Angina, MI, Aneurysms Questions (NCLEX) Answered 2022

Angina, MI, Aneurysms Questions (NCLEX) Answered 2022 The nurse teaches the client that the major difference between angina and pain associated with myocardial infarction (MI) is that: A) Angina is relieved with nitr ...

Angina, MI, Aneurysms Questions (NCLEX) Answered 2022 The nurse teaches the client that the major difference between angina and pain associated with myocardial infarction (MI) is that: A) Angina is relieved with nitroglycerin and rest. B) Angina can be fatal. C) MI pain always radiates to the left arm or jaw. D) MI pain cannot be treated. - ✔✔A) Angina is relieved with nitroglycerin and rest. The teaching plan for a client being started on long-acting nitroglycerin includes the action of this drug. The nurse teaches that this drug relieves chest pain by which action? A) Dilating just the coronary arteries B) Decreasing the blood pressure C) Increasing contractility of the heart D) Dilating arteries and veins - ✔✔D) Dilating arteries and veins The nurse cautions the client receiving isosorbide dinitrate for treatment of angina that long-term use can lead to the development of: A) Tolerance. B) Tachycardia. C) Hypotension. D) Urinary retention. - ✔✔A) Tolerance. The nurse prepares discharge teaching for a client receiving isosorbide dinitrate for treatment of angina. What information must the nurse include?A) Limit exercise to 30 minutes twice per week. B) Avoid alcohol consumption. C) Monitor intake and output. D) Report skin flushing to the physician. - ✔✔B) Avoid alcohol consumption. The nurse recognizes that the mechanism for action of beta-adrenergic blockers in the treatment of angina is: A) Positive chronotropic effect. B) Negative inotropic effect. C) Positive inotropic effect. D) Antidysrhythmia. - ✔✔B) Negative inotropic effect. Rationale: Beta blockers decrease the workload of the heart by slowing heart rate (negative chronotropic effect) and reducing contractility (negative inotropic effect). What does the nurse include in the teaching plan for a client receiving a beta blocker for treatment of angina? A) Discontinue drug if heart rate <60. B) Do not discontinue drug abruptly. C) Exercise heart rate should be 110-120. D) Monitor for hyperglycemia. - ✔✔B) Do not discontinue drug abruptly. Rationale: Beta blocker treatment should never be abruptly discontinued. With abrupt cessation, a rebound excitation occurs, and adrenergic receptors are stimulated. This can exacerbate angina, increase heart rate, and cause myocardial infarction. Clients often tolerate heart rates as low as 50. The beta blocker might blunt the compensatory increase in heart rate with exercise. Hypoglycemia can occur.The nurse recognizes that calcium channel blockers prescribed for treatment of angina exert their effect by: A) Increasing preload. B) Decreasing afterload. C) Positive chronotropic effect. D) Positive inotropic effect. - ✔✔B) Decreasing afterload. Rationale: Calcium channel blockers cause arteriolar smooth muscle relaxation, leading to lowered peripheral resistance and decreased blood pressure (decreased afterload). This decreases myocardial oxygen demand, and reduces frequency of anginal pain. The nurse determines that treatment of a client with a beta-adrenergic blocker for myocardial infarction has been effective when: A) Tachycardia occurs. B) Blood pressure is 90/50. C) Decreased dysrhythmias occur. D) Decreased urinary output occurs. - ✔✔C) Decreased dysrhythmias occur. Rationale: Beta blockers have the ability to decrease heart rate, decrease contractility, and decrease blood pressure, leading to decreased oxygen demand. They also slow conduction, which suppresses dysrhythmias. Tachycardia would not be desired with an MI. A low BP alone would not indicate effective treatment of the MI. Which of the following actions is the first priority of care for a client exhibiting signs and symptoms of coronary artery disease? A) Decrease anxiety B) Enhance myocardial oxygenation C) Administer sublingual nitroglycerinD) Educate the client about his symptoms - ✔✔B) Enhance myocardial oxygenation Enhancing myocardial oxygenation is always the first priority when a client exhibits signs or symptoms of cardiac compromise. Without adequate oxygenation, the myocardium suffers damage. Sublingual nitroglycerin is administered to treat acute angina, but administration isn't the first priority. Although educating the client and decreasing anxiety are important in care delivery, neither are priorities when a client is compromised. Medical treatment of coronary artery disease includes which of the following procedures? A) Cardiac catherization B) Coronary artery bypass surgery C) Oral medication therapy D) Percutaneous transluminal coronary angioplasty - ✔✔C) Oral medication therapy