above (D)</p> Signup and view all the answers

You are caring for a patient with a history of CAD. During your assessment, the patient experiences sudden chest pain and shortness of breath. Which of the following is the MOST appropriate initial nursing intervention?

<p>Administer oxygen and assess vital signs. (C)</p> Signup and view all the answers

Which of the following diagnostic procedures would be MOST effective to determine the extent and severity of CAD?

<p>Coronary angiography (D)</p> Signup and view all the answers

You are providing discharge instructions to a patient following a myocardial infarction. Which of the following statements by the patient indicates a good understanding of secondary prevention measures?

<p>&quot;I need to make sure that I take my medications as prescribed and follow a heart-healthy lifestyle.&quot; (B)</p> Signup and view all the answers

What is the MOST important teaching for a patient receiving a prescription for clopidogrel for CAD with a recent PCI?

<p>Use an electric razor instead of a blade razor. (A)</p> Signup and view all the answers

A patient with angina already takes a beta blocker. An additional medication to control the angina may be contraindicated after you review which aspect of the patient assessment?

<p>Use of Sildenafil (Viagra) (D)</p> Signup and view all the answers

Which of the following serum cholesterol values is MOST associated with coronary artery disease?

<p>HDL 30 mg/dL and normal LDL (D)</p> Signup and view all the answers

Flashcards

Pedal Edema and PAD

Edema is not a typical symptom of peripheral arterial disease.

CAD Risk Factors

Elevated CRP, smoking, and hypertension are risk factors for CAD.

Angina First Action

At the onset of angina, and diagnosed CAD, take nitroglycerin sublingually.

MI Complications

Arrhythmias, pericarditis, papillary muscle rupture, and heart failure.

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CAD Revascularization

Balloon angioplasty, thrombolytic therapy, and coronary stenting.

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ASCVD Modifiable Risks

Smoking, excess abdominal fat, and OSA are modifiable ASCVD risk factors.

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CAD & Beta Blocker

Beta blocker will best address the patient’s need.

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ST Depression Diagnosis

NSTEMI and Unstable Angina are potential diagnosis.

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Suspect STEMI?

If the patient has ST elevation the most appropriate is notifying the cath lab of the STEMI patient.

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Sudden Chest Pain

When having chest pain while exercising, and no history of angina, first sit down.

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Rewarming After Bypass

Patients must be rewarmed at the end of the procedure.

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Post-MI Complications

Arrhythmias, heart failure, and papillary muscle rupture are complications.

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Suspecting pain?

The patient is currently experiencing STEMI.

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What to do with angina?

To stop activity and reduce oxygen demand.

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ACS diagnosis?

The patient is experiencing Unstable Angina.

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Suspecting NSTEMI?

The patient is experiencing NSTEMI

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Silent Ischemia?

The information demonstrates Silent Ischemia.

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Study Notes

  • Perfusion Practice Questions: CAD

Peripheral Arterial Disease Symptoms

  • Pedal edema is not a symptom of peripheral arterial disease

Peripheral Arterial Disease Question

  • The non-symptom is Pedal edema

Risk Factors of CAD

  • Elevated CRP (C reactive protein) is a risk factor
  • Smoking is a risk factor
  • History of HTN is a risk factor

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