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

Answer and Explanation

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.

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Correct Answer is B

Explanation

Choice A reason:
Telling the patient to stop taking the medication if they experience constipation is not appropriate. While side effects should be reported to the healthcare provider, discontinuing the medication without professional guidance can lead to inadequate management of cholesterol levels. The nurse should advise the patient to consult their provider about any side effects.

Choice B reason:
Continuing an exercise program to increase HDL serum levels is important advice. Regular physical activity is beneficial in raising HDL (good cholesterol) levels, which help reduce the risk of heart disease. Exercise complements the effects of cholesterol-lowering medications and supports overall cardiovascular health.

Choice C reason:
Stating that the medication will replace other interventions is incorrect. Cholesterol-lowering medications should be part of a comprehensive treatment plan that includes lifestyle modifications such as diet, exercise, and weight management. These interventions work synergistically to improve lipid profiles and reduce cardiovascular risk.

Choice D reason:
Doubling the dose if a dose is missed is unsafe and not recommended. Patients should follow their prescribed dosing schedule and consult their healthcare provider for instructions if they miss a dose. Taking an extra dose can increase the risk of adverse effects and complications.

A. Elevated triglycerides B. Elevated high-density lipoprotein C. Elevated low-density lipoprotein D. Elevated cholesterol

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.

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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:

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is B

Explanation

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Correct Answer is C

Explanation

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