A nurse is caring for a client who has variant angina and is prescribed verapamil. Which of the following are expected outcomes of this medication? (Select all that apply.)

Decreased heart rate

Increased contractility

Dilated coronary arteries

Reduced blood pressure E.

Relieved chest pain.

Answer and Explanation

Correct Answer : C,E

Verapamil is a calcium channel blocker that is used to treat variant angina by dilating the coronary arteries and relieving the chest pain caused by spasms. It also reduces blood pressure and heart rate, but these are not the expected outcomes for variant angina.

Choice A is wrong because verapamil decreases heart rate, not increases it. This can help reduce the oxygen demand of the heart, but it is not the main goal of therapy for variant angina.

Choice B is wrong because verapamil decreases contractility, not increases it. This can also help reduce the oxygen demand of the heart, but it is not the main goal of therapy for variant angina.

Choice D is wrong because verapamil reduces blood pressure, not increases it. This can help lower the workload of the heart, but it is not the main goal of therapy for variant angina.

Normal ranges for heart rate are 60 to 100 beats per minute, for blood pressure are 120/80 mm Hg or lower, and for contractility are measured by ejection fraction, which is normally 55% or higher.

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Correct Answer is C

Explanation

Activated partial thromboplastin time (aPTT).

Dabigatran (Pradaxa) is a direct oral anticoagulant (DOAC) that inhibits thrombin, a key enzyme in the coagulation cascade.

Dabigatran prolongs the aPTT, which is a measure of the intrinsic and common pathways of coagulation.The aPTT can be used to monitor the anticoagulant effect of dabigatran, although routine monitoring is not required.

Choice A) Prothrombin time (PT) is wrong because PT measures the extrinsic and common pathways of coagulation, which are not affected by dabigatran.

PT is used to monitor warfarin therapy, not dabigatran.

Choice B) International normalized ratio (INR) is wrong because INR is a standardized version of PT that is used to monitor warfarin therapy, not dabigatran.

INR is not affected by dabigatran.

Choice D) Platelet count is wrong because platelet count is a measure of the number of platelets in the blood, which are involved in primary hemostasis.

Platelet count is not affected by dabigatran, which acts on secondary hemostasis.

Normal ranges for these tests are:

• aPTT: 25 to 35 seconds

• PT: 11 to 13.5 seconds

• INR: 0.8 to 1.2

• Platelet count: 150,000 to 450,000 per microliter of blood

A. 2 hours B. 4 hours C. 6 hours D. 8 hours.

Correct Answer is B

Explanation

Argatroban is a direct thrombin inhibitor (DTI) that is used as an alternative anticoagulant for patients with heparin-induced thrombocytopenia (HIT) who require urgent surgery. Argatroban has a half-life of about 40 to 50 minutes and is cleared by the liver.The infusion should be stopped at least 4 hours before the surgery to allow adequate time for the anticoagulant effect to wear off.The activated partial thromboplastin time (aPTT) should be monitored before and after the infusion to assess the degree of anticoagulation.

Choice A is wrong because 2 hours is not enough time to stop the argatroban infusion before surgery.

The patient may still have a high risk of bleeding if the aPTT is prolonged.

Choice C is wrong because 6 hours is longer than necessary to stop the argatroban infusion before surgery.

The patient may have a higher risk of thrombosis if the anticoagulation effect is too low.

Choice D is wrong because 8 hours is much longer than necessary to stop the argatroban infusion before surgery.

The patient may have a very low level of anticoagulation and a high risk of thrombosis if the infusion is stopped for too long.

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A nurse is caring for a client who has variant angina and is prescribed verapamil. Which of the following are expected outcomes of this medication? (Select all that apply.)

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Naxlex Comprehensive Predictor Exams

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Correct Answer is C

Explanation

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Correct Answer is B

Explanation

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