Acute Coronary Syndrome for Certified Emergency Nursing (CEN)

The nurse recognizes that all of the following precipitating factors can contribute to the development of angina pectoris except:

The nurse understands which EKG finding to be indicative of myocardial ischemia?

A 68-year-old man arrives at the emergency department (ED) complaining of frequent episodes of substernal chest pain that have grown increasingly severe throughout the morning. He is alert and denies experiencing nausea, vomiting, or any radiation of the pain. The episodes, which began during the past month, typically occur at rest and last 10 to 15 minutes; they subside when the patient takes nitroglycerin sublingually. After initiating cardiac monitoring, the nurse administers oxygen 24% by facemask. The patient’s electrocardiogram (EKG) demonstrates ST-segment elevation. Vital signs are blood pressure 130/90 mmHg, pulse rate 110 beats/minute, and respirations 24 breaths/minute. After reviewing the patient’s history and EKG, the nurse determines that the findings are consistent with those of:

The nurse understands that tPA (Activase) is used to:

A patient has received successful tPA therapy, which EKG changes would the nurse expect to see?

Appropriate nursing diagnoses for a patient with angina include all of the following except:

The nurse understands which of the following statementsis false regarding unstable angina?

The nurse understands which statement about tPA to be false?

Which principle is most important to remember when administering tPA?

A 56-year-old woman is brought to the ED by emergency medical service personnel for evaluation of increasing shortness of breath. Her shortness of breath began 2 days ago and has become increasingly severe. She is pale and diaphoretic, and her skin is warm. Her respirations are 36 breaths/minute, and she exhibits increasing use of supraclavicular and abdominal muscles. The nurse detects bilateral crackles on auscultation. The nurse notes that the patient has a history of coronary artery disease and that she had an MI 2 years ago. After assisting the patient into a high Fowler’s position, the nurse records the following vital signs: blood pressure 90/60 mmHg and pulse rate 116 beats/minute and irregular. The nurse notes that the patient’s presenting symptoms and vital signs are consistent with: