Deck 35: Pharmacotherapy of Angina Pectoris and Myocardial Infarction

Question 1

Which assessment finding in the client receiving a thrombolytic drug indicates a serious problem that should be reported to the health care provider immediately?

A)Excessive bleeding
B)Hypertension
C)Bradycardia
D)Prolonged prothrombin time

Answer 1

Excessive bleeding

Question 2

The nurse is reviewing the health history for a client who may be a candidate for thrombolytic therapy for the treatment of an MI.The nurse knows that therapy is contraindicated in which circumstances?
Select all that apply.

A)Menses
B)A history of intracranial hemorrhage
C)Hemophilia
D)Liver disease
E)Peptic ulcer disease

Answer 2

A history of intracranial hemorrhage
Hemophilia
Liver disease
Peptic ulcer disease

Question 3

The nurse is preparing to administer a calcium channel blocker to a client experiencing angina.Which mechanism of action makes this medication appropriate for this client?

A)It increases preload.
B)It has a positive inotropic effect.
C)It decreases afterload.
D)It has a positive chronotropic effect.

Answer 3

It decreases afterload.

Question 4

The nurse is preparing to administer a beta-adreneric blocker to a client experiencing angina.A student nurse asks the nurse why the medication is being used to treat angina.Which mechanism of action with the nurse include in the response to the student?

A)Positive chronotropic effect
B)Antidysrhythmic effect
C)Positive inotropic effect
D)Negative inotropic effect

Question 5

The nurse educator is preparing an inservice for nurses who are new to the cardiac care unit.When discussing antianginal therapy,which basic strategies will the educator include?
Select all that apply.

A)Decreasing the oxygen consumption of the brain.
B)Increasing myocardial contractility.
C)Increasing blood flow to the peripheral blood vessels.
D)Increasing blood flow to the myocardium.
E)Decreasing myocardial oxygen demand.

Question 6

The nurse uses which statement to best describe the link between atherosclerosis and coronary artery disease?

A)"Coronary artery disease results when atherosclerotic plaques break off and cause ischemia."
B)"Coronary artery disease results when atherosclerotic plaques block the inside of the blood vessels."
C)"Coronary artery disease results when atherosclerotic plaques grow large enough to rupture the coronary blood vessels."
D)"Coronary artery disease results when there are spasms around the atherosclerotic areas."

Question 7

Nitroglycerine relieves angina in part by vasodilating veins.What is the ultimate effect for a client who is prescribed nitroglycerin?

A)Increasing cardiac output
B)Increasing coronary artery perfusion
C)Increasing the heart rate
D)Decreasing contractility

Question 8

The client is admitted with a diagnosis of angina.The client's angiogram shows no sign of coronary artery disease.Which type of angina does the nurse document in the medical record for this client?

A)Unstable angina
B)Classic angina
C)Vasospastic angina
D)Stable angina

Question 9

The nurse realizes that client teaching regarding the cause of anginal pain was effective when the client makes which statement?

A)"The pain is related to remodeling of the heart muscle caused by narrowed arteries."
B)"The heart is not pumping enough blood out with each beat because of narrowed arteries."
C)"The pain is from a lack of oxygen getting to the heart,which is caused by narrowed arteries."
D)"The pain comes from the heart beating irregularly because of narrowed arteries."

Question 10

The nurse is caring for a client who is recovering from a myocardial infarction (MI).The nurse anticipates that the client will be prescribed which medications in order to reduce post-MI mortality?
Select all that apply.

A)Aspirin
B)Beta-blockers
C)Narcotic analgesics
D)ACE inhibitors
E)Antidysrhythmics

Question 11

A client asks which conditions will cause his heart to need more oxygen.Which responses by the nurse are appropriate?
Select all that apply.

A)"Increased physical activity."
B)"Watching a television show."
C)"Emotional stress."
D)"Eating a meal."
E)"Listening to music."

Question 12

A client diagnosed with myocardial infarction is prescribed thrombolytic therapy.The nurse recognizes that which is the goal of this therapy?

A)Prevent clot formation
B)Dissolve clots
C)Provide immediate relief of chest pain
D)Prevent platelet aggregation

Question 13

The nurse caring for a client who is at risk for experiencing a myocardial infarction knows that which hemodynamic factors can affect the supply of myocardial oxygen?
Select all that apply.

A)Atrial fibrillation
B)Hemorrhage
C)Anemia
D)Blood pressure
E)Coronary artery disease (CAD)

Question 14

The nurse teaches the client that which is the major difference between stable angina and the pain associated with myocardial infarction (MI)?

A)Angina can be fatal.
B)Angina is relieved with nitroglycerine and rest.
C)MI pain cannot be treated.
D)MI pain always radiates to the left arm or jaw.

Question 15

The client is admitted with a diagnosis of angina.The chest pain occurred while at rest.Which term will the nurse use when documenting this client's angina?

A)Classic angina
B)Stable angina
C)Silent angina
D)Unstable angina

Question 16

A client is diagnosed with coronary artery disease (CAD).What will the nurse teach the client in regards to weight and exercise?

A)Exercise,even when not strenuous,is beneficial.
B)Exercise and weight have no relation to CAD.
C)Exercise is not necessary.
D)Weight loss is more important than exercise.

Question 17

The nurse is preparing to teach a client therapeutic lifestyle changes that can decrease the risk of coronary artery disease.Which topics will the nurse include in the teaching?
Select all that apply.

A)Eliminating the consumption of alcohol
B)Eliminating foods high in cholesterol and saturated fats
C)Maintaining blood pressure within normal levels
D)Exercising and maintaining a healthy weight
E)Decreasing the number of cigarettes smoked

Question 18

The nurse is teaching a client about the pharmacological management of angina.The nurse plans to include which points in the client teaching?
Select all that apply.

A)The medications increase the heart rate.
B)The medications dilate the veins so that the heart receives less blood.
C)The medications cause the heart to contract with less force.
D)The medications increase blood pressure.
E)The medications increase the ability of the body to produce red blood cells.

Question 19

A client is diagnosed with coronary artery disease.What will the nurse teach the client in regards to alcohol consumption?

A)Drink as much as the client prefers.
B)Completely refrain from alcohol.
C)Limit alcohol to two drinks per day.
D)Limit alcohol to one drink per day.

Question 20

The nurse anticipates that which is a goal of antianginal therapy?

A)Increase blood flow to the peripheral blood vessels.
B)Increase myocardial contractility.
C)Increase the oxygen consumption of the heart.
D)Reduce the frequency of angina episodes.

Question 21

A client prescribed 81 mg of aspirin (ASA)daily following a myocardial infarction (MI)asks the nurse why the baby dose of ASA is prescribed.Which response by the nurse is the most appropriate?

A)"This low dose is effective and causes less GI bleeding."
B)"This is all the ASA you need right now."
C)"The lower dose is much more economical,because you will need to take this throughout your life."
D)"High doses of ASA do not prevent recurrences of an MI."

Question 22

The nurse cautions the client receiving isosorbide dinitrate for treatment of angina that long-term use can lead to the development of which manifestation?

A)Urinary retention
B)Tachycardia
C)Tolerance
D)Hypotension