Which statement made by the student nurse indicates effective learning about cardiovascular disease? Show a. "Nicotine stimulates catecholamine release." b. "Isometric exercise provides relief from angina." c. "Manifestations of angina often occur in the late evenings." d. "Decreased heart rate increases myocardial oxygen demand." a. "Nicotine stimulates catecholamine release." Rationale Which drug breaks up the fibrin meshwork in clots? A. Nadolol B. Alteplase C. Valsartan D. Nicardipine B. Alteplase Rationale Which drug produces an anticoagulant effect by interfering with hepatic synthesis of vitamin K-dependent clotting factors? A. Warfarin B. Prasugrel C. Argatroban D. Eptifibatide A. Warfarin Rationale p. 715 Which statement by a patient diagnosed with stable angina indicates understanding of the disease process? A. "Angina is caused by spasms within a coronary blood vessel." B. "Angina is causing an irreversible damage to my cardiac muscles by cardiac ischemia." C. "Anginal pain is caused by an increased demand for oxygen or a decreased supply of oxygen." D. "Symptoms of angina start when the process of atherosclerosis completely occludes a coronary artery." C. "Anginal pain is caused by an increased demand for oxygen or a decreased supply of oxygen." Rationale A patient with angina takes a total of three nitroglycerin tablets, five minutes apart. The patient's chest pain is not relieved. What is the nurse's priority action? A. Assess vital signs. B. Repeat the medication in five minutes. C. Contact the emergency medical services (EMS). D. Instruct the patient to lie quietly and to take deep breaths. C. Contact the emergency medical services (EMS). Rationale Which drug causes vasodilation by preventing conversion of angiotensin I to angiotensin II? A. Enalapril B. Losartan C. Amlodipine D. Nitroglycerin A. Enalapril Rationale p. 715 The nurse is performing an assessment on a newly admitted patient who presented to the emergency department with reports of chest pain. Which assessment data would indicate that the patient has stable angina? A. The patient developed chest pain shortly after going to bed. B. The patient developed chest pain while sitting and reading a book. C. The pain developed when the patient was jogging and subsided after the patient rested. D. The pain starts approximately the same time every day without regard to activity level. C. The pain developed when the patient was jogging and subsided after the patient rested. Rationale A patient with stable angina takes a short-acting nitrate. The nurse recognizes that it is important to monitor the patient for what? A. Decrease in heart rate B. Decreased ejection fraction C. Decrease in blood pressure D. Prolonging of the QT interval C. Decrease in blood pressure Rationale p. 716 Which drug may prevent or limit ventricular remodeling? B. Valsartan C. Metoprolol D. Nitroglycerin A. Captopril Rationale Which drugs act by decreasing the contractility of the heart? Select all that apply. A. Captopril B. Diltiazem C. Valsartan D. Carvedilol E. Morphine B. Diltiazem Rationale The nurse is caring for a female patient that reports chest pain while performing daily activities. The patient's chest x-ray reveals that there is no significant coronary atherosclerosis. Which condition is indicated in the patient? A. Silent ischemia B. Nocturnal angina C. Angina decubitus D. Microvascular angina D. Microvascular angina Rationale Which drugs act by causing vasodilation either directly or indirectly? Select all that apply. B. Morphine C. Reteplase D. Carvedilol E. Bivalirudin A. Losartan B. Morphine Rationale pp. 715-716 Which drug prevents the binding of fibrinogen to platelets, thereby preventing platelet aggregation? A. Heparin B. Tirofiban C. Ticagrelor D. Dalteparin B. Tirofiban Rationale p. 715 A patient that smokes reports chest pain while at rest. The nurse suspects that the patient is experiencing which condition? a. Silent ischemia b. Angina decubitus c. Prinzmetal's angina d. Chronic stable angina c. Prinzmetal's angina Which drugs may be prescribed for patients with chronic stable angina to help optimize myocardial perfusion? Select all that apply. a. Aspirin b. Atenolol Rationale pp. 715-717 What medication education should the nurse provide to a patient that receives a prescription for isosorbide mononitrate? Select all that apply. a. "Tolerance to this long-acting nitroglycerin can develop." Rationale The nurse provides care to a patient that undergoes intracoronary stent placement along with balloon angioplasty. Which drugs are used during the procedure to prevent platelet aggregation within the stent? Select all that apply. a. Verapamil b. Bivalirudin Rationale p. 717 Which drug is given along with aspirin to patients with unstable angina and NSTEMI? a. Heparin Rationale p. 722 A patient reports episodic chest pain lasting 10 minutes that is provoked by exertion and relieved upon resting. The nurse suspects that the cause of the patient's symptoms is what? a. Spasm of a major coronary artery c. Myocardial ischemia due to coronary artery disease Rationale p. 712 A patient states, "I have episodes of sharp and stabbing chest pain that last 10 minutes and that occur primarily when I am restocking shelves while at work." The patient is diagnosed with chronic stable angina. Which instruction should the nurse give to the patient to prevent anginal pain while at work? a. "Perform 30 minutes of moderate exercise before going to
work." b. "Take nitroglycerin 5 to 10 minutes before restocking the shelves." Rationale Which statement made by the student nurse indicates effective learning about microvascular angina? a. "Pain may occur during rapid eye movement (REM) sleep." b. "Pain occurs at night and is triggered by the patient lying down." c. "This type of angina is more common in patients with diabetic neuropathy." d. "This type of angina is more common in women and is triggered by activities of daily living." d. "This type of angina is more common in women and is triggered by activities of daily living." Rationale p. 713 A patient with coronary artery disease (CAD) is being seen in an outpatient health care setting for a routine examination. The patient states, "Over the past few months, I have needed increased amounts of insulin to control my type 1 diabetes mellitus." What is an appropriate goal for the nurse to place on the patient's plan of care, aimed at preventing the progression of CAD? a. Maintain a Hb A1C level of less than 7% b. Maintain a body mass index (BMI) between 31-35 kg/m 2 c. Maintain a fasting triglyceride level of less than 175 mg/dL d. Maintain a serum cholesterol level of less than 250 mg/dL(at least 5 days a week) a. Maintain a Hb A1C level of less than 7% Rationale A female patient reports that she often experiences chest pain while sitting at her desk at work. The nurse suspects what condition? a. Angina decubitus d. Coronary microvascular disease Rationale p. 713 Which statement made by the student nurse indicates effective learning about Prinzmetal's angina? a. "The pain may be relieved by moderate exercise." a. "The pain may be relieved by moderate exercise." Rationale p. 713 A patient with stable angina receives a prescription for isosorbide dinitrate. What medication education should the nurse provide to the patient? Select all that apply. a. "Change positions slowly after taking this medication." Rationale p. 716 A patient reports cyclic and short bursts of pain in the chest during the day and night that are relieved after performing mild exercise. The nurse anticipates a prescription for which medication? a. Prasugrel b. Sirolimus c. Abciximab d. Verapamil d. Verapamil Rationale pp. 713, 715 A patient that takes amphetamines reports cyclic, short bursts of pain in the chest during the day and late at night. What should the nurse include in the patient's plan of care? b. Performing moderate exercise during the attack c. Taking 181 to 325 mg of (chewable) aspirin during the attack d. Standing near a cool environment (such as an open refrigerator) during the attack b. Performing moderate exercise during the attack Rationale p. 713 A patient with chronic stable angina is experiencing a prolonged QT interval on the electrocardiogram (ECG) monitor. The nurse reviews the list of drugs prescribed for the patient and should question which medication? a. Aspirin b. Heparin c. Captopril d. Ranolazine d. Ranolazine Rationale A patient with a history of diabetes is diagnosed with chronic stable angina. The nurse recalls that which drug that decreases endothelial dysfunction would be beneficial to this patient? a. Diltiazem b. Sirolimus c. Captopril d. Bivalirudin c. Captopril Rationale p. 715 Which other assessment finding would the nurse expect in a patient that reports substernal pain radiating to the neck and jaw that occurs when exercising and that lasts for a few minutes? a. Decrease in the heart rate b. Depression of the ST segment c. Persistent pain even when resting d. Frequent episodes of migraine headache b. Depression of the ST segment Rationale The nurse provides information to a patient with Prinzmetal's angina related to risk factors related to this type of angina. What should the nurse include? a. Diabetes b. Smoking c. Postmenopausal state d. High cholesterol level b. Smoking Rationale p. 713 Drug-eluting stents (DES) are coated with which drugs? Select all that apply. a. Losartan b. Paclitaxel c. Captopril d. Everolimus e. Ranolazine b. Paclitaxel Rationale p. 718 A patient with a history of asthma presents to the emergency department with wheezing, chest pain, and shortness of breath. The nurse reviews the patient's medication profile and identifies that which type of medication may be responsible for the patient's symptoms? a. Short-acting nitrate b. β-adrenergic blocker c. Calcium channel blocker d. Angiotensin II receptor blocker b. β-adrenergic blocker Rationale p. 717 The nurse reviews a patient's history and notes an ejection fraction of 30%, diabetes, reports of stabbing chest pain that is relieved upon rest, and prescription for captopril. During a follow-up visit, the primary health care provider finds that the patient is intolerant of captopril. The nurse anticipates that which medication will be prescribed? a. Valsartan a. Valsartan Rationale pp. 715-717 The nurse reviews the medication profiles of four patients. The nurse should question a medication that is prescribed for which patient? Patient D Rationale pp. 713, 715-717 The nurse is caring for a patient with chronic stable angina that has a history of a stroke. Which prescription should the nurse question? a. Aspirin b. Vorapaxar c. Metoprolol d. Nitroglycerin b. Vorapaxar Rationale p. 715 A patient with angina is prescribed a calcium channel blocker. Upon reviewing the medication history, the nurse finds that the patient is on digoxin. The nurse should monitor the patient for which complication? a. Prolonging of the QT interval b. Increase in weight c. Decrease in blood pressure d. Increase in serum digoxin levels d. Increase in serum digoxin levels Rationale A patient with angina asks the nurse about the origin of the pain. The nurse explains that the pain is primarily caused by what condition? a. Atherosclerosis b. Myocardial ischemia c. Movement of a thromboembolus d. Coronary artery vasoconstriction b. Myocardial ischemia Rationale p. 712 Which type of angina occurs as a result of coronary vasospasm? a. Nocturnal angina b. Prinzmetal's angina c. Microvascular angina d. Chronic stable angina b. Prinzmetal's angina Rationale Which drug prevents the binding of fibrinogen?Tirofiban (Aggrastat)
It is a reversible antagonist of fibrinogen binding. When administered intravenously, more than 90% of platelet aggregation is inhibited.
Which drug causes vasodilation by preventing conversion of angiotensin?General Pharmacology. ACE inhibitors produce vasodilation by inhibiting the formation of angiotensin II. This vasoconstrictor is formed by the proteolytic action of renin (released by the kidneys) acting on circulating angiotensinogen to form angiotensin I.
Which drug prevents the binding of fibrinogen to platelets thereby preventing platelet aggregation?Tirofiban (Aggrastat)
Tirofiban is a nonpeptide antagonist of the platelet GP IIb/IIIa receptor; it reversibly prevents vWF, fibrinogen, and other adhesion ligands from binding to the receptor, thus inhibiting platelet aggregation.
Which drugs act by decreasing the contractility of the heart?Beta‐blockers are one kind of drug which can used for symptomatic relief of angina and prevention of ischaemic events based on the function of reducing myocardial oxygen demand by decreasing heart rate and myocardial contractility.
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Which drug may prevent or limit ventricular remodeling
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