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:
Lactulose is the medication of choice for treating elevated ammonia levels, commonly seen in hepatic encephalopathy associated with cirrhosis. It works by reducing the absorption of ammonia from the intestines, converting ammonia to ammonium, which is then excreted. Administering lactulose helps in lowering blood ammonia levels and improving mental status in affected patients.
Choice B reason:
Polyethylene glycol (MiraLax) is a laxative used to treat constipation. It does not have any role in reducing ammonia levels or treating hepatic encephalopathy. Therefore, it is not appropriate for this patient's elevated ammonia condition.
Choice C reason:
0.9% NS (normal saline) is primarily used for fluid resuscitation and electrolyte balance. While essential in managing cirrhotic patients with fluid imbalances, it does not address the elevated ammonia levels directly. Therefore, it is not the treatment of choice for this specific situation.
Choice D reason:
Docusate sodium (Colace) is a stool softener used to treat constipation. It does not have any effect on ammonia levels or the treatment of hepatic encephalopathy. Thus, it is not appropriate for managing elevated ammonia in this patient.
Correct Answer is A
Explanation
Choice A reason:
True is the correct answer. Cardiac cells can endure ischemic conditions for approximately 20 minutes before irreversible injury occurs. Beyond this period, the lack of oxygen and nutrients leads to cell death and permanent damage to the heart tissue. This understanding is crucial in acute cardiac care, where timely intervention can prevent irreversible damage.
Choice B reason:
False is incorrect because it does not align with the known tolerance period of cardiac cells to ischemic conditions. The 20-minute window is critical for initiating interventions that can save heart tissue from permanent damage.
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