A 51-year-old male presents with recurrent chest pain on exertion. He is diagnosed with angina pectoris. When he asks what causes the pain, how should the nurse respond? The pain occurs when
Cardiac output has fallen below normal levels.
The vagus nerve is stimulated.
Myocardial stretch has exceeded the upper limits.
The myocardial oxygen supply has fallen below demand.
The Correct Answer is D
Choice A reason: Cardiac output has not fallen below normal levels. Cardiac output is the amount of blood pumped by the heart per minute. It is affected by the heart rate and the stroke volume. Angina pectoris does not directly affect the cardiac output, but it can reduce the stroke volume due to impaired ventricular filling.
Choice B reason: The vagus nerve is not stimulated. The vagus nerve is a cranial nerve that innervates the heart and other organs. It is part of the parasympathetic nervous system, which slows down the heart rate and lowers the blood pressure. Angina pectoris does not activate the vagus nerve, but it can trigger the sympathetic nervous system, which increases the heart rate and blood pressure.
Choice C reason: Myocardial stretch has not exceeded the upper limits. Myocardial stretch is the degree of tension or load on the cardiac muscle fibers. It is determined by the end-diastolic volume, which is the amount of blood in the ventricle at the end of relaxation. Angina pectoris does not cause excessive myocardial stretch, but it can impair the myocardial contractility due to ischemia.
Choice D reason: The myocardial oxygen supply has fallen below demand. This is the main cause of angina pectoris. It occurs when the coronary arteries, which supply blood and oxygen to the heart muscle, are narrowed or blocked by atherosclerosis or spasm. This creates an imbalance between the oxygen demand of the heart, which increases during exertion, and the oxygen supply, which is reduced by the obstruction.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A reason: This is not the preferred agent for the initial treatment of heart failure. Vasodilators are a class of medications that lower the blood pressure by relaxing the blood vessels and reducing the resistance to blood flow. They can be used to treat hypertension, angina, and heart failure, but they are usually added to other medications, such as diuretics or beta blockers, to improve the symptoms and outcomes.
Choice B reason: This is the preferred agent for the initial treatment of heart failure. Diuretics are a class of medications that increase the urine output and reduce the fluid retention in the body. They can be used to treat hypertension, edema, and heart failure, as they reduce the preload and afterload on the heart, and decrease the pulmonary congestion and peripheral edema.
Choice C reason: This is not the preferred agent for the initial treatment of heart failure. Calcium channel blockers are a class of medications that lower the blood pressure and heart rate by blocking the calcium channels in the heart and blood vessels, which cause vasodilation and reduced cardiac contractility. They can be used to treat hypertension, angina, and arrhythmias, but they are not recommended for most patients with heart failure, as they may worsen the cardiac function and increase the mortality.
Choice D reason: This is not the preferred agent for the initial treatment of heart failure. Direct renin inhibitors are a class of medications that lower the blood pressure by inhibiting the enzyme renin, which initiates the renin-angiotensin-aldosterone system, a hormonal pathway that regulates the blood pressure and fluid balance. They can be used to treat hypertension, but they have not been proven to be effective or safe for patients with heart failure.
Correct Answer is D
Explanation
Choice A reason: The patient should not use the glucocorticoid as needed when symptoms flare. The glucocorticoid is a long-term controller medication that reduces inflammation and prevents exacerbations of COPD. It should be used regularly as prescribed, not as a rescue medication.
Choice B reason: The patient does not need to use the beta2-adrenergic agonist drug daily even when they don't have any symptoms. The beta2-adrenergic agonist is a short-acting bronchodilator that relaxes the smooth muscles of the airways and improves airflow. It should be used as needed for relief of acute symptoms, not as a maintenance medication.
Choice C reason: The beta2-adrenergic agonist does not suppress the synthesis of inflammatory mediators. The beta2-adrenergic agonist is a bronchodilator that acts on the beta2 receptors of the airways and causes relaxation of the smooth muscles. It does not have any anti-inflammatory effects.
Choice D reason: The glucocorticoid is used as prophylaxis to prevent exacerbations every day. This is the correct statement that indicates understanding of this medication regimen. The glucocorticoid is a long-term controller medication that reduces inflammation and prevents exacerbations of COPD. It should be used regularly as prescribed, along with the beta2-adrenergic agonist as needed for relief of acute symptoms.
Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.
Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today
Report Wrong Answer on the Current Question
Do you disagree with the answer? If yes, what is your expected answer? Explain.
Kindly be descriptive with the issue you are facing.