A client is diagnosed with chronic stable angina caused by plaques in the coronary arteries. The client receives a prescription for sublingual nitroglycerin to use as needed when angina occurs. Which additional medication does the nurse anticipate would be prescribed for this client?

Atorvastatin

Digoxin

Furosemide

Rituximab

Answer and Explanation

The Correct Answer is A

A.   Atorvastatin is a statin used to lower cholesterol levels in the blood. Reducing cholesterol levels helps to prevent the progression of atherosclerosis (plaque buildup in the arteries), which is a major cause of chronic stable angina. Statins are commonly prescribed to manage the underlying condition that leads to angina by stabilizing plaques and reducing the risk of heart attacks and strokes.
B.   Digoxin is a medication used to treat heart failure and certain types of abnormal heart rhythms (arrhythmias). It works by increasing the force of heart contractions and controlling heart rate. While it can be helpful in specific cases of heart failure or arrhythmias, it is not typically used for the management of chronic stable angina.
C.   Furosemide is a diuretic used to treat conditions such as heart failure and edema by removing excess fluid from the body. It helps to reduce fluid buildup but does not address the underlying cause of chronic stable angina or improve coronary artery function. It is not a primary medication for managing angina.
D.   Rituximab is a monoclonal antibody used primarily to treat certain types of cancer and autoimmune diseases by targeting specific immune cells. It is not used to treat chronic stable angina or related cardiovascular conditions. It does not play a role in managing cholesterol levels or improving coronary artery health.

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Correct Answer is {"A":{"answers":"A"},"B":{"answers":"A,B"},"C":{"answers":"A"},"D":{"answers":"B"}}

Explanation

Client's Response to Nitroglycerin Therapy

• Unstable Angina:
o Typically, unstable angina responds well to nitroglycerin. The relief of discomfort after nitroglycerin administration suggests that the chest pain was likely related to unstable angina, as it indicates a reduction in coronary artery spasm or temporary ischemia.
• Myocardial Infarction:
o In an MI, nitroglycerin may help alleviate pain, but it does not address the underlying cause of myocardial injury. The pain relief in an MI is generally more variable and may not be as effective if there is significant myocardial damage.

2. Client's Initial Report of Manifestations

• Unstable Angina:
o The symptoms described (shortness of breath, dizziness, and discomfort in the jaw, neck, and left arm) are consistent with unstable angina, which is characterized by episodes of chest pain or discomfort at rest or with minimal exertion, often associated with transient ischemia.
• Myocardial Infarction:
o These symptoms can also be consistent with MI, especially if they are severe or persistent. However, MI often presents with more intense and prolonged pain, and the discomfort might not always resolve with rest.

3. 12 Lead EKG Report

• Unstable Angina:
o ST depression on an EKG is more commonly associated with unstable angina, which indicates transient ischemia rather than a sustained myocardial injury.
• Myocardial Infarction:
o ST depression indicates ischemia commonly in angina.

4. Troponin Results

• Unstable Angina:
o Troponin levels are typically normal in unstable angina. The client’s troponin I (0.01 ng/mL) and troponin T (0.03 ng/mL) are within the normal range, suggesting no significant myocardial injury. This is consistent with unstable angina.
• Myocardial Infarction:
o Elevated troponin levels are a key marker of myocardial injury. The normal troponin results in this case do not support an MI diagnosis, as elevated troponin levels would be expected in MI.

A. Thirty seconds after administration, the facial weakness and ptosis will be relieved for approximately 5 minutes. B. After administration, the client will experience worsening facial weakness and ptosis. C. After administration of the medication, there will be no change in the status of the ptosis or facial weakness. D. The client will have elimination of symptoms lasting at least 24 hours after the administration of the medication.

Correct Answer is A

Explanation

This is the correct expected outcome if the test is positive for myasthenia gravis. Edrophonium works quickly to increase acetylcholine levels, leading to temporary improvement in muscle strength. In a patient with myasthenia gravis, administration of edrophonium typically results in a rapid improvement in symptoms like facial weakness and ptosis within 30 to 60 seconds, with the effects lasting for a few minutes. This brief improvement is indicative of a positive result for myasthenia gravis.
B.A Worsening symptoms after administration of edrophonium are not expected and could indicate an adverse reaction or incorrect diagnosis. In myasthenia gravis, edrophonium typically improves symptoms rather than worsening them.
C. No change in symptoms would be unexpected in the case of myasthenia gravis. If edrophonium is effective, there should be a noticeable improvement in symptoms. If there is no change, it might suggest a diagnosis other than myasthenia gravis or that the test is inconclusive.
D. This outcome is not expected. Edrophonium has a very short duration of action, typically relieving symptoms for only a few minutes. The effects do not last for 24 hours. A longer-lasting improvement might be observed with other treatments for myasthenia gravis, such as anticholinesterase medications like pyridostigmine, but not with edrophonium.

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A client is diagnosed with chronic stable angina caused by plaques in the coronary arteries. The client receives a prescription for sublingual nitroglycerin to use as needed when angina occurs. Which additional medication does the nurse anticipate would be prescribed for this client?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse in the emergency department is admitting a client. Exhibits For each of the following findings in the client's medical record, click to specify if they are consistent with unstable angina or a myocardial infarction (MI). Each finding may support more than one disease process.

Correct Answer is {"A":{"answers":"A"},"B":{"answers":"A,B"},"C":{"answers":"A"},"D":{"answers":"B"}}

Explanation

The nurse is assisting while a neurologist administers an edrophonium (Tensilon) test to a client with facial weakness and ptosis. If the test is positive for myasthenia gravis, which outcome would the nurse observe?

Correct Answer is A

Explanation

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