INSTRUCTIONS UA/NSTEMI: Are you following the latest guidelines?
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- You will receive your CE certificate of earned contact hours and an answer key to review your results. There is no minimum passing grade.
- Registration deadline is September 30, 2014.
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UA/NSTEMI: Are you following the latest guidelines?
GENERAL PURPOSE: To provide nurses with an overview of the latest guidelines for treating UA/NSTEMI. LEARNING OBJECTIVES: After reading this article and taking the test, you should be able to: 1. Discuss the pathophysiology of UA and NSTEMI. 2. Differentiate the signs and symptoms of UA and NSTEMI. 3. Identify medications used to treat patients with UA/NSTEMI.
- UA/NSTEMI is usually caused by
- congenital coronary anomalies.
- cocaine use.
- UA/NSTEMI is associated with an increased risk for
- coronary artery emboli.
- coronary artery aneurysm.
- Clinically, UA and NSTEMI are
- closely related.
- treated with fibrinolytic therapy.
- characterized by widened QRS complexes.
- characterized by new left bundle branch blocks.
- Both UA and NSTEMI are characterized by
- pathologic Q waves.
- chest pain or anginal equivalent.
- a prolonged QT interval.
- NSTEMI is differentiated from UA by
- increased serum troponin levels in the presence of ST-segment elevation.
- positive biomarkers of myocardial necrosis.
- normal serum troponin levels in the presence of ST-segment depression.
- negative cardiac biomarkers.
- Which statement about use of the platelet inhibitor ticagrelor is accurate?
- It's used in combination with low-dose aspirin.
- It's given daily with 325 mg of aspirin.
- It's more effective when used with full-strength aspirin.
- It should never be used with aspirin.
- UA symptoms reflect
- the presence of coronary artery emboli.
- total occlusion of a coronary artery.
- myocardial necrosis.
- an imbalance between oxygen supply and demand.
- Pain associated with NSTEMI is
- less intense than pain associated with UA.
- not caused by an imbalance between oxygen supply and demand.
- usually prolonged and more intense than rest angina.
- usually not indicative of myocardial damage.
- Thienopyridines constitute a drug class that
- lyses thrombi.
- prevents platelet aggregation.
- can't be used with aspirin.
- includes just one FDA-approved medication, clopidogrel.
- Which of the following statements about prasugrel is correct?
- It's more likely to cause bleeding than clopidogrel.
- It should be discontinued at least 5 days before any surgery.
- It's a prodrug that's converted to its active metabolite in the kidneys.
- It's inferior to clopidogrel in reducing clinical events.
- Which of the following is correct about clopidogrel?
- Its onset of action occurs in about 4 hours.
- It requires several passes through the liver to convert to its active metabolite.
- It's classified as a fibrinolytic.
- It promotes platelet activation and aggregation.
- A patient who received a bare metal stent should continue on dual antiplatelet therapy for
- at least 2 years.
- 18 months.
- at least 15 months.
- at least a year.
- Abruptly stopping dual antiplatelet therapy after receiving a stent places patients at high risk for
- restenosis and STEMI.
- stent dislodgement.
- GP IIb/IIIa platelet inhibitors
- may be considered for patients on clopidogrel to prevent further platelet aggregation.
- may be initiated with patients taking clopidogrel who are at high risk for bleeding.
- should never be combined with thienopyridines.
- should never be combined with aspirin.
- Which of the following statements is correct?
- PPIs increase the metabolite conversion of thienopyridines.
- PPIs increase clopidogrel's antiplatelet effect.
- PPIs increase prasugrel's antiplatelet effect.
- PPIs decrease gastrointestinal adverse reactions to dual antiplatelet therapy.
- Using acetylcysteine to help prevent CIN is
- an FDA-approved nephroprotective treatment.
- a primary indication.
- a common off-label use.
- recommended in current task force guidelines.
- Strict glycemic control after an MI
- increases the risk of death at 90 days.
- reduces the risk of hypoglycemia.
- improves clinical outcomes after an MI.
- was proven beneficial by the NICE-SUGAR Trial.
- The drug metformin
- reduces the risk of developing CIN.
- is held prior to coronary angiography.
- reduces the risk of lactic acidosis in a patient who develops CIN.
- should be resumed immediately following coronary angiography.