Based on an understanding of nitroglycerine, the RN administers it for which of the following reasons to a client with angina?
Increase afterload
Constrict the arteries
Dilate the vessels
Increase preload
The Correct Answer is C
A. Increase afterload: Increasing afterload would raise systemic vascular resistance and the workload on the heart, which is the opposite of nitroglycerin’s therapeutic effect. Nitroglycerin aims to reduce cardiac workload, not exacerbate it.
B. Constrict the arteries: Nitroglycerin does not constrict arteries; vasoconstriction would worsen myocardial oxygen demand and angina symptoms. Its action is primarily vasodilatory to improve coronary blood flow.
C. Dilate the vessels: Nitroglycerin is a nitrate that relaxes vascular smooth muscle, causing dilation of coronary and systemic vessels. This reduces both preload and afterload, lowers myocardial oxygen demand, and improves perfusion to ischemic myocardium, effectively relieving angina symptoms.
D. Increase preload: Nitroglycerin actually decreases preload by venous dilation, reducing ventricular filling pressure and myocardial oxygen consumption. Increasing preload would worsen cardiac workload, contrary to the drug’s intended use.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Total Volume: 50 mL
Infusion Time: 30 minutes (0.5 hours)
Calculate the flow rate
Flow Rate (mL/hr) = Total Volume ÷ Time in hours
Flow Rate = 50 ÷ 0.5
= 100 mL/hr
Correct Answer is B
Explanation
A. Atropine: Atropine is used to treat symptomatic bradycardia by increasing heart rate through vagal inhibition. It has no role in pulseless ventricular tachycardia (VT) and would not address the life-threatening arrhythmia, making it inappropriate in this context.
B. Amiodarone: Amiodarone is a class III antiarrhythmic indicated for refractory ventricular tachycardia or ventricular fibrillation unresponsive to initial defibrillation and epinephrine. It works by prolonging the action potential and refractory period in cardiac tissue, helping to stabilize ventricular conduction and increase the likelihood of return of spontaneous circulation.
C. Dopamine: Dopamine is a vasoactive agent used to support blood pressure and cardiac output in hypotension or shock. It does not terminate pulseless VT and would not be effective in restoring a perfusing rhythm, so it is not appropriate as the next step in this scenario.
D. Adenosine: Adenosine is effective for terminating supraventricular tachycardias by transiently blocking AV nodal conduction. It is ineffective for ventricular arrhythmias such as pulseless VT and could delay appropriate life-saving therapy if used in this situation.
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