A 51-year-old male has come to the health clinic for his annual physical exam. After exerting himself by walking from his car to the clinic, he experienced substernal pain, discomfort in his left shoulder, and his jaw.

These symptoms lasted for 2-3 minutes and then subsided with rest.

He mentions that this has been a frequent occurrence over the past few months with similar levels of exertion.

What is the nurse likely to suspect he is experiencing?

Stable angina.

Prinzmetal angina.

Myocardial infarction (MI).

Unstable angina.

Answer and Explanation

The Correct Answer is A

Choice A rationale
Stable angina typically occurs with exertion and goes away with rest. The symptoms described, including substernal pain, discomfort in the left shoulder and jaw, which subside with rest, are characteristic of stable angina.
Choice B rationale
Prinzmetal angina, also known as variant angina, is a type of angina (chest pain) caused by spasms in the coronary arteries. These spasms occur most often in coronary arteries that have not become hardened due to plaque buildup. However, they can also occur in hardened arteries. The symptoms can be similar to those of stable angina, but the typical triggers for the episodes are different.
Choice C rationale
A myocardial infarction (MI), or heart attack, occurs when one of the coronary arteries becomes blocked, often by a blood clot, causing part of the heart muscle to be damaged or die. The symptoms are usually more severe than what is described and do not typically subside with rest.
Choice D rationale
Unstable angina is a condition in which the angina symptoms become more severe, occur more frequently, or occur at rest. This is a medical emergency as it can often lead to a heart attack.

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Correct Answer is ["B","C","D"]

Explanation

Choice A rationale
Rheumatoid arthritis is an autoimmune disease that primarily affects the joints. While it can increase the risk of cardiovascular disease due to systemic inflammation, it is not typically considered a direct cause of secondary hypertension.
Choice B rationale
Coarctation of the aorta, a congenital condition characterized by a narrowing of the aorta, can cause secondary hypertension. This is because the narrowing can increase resistance to blood flow, leading to increased pressure.
Choice C rationale
Increased intracranial pressure (ICP) can cause secondary hypertension as part of Cushing’s reflex, a physiological response to protect the brain from damage. This reflex can lead to an increase in systemic blood pressure in an attempt to maintain cerebral perfusion.
Choice D rationale
Renal disease is a common cause of secondary hypertension. The kidneys play a crucial role in regulating blood pressure, and damage to the kidneys can lead to hypertension.
Choice E rationale
Colon cancer is not typically associated with secondary hypertension. While some cancers can produce substances that increase blood pressure, colon cancer is not commonly associated with this phenomenon.

A. It increases the contractile force of the heart. B. It reduces heart palpitations. C. It decreases coronary artery spasms. D. It prevents the formation of plaque in the coronary arteries.

Correct Answer is C

Explanation

Choice A rationale
Diltiazem does not increase the contractile force of the heart. In fact, it is classified as a negative inotrope, meaning it decreases the force of heart contractions.
Choice B rationale
While diltiazem can affect heart rhythm, it does not specifically reduce heart palpitations. Its primary effect is to slow the heart rate and relax the blood vessels.
Choice C rationale
Diltiazem is a calcium channel blocker used to manage cardiovascular conditions such as hypertension, chronic stable angina, atrial fibrillation, and Prinzmetal’s angina. It works by inhibiting the calcium influx into cardiac and vascular smooth muscle during depolarization. This results in vasodilation, or the widening of blood vessels, which can help decrease coronary artery spasms, a characteristic feature of Prinzmetal’s angina.
Choice D rationale
Diltiazem does not prevent the formation of plaque in the coronary arteries. It primarily acts to relax the blood vessels and slow the heart rate.

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Naxlex Comprehensive Predictor Exams

Which of the following conditions are potential causes of secondary hypertension? (Select all that apply)

Correct Answer is ["B","C","D"]

Explanation

Diltiazem (Cardizem) has been prescribed for a patient newly diagnosed with Prinzmetal’s (variant) angina. What accurate action of diltiazem should the nurse include in the teaching plan?

Correct Answer is C

Explanation

The nurse is providing care for a patient with the following tracing on the electrocardiogram (ECG) for atrial fibrillation. What prescription should the nurse anticipate from the primary healthcare provider (PHCP)?

Given the electrocardiogram tracing below for a client who is unresponsive and without a pulse, what should be the nurse’s priority action?

A client is admitted to the telemetry unit with an episode of substernal chest pain. His diagnostic studies reveal an elevated ST segment on the electrocardiogram (ECG) and an elevated cardiac troponin level. What would be an appropriate initial nursing goal?

The nurse is reviewing the laboratory test results for a patient who has recently been diagnosed with hypertension. Which result is most important to communicate to the health care provider?

What is the primary pathophysiological reason for performing Coronary Artery Bypass Surgery?

While admitting a patient with pericarditis, what manifestations of this disorder should the nurse assess for?

What nursing assessment finding would suggest inadequate renal perfusion in a patient being stabilized after an acute coronary syndrome (myocardial infarction)?