Question

1. Patient S is a white woman, 43 years of age, and mother of three small children. She has a long-standing history of significant obesity with little success in dieting over the years. At 5'3", she is obese, weighing 220 pounds. Her fat distribution is "apple-shaped" and consequently, her waist-hip ratio is more than the 0.8 normal range. In addition, Patient S lives a fairly sedentary lifestyle and does not have a regular exercise program. Her dietary habits do not take into account basic recommendations for cardiac nutrition.

   Patient S has a previous history of MI 1 year ago. Today she presents to the ER with complaints of chest pain and nausea. Her ECG is unremarkable, she has an elevated troponin with ongoing intermittent left side chest pain that she describes as "sharp and intermittent".

   She reports that she did not comply to the cardiac rehab program post cardiac event 1 year ago stating, "I have been lethargic and unmotivated since then". The patient goes on to tell you that she has been unable to return to work due to ongoing symptoms of depression. Patient S is not seeing a psychiatrist in the community. She is not taking any medication currently. She reports her symptoms of depression that surfaced following her MI have been persistent but have not worsened over time.

   What is the priority nursing intervention at this point?

2. Although patient S did not fully commit to the cardiac rehab program in the past what is one nursing intervention that may assist her currently?

   	1.	Offer individual and small group education and counseling regarding adjustment to heart disease
   	2.	Suggest she get more exercise in on a daily basis
   	3.	Encourage Mrs. M to return to work
   	4.	Teach Mrs M. how to assess her blood pressure and heart rate at home

1 points   

QUESTION 3

1. Cardiac rehab includes education, exercise and counseling for both patients whom have had a cardiac event and those at risk. Which category does this patient fall into?

   	1.	None of the cardiac categories
   	2.	Lower-risk following an acute cardiac event
   	3.	No prior event but unfavorable risk profile
   	4.	Patient with stable heart failure Cardiac rehab is contraindicated for patients 1. with severe residual angina 2. who have an elevated troponin 3. who are obese 4. post cardiac bypass 2 points    QUESTION 5 Identify the priority cardiac risk factor in this case study. 1. Patient S is 43 years of age 2. Patient S is obese with "apple-shaped" fat distribution 3. Patient S does not eat many vegetables 4. Patient S is a Caucasian female

2. Mrs. S is learning about how to exercise cardiac event. Which of the following statements is accurate?

   	1.	Exercise post cardiac event should commence once the patient is discharged home
   	2.	An exercise schedule will be prescribed based on the cardiac event.
   	3.	The exercise a patient is prescribed is largely based on their previous level of activity
   	4.	Exercise is not recommended for at least 1 month post bypass surgery.

3. 1 points   

   QUESTION 7

4. What are the two forms of exercise tests performed in patients following an acute cardiac event?

   	1.	Walking and running test
   	2.	Pace and Trace test
   	3.	Submaximal and symptom-limited exercise testing
   	4.	Stress test

5. What is the best definition of functional capacity?

   	1.	Maximum ability of the heart and lungs to deliver oxygen and the ability of the muscles to extract it.
   	2.	The patients ability to exercise on a regular basis
   	3.	The patients ability to complete prescribed exercise without assistance
   	4.	The patients capacity to reduce overall cardiac risk

6. 1 points   

   QUESTION 9

7. What is the definition of Myocardial Ischemia?

   	1.	A cardiac event involving an area of the myocardium
   	2.	A heart attack
   	3.	A cardiac event that may limit a patients exertional capacity by causing limiting angina, dyspnea, or fatigue.
   	4.	Chest pain not yet diagnosed What is the purpose of risk stratifcation? 1. To identify those in need of cardiac rehab services. 2. Assists patients in understanding how to function optimally post cardiac event. 3. Serves as the basis of individualizing the prescription of exercise training and for assessing the need and extent of supervision required. 4. Helps the patient return to work safely.

Answer 1

Priority nursing intervention.

Question 3:

option 4.Patient with stable cardiac failure.

Option 1 mentiond none of the cardiac categories. But she is in risk category.

other option mentioned no prior event,lower risk etc.Its false because patient had a prior event and she is in higher risk category.

Question 4:

Option 2.who have an elevated toponin.

In other options cardiac rehabilation is necessary.

Question 5.

Option:2.apple shaped fat is the most preferable option in this question. It has higher risk of cardiac failure.

Question 6.

Option 2.

An exercise schedule is prescribed based on cardiac event.

Question 7.

Option 4.stress test.

It is more important to predict the stressful exercises after cardiac event.

Question 8.

Option 2.Patients ability to do exercises a regular manner.becase functional capacity is the ability to return back to normal life activity.

Question 9.

Option. 1.

Because Ishchemic disease involves the less oxygen transport to heart muscles (myocardium) Because of block of blood vessels to heart muscles.

Question 10.

Option 1.to know the patient who needs rehabilation services.

To know the patients needs and ability during a cardiac event.