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 definition of ejection fraction. The percentage of blood that leaves the heart in a minute is related to the cardiac output, which is the product of the heart rate and the stroke volume.
Choice B reason: This is the correct definition of ejection fraction. It is the ratio of the stroke volume (the amount of blood pumped by the left ventricle) to the end-diastolic volume (the amount of blood in the left ventricle at the end of diastole). It is a measure of the efficiency of the heart and reflects the contractility of the cardiac muscle.
Choice C reason: This is not the definition of ejection fraction. The amount of blood that leaves the heart with each beat is the stroke volume, which is one of the factors that determine the ejection fraction.
Choice D reason: This is not the definition of ejection fraction. The amount of blood that leaves the heart in a minute is the cardiac output, which is influenced by the ejection fraction, but not equivalent to it.
Correct Answer is D
Explanation
Choice A reason: This is not a physiological response to hydralazine. Cool extremities are a sign of poor peripheral perfusion, which can be caused by vasoconstriction, not vasodilation.
Choice B reason: This is not a physiological response to hydralazine. Increased urinary output is a sign of diuresis, which can be caused by diuretic medications, not vasodilators.
Choice C reason: This is not a physiological response to hydralazine. Pale skin is a sign of reduced blood flow to the skin, which can be caused by vasoconstriction, not vasodilation.
Choice D reason: This is a physiological response to hydralazine. Reflex tachycardia is a compensatory mechanism that occurs when the blood pressure drops due to vasodilation. The heart rate increases to maintain the cardiac output and perfusion pressure.
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