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UA/NSTEMI: Are you following the latest guidelines?

doi: 10.1097/01.NURSE.0000419444.21492.d2
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INSTRUCTIONS UA/NSTEMI: Are you following the latest guidelines?


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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.

  1. UA/NSTEMI is usually caused by
    1. vasculitis.
    2. atherosclerosis.
    3. congenital coronary anomalies.
    4. cocaine use.
  2. UA/NSTEMI is associated with an increased risk for
    1. coronary artery emboli.
    2. coronary artery aneurysm.
    3. arteritis.
    4. MI.
  3. Clinically, UA and NSTEMI are
    1. closely related.
    2. treated with fibrinolytic therapy.
    3. characterized by widened QRS complexes.
    4. characterized by new left bundle branch blocks.
  4. Both UA and NSTEMI are characterized by
    1. pathologic Q waves.
    2. hyperthermia.
    3. chest pain or anginal equivalent.
    4. a prolonged QT interval.
  5. NSTEMI is differentiated from UA by
    1. increased serum troponin levels in the presence of ST-segment elevation.
    2. positive biomarkers of myocardial necrosis.
    3. normal serum troponin levels in the presence of ST-segment depression.
    4. negative cardiac biomarkers.
  6. Which statement about use of the platelet inhibitor ticagrelor is accurate?
    1. It's used in combination with low-dose aspirin.
    2. It's given daily with 325 mg of aspirin.
    3. It's more effective when used with full-strength aspirin.
    4. It should never be used with aspirin.
  7. UA symptoms reflect
    1. the presence of coronary artery emboli.
    2. total occlusion of a coronary artery.
    3. myocardial necrosis.
    4. an imbalance between oxygen supply and demand.
  8. Pain associated with NSTEMI is
    1. less intense than pain associated with UA.
    2. not caused by an imbalance between oxygen supply and demand.
    3. usually prolonged and more intense than rest angina.
    4. usually not indicative of myocardial damage.
  9. Thienopyridines constitute a drug class that
    1. lyses thrombi.
    2. prevents platelet aggregation.
    3. can't be used with aspirin.
    4. includes just one FDA-approved medication, clopidogrel.
  10. Which of the following statements about prasugrel is correct?
    1. It's more likely to cause bleeding than clopidogrel.
    2. It should be discontinued at least 5 days before any surgery.
    3. It's a prodrug that's converted to its active metabolite in the kidneys.
    4. It's inferior to clopidogrel in reducing clinical events.
  11. Which of the following is correct about clopidogrel?
    1. Its onset of action occurs in about 4 hours.
    2. It requires several passes through the liver to convert to its active metabolite.
    3. It's classified as a fibrinolytic.
    4. It promotes platelet activation and aggregation.
  12. A patient who received a bare metal stent should continue on dual antiplatelet therapy for
    1. at least 2 years.
    2. 18 months.
    3. at least 15 months.
    4. at least a year.
  13. Abruptly stopping dual antiplatelet therapy after receiving a stent places patients at high risk for
    1. bleeding.
    2. UA/NSTEMI.
    3. restenosis and STEMI.
    4. stent dislodgement.
  14. GP IIb/IIIa platelet inhibitors
    1. may be considered for patients on clopidogrel to prevent further platelet aggregation.
    2. may be initiated with patients taking clopidogrel who are at high risk for bleeding.
    3. should never be combined with thienopyridines.
    4. should never be combined with aspirin.
  15. Which of the following statements is correct?
    1. PPIs increase the metabolite conversion of thienopyridines.
    2. PPIs increase clopidogrel's antiplatelet effect.
    3. PPIs increase prasugrel's antiplatelet effect.
    4. PPIs decrease gastrointestinal adverse reactions to dual antiplatelet therapy.
  16. Using acetylcysteine to help prevent CIN is
    1. an FDA-approved nephroprotective treatment.
    2. a primary indication.
    3. a common off-label use.
    4. recommended in current task force guidelines.
  17. Strict glycemic control after an MI
    1. increases the risk of death at 90 days.
    2. reduces the risk of hypoglycemia.
    3. improves clinical outcomes after an MI.
    4. was proven beneficial by the NICE-SUGAR Trial.
  18. The drug metformin
    1. reduces the risk of developing CIN.
    2. is held prior to coronary angiography.
    3. reduces the risk of lactic acidosis in a patient who develops CIN.
    4. should be resumed immediately following coronary angiography.


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