Question

A nurse is preparing a client for a scheduled Percutaneous Coronary Intervention (PCI). Which statement made by the client should the nurse report to the Primary Healthcare Provider (PHCP)?

Answer 1

Correct Answers:

“I took my metformin this morning.”.

Rationale :

🔷 Metformin must be held before PCI due to the use of contrast dye, which may cause renal impairment.

🔷 The combination of iodine-based contrast and metformin can result in lactic acidosis, a potentially life-threatening condition.

🔷 The provider needs to be informed immediately so that metformin can be discontinued 24–48 hours pre-procedure.

🔷 The contrast can accumulate if renal clearance is reduced, increasing toxicity.

🔷 Monitoring renal function (e.g., BUN, creatinine) is essential before and after the PCI when metformin is involved.

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Answer 2

Correct Answers:

Yaz (drospirenone/estradiol) as an oral contraceptive.

Rationale :

♦ Oral contraceptives containing estrogen may increase clotting risk and reduce warfarin effectiveness.

♦ Estrogen stimulates coagulation factors, opposing warfarin’s anticoagulant action.

♦ This can lead to subtherapeutic INR levels, putting the patient at risk for thromboembolic events.

♦ Nurses must monitor for drug interactions with warfarin due to its narrow therapeutic index.

♦ Providers may consider an alternative contraceptive or adjust the warfarin dosage.

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Answer 3

Correct Answers:

An aneurysm.

Rationale :

A history of DVT and vascular problems increases the risk of aneurysmal changes due to vascular wall weakness.

💠 An aneurysm can cause asymptomatic progression and rupture, so early recognition is key.

💠 Risk factors include hypertension, hyperlipidemia, and chronic vessel damage, often present in DVT patients.

💠 Aneurysms are important to assess in any client with compromised vascular integrity.

💠 Asking about this history can help prevent life-threatening complications, such as abdominal aortic aneurysm rupture.

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Answer 4

Correct Answers:

To increase oxygen supply to the heart muscle.

Rationale :

🟨 CABG reroutes blood around a blocked coronary artery, restoring oxygen-rich blood flow to heart tissue.

🟨 It is used in severe coronary artery disease where perfusion is critically impaired.

🟨 The goal is to prevent myocardial infarction and preserve cardiac function.

🟨 Increased oxygen supply reduces anginal symptoms and improves activity tolerance.

🟨 It helps protect the myocardium from ischemic injury, reducing the risk of sudden cardiac death.

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Answer 5

Correct Answers:

Checking peripheral pulses in the affected leg.

Rationale :

🟥 After an angiogram, there is risk for arterial occlusion or hematoma, especially at the access site.

🟥 Peripheral pulses (e.g., dorsalis pedis, posterior tibial) must be assessed frequently to detect compromised perfusion.

🟥 Diminished or absent pulses could signal compartment syndrome or thrombosis, which are emergencies.

🟥 Monitoring includes skin color, temperature, and capillary refill, alongside pulse strength.

🟥 Documentation helps identify trends in vascular status and guides immediate interventions if changes occur.

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Answer 6

Correct Answers:

Keep the patient in bed in the supine position.

Rationale :

⚫ Acute arterial occlusion is a vascular emergency; elevation or exercise may worsen ischemia.

⚫ Supine positioning maintains neutral blood flow to the affected limb.

⚫ Resting the limb helps prevent further oxygen demand, avoiding worsening tissue necrosis.

⚫ The nurse should also prepare for immediate intervention, such as thrombolytic therapy or surgery.

⚫ Monitor for pain, pallor, pulselessness, poikilothermia, paresthesia, and paralysis (6 Ps).

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Answer 7

Correct Answers:

Right heart failure.

Rationale :

🟢 Chronic pulmonary disease causes increased pulmonary vascular resistance, leading to right ventricular strain.

🟢 The condition is known as cor pulmonale, a form of right-sided heart failure.

🟢 Blood backs up into the systemic circulation, causing peripheral edema, hepatomegaly, and jugular vein distention.

🟢 The left heart typically remains unaffected in early stages unless bi-ventricular failure develops.

🟢 Monitoring includes pulmonary artery pressures and signs of systemic venous congestion.

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Answer 8

Correct Answers:

Arterial occlusion.

Rationale :

🔴 Classic signs include pallor, pulselessness, pain, paresthesia, paralysis, and poikilothermia.

🔴 Cold, pale extremity with absent pulses strongly suggests arterial blockage.

🔴 It requires urgent vascular intervention to restore perfusion and prevent tissue death.

🔴 Risk factors include atherosclerosis, thromboembolism, or trauma.

🔴 Diagnostic tests such as Doppler ultrasound or arteriography are often ordered.

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Answer 9

Correct Answers:

Percutaneous coronary intervention (PCI).

Rationale :

🟣 PCI is a first-line treatment for acute myocardial infarction to open blocked coronary arteries.

🟣 It improves myocardial perfusion, limits infarct size, and reduces mortality.

🟣 The sooner PCI is performed, the better the cardiac muscle preservation.

🟣 PCI may involve angioplasty and stent placement to restore coronary blood flow.

🟣 It is often preferred over thrombolytics when available within the golden hour.

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Answer 10

Correct Answers:

The ductus arteriosus.

Rationale :

🟡 Coarctation of the aorta usually occurs near the ductus arteriosus, often at the insertion site.

🟡 This narrowing increases afterload on the left ventricle, leading to hypertension in upper extremities.

🟡 The ductus arteriosus is a fetal blood vessel that connects the pulmonary artery to the descending aorta.

🟡 After birth, this area remains vulnerable to malformation or constriction, resulting in coarctation.

🟡 Symptoms include diminished femoral pulses, differential blood pressures, and murmurs.

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Med Surg 2 Miami Regional University

No.

1 :
A nurse is preparing a client for a scheduled Percutaneous Coronary Intervention (PCI). Which statement made by the client should the nurse report to the Primary Healthcare Provider (PHCP)?

2 :
Which medication, when noted in a patient’s history, will diminish the effects of Warfarin (Coumadin)?

3 :
What should a nurse inquire about from a patient with a past history of Deep Vein Thrombosis (DVT) and other vascular issues?

4 :
What is the primary pathophysiological reason for performing Coronary Artery Bypass Surgery?

5 :
A nurse is caring for a patient who has undergone an angiogram. What should the nurse prioritize in assessing and documenting for this patient?

6 :
An older patient with chronic atrial fibrillation develops sudden severe pain, pulselessness, pallor, and coolness in the right leg, consistent with acute arterial occlusion. After the nurse notifies the healthcare provider, what should the nurse do next?

7 :
In the context of a 65-year-old male patient diagnosed with chronic pulmonary disease and elevated pulmonary vascular resistance, which type of heart failure should the nurse assess for in this patient?

8 :
An obese post-surgical patient reports sudden discomfort in her leg. Upon assessment, the nurse finds the leg to be cold and pale, with no pedal or popliteal pulse. What should the nurse suspect?

9 :
The nurse is caring for a client with an acute myocardial infarction (AMI). What emergent procedure does the nurse anticipate the physician will order?

10 :
Coarctation of the aorta refers to the local narrowing of the aorta near which location?

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Med Surg 2 Miami Regional University

No.

1 : A nurse is preparing a client for a scheduled Percutaneous Coronary Intervention (PCI). Which statement made by the client should the nurse report to the Primary Healthcare Provider (PHCP)?

2 : Which medication, when noted in a patient’s history, will diminish the effects of Warfarin (Coumadin)?

3 : What should a nurse inquire about from a patient with a past history of Deep Vein Thrombosis (DVT) and other vascular issues?

4 : What is the primary pathophysiological reason for performing Coronary Artery Bypass Surgery?

5 : A nurse is caring for a patient who has undergone an angiogram. What should the nurse prioritize in assessing and documenting for this patient?

6 : An older patient with chronic atrial fibrillation develops sudden severe pain, pulselessness, pallor, and coolness in the right leg, consistent with acute arterial occlusion. After the nurse notifies the healthcare provider, what should the nurse do next?

7 : In the context of a 65-year-old male patient diagnosed with chronic pulmonary disease and elevated pulmonary vascular resistance, which type of heart failure should the nurse assess for in this patient?

8 : An obese post-surgical patient reports sudden discomfort in her leg. Upon assessment, the nurse finds the leg to be cold and pale, with no pedal or popliteal pulse. What should the nurse suspect?

9 : The nurse is caring for a client with an acute myocardial infarction (AMI). What emergent procedure does the nurse anticipate the physician will order?

10 : Coarctation of the aorta refers to the local narrowing of the aorta near which location?

1 :
A nurse is preparing a client for a scheduled Percutaneous Coronary Intervention (PCI). Which statement made by the client should the nurse report to the Primary Healthcare Provider (PHCP)?

2 :
Which medication, when noted in a patient’s history, will diminish the effects of Warfarin (Coumadin)?

3 :
What should a nurse inquire about from a patient with a past history of Deep Vein Thrombosis (DVT) and other vascular issues?

4 :
What is the primary pathophysiological reason for performing Coronary Artery Bypass Surgery?

5 :
A nurse is caring for a patient who has undergone an angiogram. What should the nurse prioritize in assessing and documenting for this patient?

6 :
An older patient with chronic atrial fibrillation develops sudden severe pain, pulselessness, pallor, and coolness in the right leg, consistent with acute arterial occlusion. After the nurse notifies the healthcare provider, what should the nurse do next?

7 :
In the context of a 65-year-old male patient diagnosed with chronic pulmonary disease and elevated pulmonary vascular resistance, which type of heart failure should the nurse assess for in this patient?

8 :
An obese post-surgical patient reports sudden discomfort in her leg. Upon assessment, the nurse finds the leg to be cold and pale, with no pedal or popliteal pulse. What should the nurse suspect?

9 :
The nurse is caring for a client with an acute myocardial infarction (AMI). What emergent procedure does the nurse anticipate the physician will order?

10 :
Coarctation of the aorta refers to the local narrowing of the aorta near which location?