Question 1

The nurse is administering intravenous nitroglycerin to a patient who has just been admitted for an acute myocardial infarction.
Which statement is true in regard to the administration of this medication?

Accepted Answer

This medication must be contained in specifically designed non-PVC plastic IV bags.IV nitroglycerin is stable for 96 hours after preparation,it cannot be given with any other drugs,and IV filters will absorb the drug.

Question 2

A patient is taking a calcium channel blocker as part of his therapy after a myocardial infarction.What important information or instructions should the nurse give the patient about this medication?

Accepted Answer

Constipation is a common effect of calcium channel blockers.Consuming a diet high in fibre and drinking fluids will help to prevent constipation.Extended-release tablets should never be chewed or crushed.Calcium channel blockers may cause hypotension; because of the risks of rebound hypertension and worsening of tissue ischemia,they should never be discontinued abruptly.

Question 3

Which is a true statement concerning the administration of topical nitroglycerin ointment?

Accepted Answer

The old ointment should be removed before a new dose is applied; the ointment is not massaged or spread on the skin,and it is not indicated for the treatment of acute angina.

Question 4

Unstable angina is the most dangerous type of angina.

Accepted Answer

The statement is true.Unstable angina is the most dangerous,as it is the clinical presentation of acute coronary syndrome with cardiac ischemia without persistent ST-segment elevation as seen on an electrocardiogram and no detectable release of the enzymes and biomarkers of myocardial necrosis.It often ends in a myocardial infarction.

Question 5

Calcium channel blockers are indicated for patients experiencing an acute MI.

Accepted Answer

The statement is false.Contraindications include known drug allergy,acute MI,second- or third-degree AV block (unless the patient has a pacemaker),and hypotension.

Question 6

A 53-year-old male patient has been admitted for evaluation of chest pain.He has been diagnosed with angina and prescribed sublingual nitroglycerin tablets.What important instructions for using this medication should the nurse give the patient?

Accepted Answer

Sublingual nitroglycerin may cause hypotension.Therefore,the patient should sit or lie down when taking a dose and should move slowly to avoid injury from falling or fainting.One tablet should be taken every 5 minutes,up to 3 tablets in 15 minutes.This drug should never be chewed.If chest pain is not relieved after the first tablet and within 5 minutes,call 911 to activate emergency medical services.

Question 7

A patient has developed tolerance to transdermal nitroglycerin therapy.Which instruction is the best one for the nurse to give the patient?

Accepted Answer

To prevent tolerance,remove the transdermal patch at night for 8 hours and apply a new patch in the morning.

Question 8

Amlodipine (Norvasc)can be used to treat both angina and hypertension.

Accepted Answer

This statement is true.Amlodipine is indicated for both angina and hypertension.

Question 9

The onset of action of metoprolol is 1 hour.

Accepted Answer

The statement is true.The onset of action of metoprolol is 1 hour,with a peal plasma concentration of 2 to 4 hours,an elimination half-life of 3 to 8 hours,and a duration of action of 10 to 20 hours.

Question 10

A patient has been prescribed transdermal nitroglycerin patches.What important instructions for applying these patches should the nurse give the patient?

Accepted Answer

A transdermal patch should be applied to any nonhairy area on the body; the old patch should first be removed.The patch may be worn while swimming,but if it comes off,it should be replaced after the old site has been cleansed.Application sites should be rotated.

Question 11

A person who is experiencing chest pain while playing tennis has brought along a bottle of sublingual nitroglycerin.In this situation,which action is appropriate for this person to take? (Select all that apply.)

Accepted Answer

Stopping the activity and lying or sitting down,placing a tablet under the tongue,taking another sublingual tablet if chest pain is not relieved after 5 minutes,and calling 911 if the pain is not relieved within 5 minutes after taking one sublingual tablet are all correct actions.Calling 911 immediately is an incorrect action because 911 should be called only after 1 tablet has been taken and there is no relief within 5 minutes apart."Place a tablet in the space between the gum and cheek" describes buccal administration.Taking another sublingual tablet if chest pain is not relieved after a minute is an incorrect action because tablets should be taken 5 minutes apart,and taking a sip of liquid to help dissolve the pill is incorrect because the patient should not drink any liquids while taking sublingual tablets.

Question 12

A 74-year-old professional golfer has chest pain that occurs toward the end of his golf games.He says the pain usually goes away after he takes one or two sublingual nitroglycerin tablets and rests.What type of angina does he have?

Accepted Answer

The patient has classic angina.Also called chronic stable angina,it is triggered by either exertion or stress and usually subsides within 15 minutes with either rest or drug therapy.

Question 13

Most available β-blockers demonstrate antianginal efficacy.

Accepted Answer

This statement is true.Most available β-blockers demonstrate antianginal efficacy,although not all have been approved for this use.

Question 14

A female patient arrives in the emergency department with severe chest pain.She has had pain off and on for a week.Which assessment finding indicates a need for cautious use of nitrates and nitrites?

Accepted Answer

Anemia is a contraindication to the use of nitrates and nitrites.

Quiz 24: Antianginal Drugs

The nurse is administering intravenous nitroglycerin to a patient who has just been admitted for an acute myocardial infarction. Which statement is true in regard to the administration of this medication?