A nurse is providing teaching for a client who has a new diagnosis of angina pectoris. Which of the following information should the nurse include about anginal pain?

The pain usually lasts longer than 20 min.

The pain persists with rest and organic nitrates.

Pain can often be relieved by sitting up.

Exertion and anxiety can trigger the pain.

Answer and Explanation

The Correct Answer is D

Choice A Reason: This is incorrect. Anginal pain usually lasts less than 20 min and subsides with rest or medication. Pain that lasts longer than 20 min may indicate a myocardial infarction.

Choice B Reason: This is incorrect. Anginal pain usually responds to rest and organic nitrates, such as nitroglycerin. Pain that does not improve with these measures may indicate unstable angina or a myocardial infarction.

Choice C Reason: This is incorrect. Anginal pain is not aﬀected by the position of the client. Pain that is relieved by sitting up may indicate pericarditis or pleurisy.

Choice D Reason: This is correct. Anginal pain is caused by a temporary imbalance between the oxygen demand and supply of the myocardium. Factors that increase the oxygen demand, such as exertion, anxiety, cold, or heavy meals, can trigger anginal pain.

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Correct Answer is D

Explanation

Choice A: Decreased specific gravity is not a finding of right-sided heart failure. Specific gravity is a measure of urine concentration, which can be aﬀected by ﬂuid intake, dehydration, kidney function, and diuretic use. Right-sided heart failure does not directly aﬀect urine concentration, but it can cause ﬂuid retention and edema in the body.

Choice B: Decreased brain natriuretic peptide (BNP) is not a finding of right-sided heart failure. BNP is a hormone that is released by the heart when it is stretched or overloaded. BNP helps to lower blood pressure and reduce ﬂuid volume by increasing urine output and dilating blood vessels. BNP levels are elevated in both left-sided and right- sided heart failure, as the heart is under increased pressure and volume.

Choice C: Increased pulmonary artery wedge pressure (PAWP) is not a finding of right-sided heart failure. PAWP is a measure of the pressure in the left atrium, which reﬂects the pressure in the pulmonary capillaries. PAWP is elevated in left-sided heart failure, as the blood backs up in the lungs due to impaired left ventricular function. PAWP is normal or low in right-sided heart failure, as the blood backs up in the systemic circulation due to impaired right ventricular function.

Choice D: Elevated central venous pressure (CVP) is a finding of right-sided heart failure. CVP is a measure of the pressure in the right atrium, which reﬂects the pressure in the systemic venous system. CVP is elevated in right-sided heart failure, as the blood backs up in the body due to impaired right ventricular function. CVP can cause jugular venous distension, hepatomegaly, splenomegaly, ascites, and peripheral edema.

A. Flushing of the skin B. Oliguria C. Hypertension D. Bradypnea

Correct Answer is B

Explanation

Choice A Reason: This is incorrect. Flushing of the skin is not a sign of hypovolemic shock, but rather of vasodilation or fever. Hypovolemic shock causes vasoconstriction and pale, cool, clammy skin.

Choice B Reason: This is correct. Oliguria is a decreased urine output that indicates reduced renal perfusion due to hypovolemia. The normal urine output for an adult is 0.5 to 1 mL/kg/hr.

Choice C Reason: This is incorrect. Hypertension is not a sign of hypovolemic shock, but rather of increased vascular resistance or ﬂuid overload. Hypovolemic shock causes hypotension due to decreased blood volume and cardiac output.

Choice D Reason: This is incorrect. Bradypnea is a slow respiratory rate that indicates respiratory depression or fatigue. Hypovolemic shock causes tachypnea due to hypoxia and increased metabolic demand.

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A nurse is providing teaching for a client who has a new diagnosis of angina pectoris. Which of the following information should the nurse include about anginal pain?

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Correct Answer is B

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