The nurse is providing care for a client diagnosed with cardiovascular disease and hypertension who is complaining of chest pain. Which medication should the nurse administer?
Furosemide 40 mg PO daily
Diltiazem 30 mg PO daily
Metoprolol 25 mg PO bid
Nitroglycerin 0.4 mg SL PRN
The Correct Answer is D
Choice A reason: Furosemide 40 mg PO daily is not the medication that the nurse should administer for chest pain. Furosemide is a diuretic that reduces fluid volume and lowers blood pressure, but it does not relieve anginal pain.
Choice B reason: Diltiazem 30 mg PO daily is not the medication that the nurse should administer for chest pain. Diltiazem is a calcium channel blocker that relaxes the blood vessels and lowers blood pressure, but it does not act quickly enough to relieve acute anginal pain.
Choice C reason: Metoprolol 25 mg PO bid is not the medication that the nurse should administer for chest pain. Metoprolol is a beta blocker that slows down the heart rate and lowers blood pressure, but it does not act quickly enough to relieve acute anginal pain.
Choice D reason: Nitroglycerin 0.4 mg SL PRN is the medication that the nurse should administer for chest pain. Nitroglycerin is a nitrate that dilates the coronary arteries and increases blood flow to the heart, thus relieving anginal pain. It is given sublingually (under the tongue) as needed for chest pain.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A reason: The pain you have is because your heart valves are damaged is not the most appropriate response. This statement may apply to a client with valvular heart disease, but not necessarily to a client with coronary artery disease. The nurse should explain that coronary artery disease is a condition that affects the blood vessels that supply the heart, not the heart valves.
Choice B reason: Your heart muscle is weak and is not pumping forcefully is not the most appropriate response. This statement may apply to a client with heart failure, but not necessarily to a client with coronary artery disease. The nurse should explain that coronary artery disease is a condition that reduces the blood flow to the heart, not the heart's contractility.
Choice C reason: The pain is caused by decreased oxygen to the heart muscle is the most appropriate response. This statement accurately describes the cause of angina, which is the chest pain that occurs when the heart does not receive enough oxygen due to narrowed or blocked coronary arteries. The nurse should also inform the client about the factors that can trigger or relieve angina, such as physical exertion, emotional stress, cold weather, or nitroglycerin.
Choice D reason: The layers of your heart are weak and thin is not the most appropriate response. This statement may apply to a client with cardiomyopathy, but not necessarily to a client with coronary artery disease. The nurse should explain that coronary artery disease is a condition that affects the blood vessels that supply the heart, not the heart's structure.
Correct Answer is ["A","C"]
Explanation
Choice A: Elevated troponins. This is a correct answer. Troponins are proteins that regulate the myocardial contractile process². They are released into the bloodstream when the myocardial cells are damaged by ischemia or infarction². Troponins are highly specific and sensitive indicators of myocardial injury². The normal range for troponin I is less than 0.03 ng/mL and for troponin T is less than 0.01 ng/mL².
Choice B: Decreased homocysteine levels. This is not a correct answer. Homocysteine is an amino acid that is involved in the metabolism of methionine². Elevated homocysteine levels are associated with an increased risk of cardiovascular disease, but they are not a direct marker of myocardial injury². The normal range for homocysteine is 5 to 15 micromol/L².
Choice C: Elevated CK-MB. This is a correct answer. CK-MB is one of the isoenzymes of creatine kinase, an enzyme that catalyzes the conversion of creatine to phosphocreatine, which is used for energy storage in the muscles². CK-MB is found mainly in the myocardium and is released into the blood when the myocardial cells are injured². CK-MB is a specific and sensitive marker of myocardial injury, but it is less specific than troponins². The normal range for CK-MB is 0 to 3 ng/mL².
Choice D: Decreased alkaline phosphatase (ALP).This is not a correct answer. ALP is an enzyme that is found in various tissues, such as the liver, bone, intestine, and placenta². ALP is not a marker of myocardial injury, and its levels are not affected by ischemia or infarction². The normal range for ALP is 30 to 120 U/L².
Choice E: Increased platelet count.This is not a correct answer. Platelets are blood cells that are involved in hemostasis and clot formation². Increased platelet count, or thrombocytosis, can be a sign of inflammation, infection, malignancy, or other conditions². Platelet count is not a marker of myocardial injury, and it does not reflect the extent of ischemia or infarction². The normal range for platelet count is 150,000 to 450,000 per microliter of blood².
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