Chapter 26 Drug Therapy for Angina

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Chapter 26  Drug Therapy for Angina

 

 

Complete chapter Questions And Answers
 

Sample Questions

 

 

1. A patient has substernal chest pain that radiates to the neck. The pain lasts 5 minutes and then subsides with relaxation. What is the most likely cause of the chest pain?

  1. A)  Myocardial infarction
  2. B)  Intermittent claudication
  3. C)  Hypertension
  4. D)  Angina pectoris

Ans: D
Feedback:
Classic angina pain related to angina pectoris is substernal chest pain that can radiate to the jaw. Chest pain that lasts longer than 5 minutes is not associated with angina but is associated with myocardial infarction. Hypertension is usually a condition in which the patient is pain free. Intermittent claudication is not associated with chest pain.

2. A patient is experiencing episodes of chest pain. He smokes one pack of cigarettes per day and has done so for many years. When teaching him about the effect of smoking on the cardiovascular system, the nurse will teach the patient about the effects of nicotine, including which of the following?

  1. A)  It increases catecholamines to increase heart rate.
  2. B)  It diminishes the blood’s ability to clot.
  3. C)  It increases myocardial contractility of the heart.
  4. D)  It increases high-density lipoproteins.

Ans: A

Feedback:

Nicotine increases catecholamines to increase heart rate and blood pressure. It increases platelet adhesiveness and aggregation to increase, not decrease, clotting. It decreases myocardial contractility. It does not increase myocardial contractility. It decreases good cholesterol, which is the high-density lipoprotein.

3. The nurse is teaching the patient about angina pectoris. Which of the following statements by the patient indicates that he has understood the teaching?

  1. A)  “I will avoid exercise because it will precipitate my angina.”
  2. B)  “As long as I take my medicines, I will not need to decrease my fat intake.”
  3. C)  “My high blood pressure has no effect on my episodes of chest pain.”
  4. D)  “High fat in the diet and smoking can cause my episodes of chest pain.”

Ans: D
Feedback:
A diet high in fat and calories will precipitate episodes of chest pain. The implementation of an exercise routine prevents cardiac pain and should be adhered to. The patient will need to alter his lifestyle to maintain heart health. High blood pressure will affect episodes of chest pain.

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4. A patient is admitted to the emergency department with chest pain that is unrelieved with sublingual organic nitrates. What medication will most likely be administered?

  1. A)  Intravenous morphine sulfate
  2. B)  Intravenous nitroglycerin
  3. C)  Oral nonsteroidal anti-inflammatory agents
  4. D)  Duragesic topical patch

Ans: B Feedback:

Intravenous nitroglycerin is used to manage angina that is unresponsive to organic nitrates via other routes. The use of intravenous morphine sulfate will decrease pain but will not increase blood flow. Oral nonsteroidal anti-inflammatory agents will not assist in decreasing pain or increasing blood flow. The application of a Duragesic patch will not increase blood flow.

5. A patient with a history of angina has sustained a mild head injury in a motor vehicle accident. He has nitroglycerin tablets for chest pain and asks the nurse for one due to chest pain. What effect will the nitroglycerin have on the patient’s current status?

  1. A)  Nitroglycerin will raise the patient’s blood pressure.
  2. B)  Nitroglycerin will cause decreased cerebral edema.
  3. C)  Nitroglycerin will increase intracranial pressure.
  4. D)  Nitroglycerin will decrease blood glucose.

Ans: C

Feedback:

Nitroglycerin should be used cautiously in the presence of a head injury or cerebral hemorrhage because it may increase intracranial pressure. Nitroglycerin will lower blood pressure. Nitroglycerin can increase cerebral edema. Nitroglycerin does not have a direct effect on blood glucose.

6. A patient is diagnosed with erectile dysfunction. He asks what effect sildenafil (Viagra) has because he is taking nitroglycerin for chest pain. What is the best explanation for why nitrates are contraindicated with sildenafil (Viagra)?

  1. A)  “Nitroglycerin and Viagra cause a severe decrease in blood pressure.”
  2. B)  “Nitroglycerin and Viagra can lead to prostate cancer.”
  3. C)  “Nitroglycerin decreases the effect of Viagra for erectile dysfunction.”
  4. D)  “Nitroglycerin and Viagra will diminish the effectiveness of chest pain relief.”

Ans: A
Feedback:
Nitrates and phosphodiesterase enzyme type 5 inhibitors decrease blood pressure, and the combined effect can produce profound, life-threatening hypotension.

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