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 A
Explanation
Choice A reason:
Using a different antifungal agent might be necessary due to the potential interaction between voriconazole and warfarin. Voriconazole can increase the anticoagulant effects of warfarin, leading to an increased risk of bleeding. Therefore, selecting an alternative antifungal that does not interact with warfarin could be the safest option for the patient.
Choice B reason:
Reducing the dose of voriconazole may not adequately address the drug interaction issue. Voriconazole can significantly affect warfarin metabolism even at lower doses, leading to potential complications. Therefore, this choice is less likely to be recommended.
Choice C reason:
Administering intravenous voriconazole does not change its interaction with warfarin. The method of administration does not alter the drug's effect on warfarin metabolism, making this option inappropriate for managing the drug interaction.
Choice D reason:
Increasing the dose of warfarin is not a viable option as voriconazole increases warfarin's anticoagulant effect. This would further elevate the risk of bleeding and is not recommended. Thus, this option is incorrect.
Correct Answer is C
Explanation
Choice A reason:
Aspirin is an antiplatelet medication used to prevent blood clots in the arteries but is not the primary treatment for deep vein thrombosis (DVT), which is likely in this scenario. The patient's symptoms suggest a possible DVT, which requires anticoagulation therapy.
Choice B reason:
Clopidogrel (Plavix) is another antiplatelet medication, similar to aspirin, and is not the primary treatment for DVT. It is more commonly used to prevent clotting in arterial diseases such as coronary artery disease but not for venous thromboembolism.
Choice C reason:
Enoxaparin (Lovenox) is a low molecular weight heparin used for the initial treatment of DVT. It is an anticoagulant that helps prevent further clot formation and allows the body to break down the existing clot. Given the patient's symptoms, enoxaparin is the appropriate medication to anticipate for managing DVT.
Choice D reason:
Warfarin (Coumadin) is an oral anticoagulant used for long-term prevention of thromboembolism but is not typically used for initial DVT treatment due to its slow onset of action. Enoxaparin or other forms of heparin are preferred for immediate anticoagulation.
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