A patient with a history of atherosclerosis complains of chest pain that is consistent at rest. The pain does not improve after sublingual Nitroglycerin. The likely cause of this pain is:
Hypotension
Stable angina
Unstable angina
Coronary vasodilation
The Correct Answer is C
Choice A reason:
Hypotension is not the likely cause of chest pain that does not improve after sublingual Nitroglycerin in a patient with a history of atherosclerosis. While hypotension can cause symptoms, the description of chest pain at rest that does not respond to Nitroglycerin suggests a more severe cardiac issue.
Choice B reason:
Stable angina typically occurs with exertion and is relieved by rest or Nitroglycerin. Chest pain consistent at rest that does not improve with Nitroglycerin suggests unstable angina, which is a more serious condition and requires immediate medical attention.
Choice C reason:
Unstable angina is the correct answer. It occurs when chest pain happens at rest and is not relieved by Nitroglycerin, indicating that the blood flow to the heart is severely restricted. This condition is a medical emergency as it can lead to a myocardial infarction.
Choice D reason:
Coronary vasodilation would typically relieve chest pain by increasing blood flow to the heart. The pain described is more consistent with unstable angina, where there is a significant reduction in blood flow to the heart that does not respond to vasodilation.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A reason:
Decreased afterload due to vasodilation is not the primary cause of hypotension in acute myocardial infarction. While vasodilation can lower blood pressure, in the context of MI, the more direct and significant cause of hypotension is the reduced cardiac contractility leading to decreased cardiac output. Vasodilation and afterload reduction are not the primary mechanisms in this scenario.
Choice B reason:
A rapid heart rate, or tachycardia, can contribute to hypotension by reducing the time for the heart to fill with blood between beats. However, in the context of an acute myocardial infarction, the primary issue is the heart's ability to contract effectively. Therefore, while a rapid heart rate might exacerbate the condition, it is not the main cause of hypotension.
Choice C reason:
Decreased cardiac contractility, resulting in decreased cardiac output, is the primary cause of hypotension in acute myocardial infarction. The damaged heart muscle cannot pump effectively, leading to reduced blood flow and low blood pressure. This is a direct consequence of the myocardial damage caused by the infarction, making this the correct answer.
Choice D reason:
Increased capillary permeability is not a primary cause of hypotension in acute myocardial infarction. This condition is more associated with inflammatory responses, sepsis, or allergic reactions. The main cause of hypotension in MI is related to the heart's reduced pumping ability.
Correct Answer is C
Explanation
Choice A reason:
Elevated triglycerides are a concern and are associated with an increased risk of coronary artery disease, but they are not as strong a predictor of coronary atherosclerosis as elevated low-density lipoprotein (LDL) levels. Triglycerides contribute to the overall lipid profile and can indicate metabolic issues, but LDL is more directly linked to plaque formation in arteries.
Choice B reason:
Elevated high-density lipoprotein (HDL) is generally considered beneficial and protective against coronary artery disease. HDL helps remove cholesterol from the bloodstream and arterial walls, transporting it to the liver for excretion. Therefore, elevated HDL is not concerning and is actually desirable.
Choice C reason:
Elevated low-density lipoprotein (LDL) is the most concerning when considering the risk of coronary atherosclerosis. LDL is known as "bad cholesterol" because high levels can lead to the buildup of plaque in the arteries, increasing the risk of heart attacks and strokes. Managing and reducing LDL levels is a primary goal in preventing and treating coronary artery disease.
Choice D reason:
Elevated cholesterol is a general term that can refer to increased levels of any lipoprotein in the blood. While concerning, it is more important to identify which specific lipoproteins are elevated. Elevated LDL levels, in particular, are more directly related to the risk of coronary atherosclerosis compared to total cholesterol.
Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.
Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today
Report Wrong Answer on the Current Question
Do you disagree with the answer? If yes, what is your expected answer? Explain.
Kindly be descriptive with the issue you are facing.