What is the primary cause of myocardial ischemia?

Idiopathic vasospasm.

Atherosclerosis.

Venous emboli.

Arterial emboli from a heart valve.

Answer and Explanation

The Correct Answer is B

Choice A rationale
Idiopathic vasospasm, or spontaneous constriction of the blood vessels, can cause myocardial ischemia. However, this is a relatively rare cause compared to atherosclerosis.
Choice B rationale
Atherosclerosis, a condition characterized by the buildup of fatty plaques in the arteries, is the most common cause of myocardial ischemia. These plaques can restrict blood flow to the heart muscle, leading to ischemia.
Choice C rationale
Venous emboli, or blood clots that form in the veins, typically do not cause myocardial ischemia. These clots are more likely to cause problems in the lungs (pulmonary embolism) if they travel through the bloodstream.
Choice D rationale
Arterial emboli from a heart valve can cause myocardial ischemia, but this is less common than atherosclerosis. These emboli, or blood clots, can block blood flow to the heart muscle if they travel through the bloodstream.

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Correct Answer is D

Explanation

Choice A rationale
Increasing glomerular filtration would result in increased urine output, not decreased venous return. This action is not directly related to the therapeutic action of nitroglycerin.
Choice B rationale
While enhancing the contractility of the myocardium would increase oxygen delivery, this is not the primary action of nitroglycerin. Nitroglycerin primarily works by dilating the blood vessels, which reduces the amount of work the heart has to do and increases the blood supply to the heart muscle.
Choice C rationale
Nitroglycerin does not produce an immediate analgesic effect. While it can relieve chest pain, it does so by increasing blood flow to the heart, not by acting as an analgesic.
Choice D rationale
Nitroglycerin increases the coronary blood supply and decreases the afterload314. By dilating the blood vessels, nitroglycerin reduces the amount of work the heart has to do and increases the blood supply to the heart muscle. This is the primary therapeutic action of nitroglycerin in alleviating chest pain.

A. A 59-year-old patient with unstable angina who has just returned from a percutaneous coronary intervention (PCI). B. A 56-year-old patient with variant angina due to receive nifedipine (Procardia). C. A 65-year-old patient who had a myocardial infarction (MI) 4 days ago and is anxious about discharge planned for today. D. A 39-year-old patient with pericarditis complaining of sharp, stabbing chest pain.

Correct Answer is A

Explanation

Choice A rationale
A 59-year-old patient with unstable angina who has just returned from a percutaneous coronary intervention (PCI) should be prioritized for assessment. PCI is a procedure to open blocked or narrowed coronary arteries and can lead to complications such as re-occlusion of the artery or bleeding from the catheter insertion site. Furthermore, unstable angina is a condition that can progress to myocardial infarction if not managed effectively.
Choice B rationale
A 56-year-old patient with variant angina due to receive nifedipine (Procardia) requires monitoring, but is not the highest priority. Variant angina is a form of angina that occurs at rest, often with severe pain, but it is usually well-controlled with medications like nifedipine.
Choice C rationale
A 65-year-old patient who had a myocardial infarction (MI) 4 days ago and is anxious about discharge planned for today is a lower priority for assessment. While it’s important to address the patient’s anxiety and provide education about post-discharge care, this patient is not in immediate danger.
Choice D rationale
A 39-year-old patient with pericarditis complaining of sharp, stabbing chest pain requires assessment, but is not the highest priority. Pericarditis is inflammation of the pericardium, the sac-like covering of the heart, and while it can cause severe pain, it is not typically life- threatening.

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What is the primary cause of myocardial ischemia?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is administering nitroglycerin intravenously to alleviate chest pain. What is the therapeutic action of this medication?

Correct Answer is D

Explanation

After receiving the shift change report about four patients in the cardiac care unit, which patient should the nurse prioritize for assessment?

Correct Answer is A

Explanation

A 75-year-old male experiences severe chest pain and calls 911. Given that lab findings indicate elevated levels of cardiac troponins I and T, what condition does the nurse suspect?

An older patient with chronic atrial fibrillation develops sudden severe pain, pulselessness, pallor, and coolness in the right leg, consistent with acute arterial occlusion. After the nurse notifies the healthcare provider, what should the nurse do next?

The standard policy on the cardiac unit states, “Notify the health care provider for mean arterial pressure (MAP) less than 70 mm Hg.”. Which patient should the nurse call the health care provider about?

Which of the following findings in a patient with Raynaud’s disease would indicate a need for further teaching?

After receiving a change-of-shift report, which patient admitted to the emergency department should the nurse assess first?

As a nurse preparing for the admission of a child diagnosed with acute-stage Kawasaki disease, what clinical manifestation of the acute stage of the disease should be anticipated during the assessment?

A nurse is providing care for a patient who has weak pedal pulses, no hair on both legs, and a full-thickness wound on the right lateral malleolus with defined margins, which includes a small amount of serous exudate. Which intervention should not be performed?