A client is recently diagnosed with stable angina. The LPN is reinforcing teaching for the patient. The LPN knows which statement about stable angina is correct?
Troponin levels will always be elevated.
The pain is sharp and last for hours, usually radiating down the left leg.
The pain is predictable with exertion and is relieved by rest or nitroglycerin.
Pain occurs at rest and is relieved by nitroglycerin.
The Correct Answer is C
A. Troponin levels will always be elevated: Troponin is a biomarker for myocardial necrosis and cell death, which does not occur in stable angina. In stable angina, the ischemia is transient and reversible, meaning cardiac enzymes typically remain within normal limits. Elevated troponin levels are diagnostic of an acute myocardial infarction rather than angina.
B. The pain is sharp and last for hours, usually radiating down the left leg: Anginal pain is characteristically described as a dull, crushing, or squeezing pressure in the substernal region. It typically lasts only a few minutes and may radiate to the left arm, neck, or jaw, but not the leg. Prolonged pain lasting for hours suggests a more serious acute coronary syndrome.
C. The pain is predictable with exertion and is relieved by rest or nitroglycerin: Stable angina follows a consistent pattern where chest discomfort is triggered by specific levels of physical activity or emotional stress. The increased myocardial demand is eased once the activity stops or when nitroglycerin causes coronary vasodilation. This predictability is the defining feature that differentiates it from unstable angina.
D. Pain occurs at rest and is relieved by nitroglycerin: Pain that occurs without exertion or while the patient is resting is classified as unstable angina or Prinzmetal's angina. This represents a more dangerous clinical state where blood flow is compromised even at baseline. Stable angina requires an external stressor to trigger the imbalance in oxygen supply.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A. Assessing the legs and feet for peripheral edema: While edema is an important indicator of heart failure, it does not provide real-time information about the electrical activity of the heart. Edema is a chronic sign of volume overload rather than an acute indicator of dysrhythmia severity. It is not the most critical assessment prior to antiarrhythmic administration.
B. Checking the results of the most recent ECG: An ECG provides a snapshot of previous electrical activity but may not reflect the patient's current hemodynamic status. The nurse must assess the patient's actual physiological presentation at the moment the medication is being given. Bedside assessment is superior to relying solely on historical diagnostic data.
C. Listening to the apical pulse for a full minute: Antiarrhythmic medications can significantly alter heart rate and rhythm, potentially causing profound bradycardia or new conduction blocks. Assessing the apical pulse for 60 seconds provides the most accurate baseline of the heart's current rate and regularity. This is a mandatory safety step to ensure the patient can tolerate the drug.
D. Taking the blood pressure in both arms: While blood pressure is a vital sign, it is a secondary manifestation of the heart's pumping efficiency rather than a direct measure of the rhythm. A single arm reading is usually sufficient unless a specific vascular discrepancy is suspected. The primary concern with dysrhythmia medications is the heart rate itself.
Correct Answer is A
Explanation
A. Coronary arteriosclerosis: The narrowing and hardening of the coronary arteries restrict the flow of oxygenated blood to the myocardium. When physical activity increases the heart's oxygen demand, the restricted vessels cannot provide adequate supply, resulting in ischemic pain known as angina. This is the primary underlying cause of most cases of chronic stable angina.
B. Decreased workload of the heart: A reduction in cardiac workload would actually decrease the likelihood of experiencing angina. Angina is triggered when the workload exceeds the available oxygen supply, such as during physical exertion or stress. Management of angina focuses on reducing this workload through rest and medications like beta-blockers.
C. Atrial septal defect: This congenital heart defect involves an opening in the wall between the atria, which primarily causes shunting of blood. While it can lead to long-term complications like pulmonary hypertension, it is not the most common cause of typical angina pectoris in adults. Angina is almost always a result of obstructive coronary artery disease.
D. Infarction of the myocardium: Myocardial infarction refers to actual tissue death due to a complete and prolonged lack of blood flow. Angina is a warning sign of ischemia without cell death, which is why the client's cardiac labs and EKG remained normal. Infarction represents a permanent injury, whereas angina is a transient episode of oxygen mismatch.
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