Deck 23: Antianginal Drugs

Question 1

A patient arrives in the emergency department with severe chest pain. The patient reports that the pain has been occurring off and on for a week now. Which assessment finding would indicate the need for cautious use of nitrates and nitrites?

A) Blood pressure of 88/62 mm Hg
B) Apical pulse rate of 110 beats/min
C) History of renal disease
D) History of a myocardial infarction 2 years ago

Answer 1

Blood pressure of 88/62 mm Hg

Question 2

What action is often recommended to help reduce tolerance to transdermal nitroglycerin therapy?

A) Omit a dose once a week.
B) Leave the patch on for 2 days at a time.
C) Cut the patch in half for 1 week until the tolerance subsides.
D) Remove the patch at bedtime, and then apply a new one in the morning.

Answer 2

Remove the patch at bedtime, and then apply a new one in the morning.

Question 3

A patient with a history of angina will be started on ranolazine ( Ranexa ). The nurse is reviewing the patient's history and will note potential contraindications to this drug therapy if which condition is present? (Select all that apply.)

A) Type 2 diabetes mellitus
B) Prolonged QT interval on the electrocardiogram
C) Heart failure
D) Closed-angle glaucoma
E) Decreased liver function

Answer 3

Prolonged QT interval on the electrocardiogram
Decreased liver function

Question 4

While assessing a patient who is taking a beta blocker for angina, the nurse knows to monitor for which adverse effect?

A) Nervousness
B) Hypertension
C) Bradycardia
D) Dry cough

Question 5

A 74-year-old professional golfer has chest pain that occurs toward the end of his golfing games. He says the pain usually goes away after 1 or 2 sublingual nitroglycerin tablets and rest. What type of angina is he experiencing?

A) Classic
B) Variant
C) Unstable
D) Prinzmetal's

Question 6

The nurse is giving intravenous nitroglycerin to a patient who has just been admitted because of an acute myocardial infarction. Which statement is true regarding the administration of the intravenous form of this medication?

A) The solution will be slightly colored green or blue.
B) The intravenous form is given by bolus injection.
C) It can be given in infusions with other medications.
D) Non-polyvinylchloride ( non-PVC ) plastic intravenous bags and tubing must be used.

Question 7

When applying transdermal nitroglycerin patches, which instruction by the nurse is correct?

A) "Rotate application sites with each dose."
B) "Use only the chest area for application sites."
C) "Temporarily remove the patch if you go swimming."
D) "Apply the patch to the same site each time."

Question 8

When teaching a patient who has a new prescription for transdermal nitroglycerin patches, the nurse tells the patient that these patches are most appropriately used for which situation?

A) To prevent palpitations
B) To relieve shortness of breath
C) To prevent the occurrence of angina
D) To keep the heart rate from rising too high during exercise

Question 9

A patient has been taking a beta blocker for 4 weeks as part of his antianginal therapy. He also has type II diabetes and hyperthyroidism. When discussing possible adverse effects, the nurse will include which information?

A) "Watch for unusual weight loss."
B) "Monitor your pulse for increased heart rate."
C) "Use the hot tub and sauna at the gym as long as time is limited to 15 minutes."
D) "Monitor your blood glucose levels for possible hypoglycemia or hyperglycemia."

Question 10

A calcium channel blocker ( CCB ) is prescribed for a patient, and the nurse provides instructions to the patient about the medication. Which instruction is correct?

A) Chew the tablet for faster release of the medication.
B) To increase the effect of the drug, take it with grapefruit juice.
C) If the adverse effects of chest pain, fainting, or dyspnea occur, discontinue the medication immediately.
D) A high-fiber diet with plenty of fluids will help prevent the constipation that may occur.

Question 11

A patient has been diagnosed with angina and will be given a prescription for sublingual nitroglycerin tablets. When teaching the patient how to use sublingual nitroglycerin, the nurse will include which instruction?

A) Take up to five doses at 15-minute intervals for an angina attack.
B) If the tablet does not dissolve quickly, chew the tablet for maximal effect.
C) If the chest pain is not relieved after one tablet, call 911 immediately.
D) Wait 1 minute between doses of sublingual tablets, up to three doses.

Question 12

A patient will be receiving metoprolol (Lopressor) 5 mg IV push ´ 3 doses for angina. The medication is available in a strength of 1 mg/mL. How much medication will the nurse draw up for each dose?

Question 13

The nurse is providing education about the use of sublingual nitroglycerin tablets. She asks the patient, "What would you do if you experienced chest pain while mowing your yard? You have your bottle of sublingual nitroglycerin with you." Which actions by the patient are appropriate in this situation? (Select all that apply.)

A) Stop the activity, and lie down or sit down.
B) Call 911 immediately.
C) Call 911 if the pain is not relieved after taking 1 sublingual tablet.
D) Call 911 if the pain is not relieved after taking 3 sublingual tablets in 15 minutes.
E) Place a tablet under the tongue.
F) Place a tablet in the space between the gum and cheek.
G) Take another sublingual tablet if chest pain is not relieved after 5 minutes, up to three total.

Question 14

When the nurse is administering topical nitroglycerin ointment, which technique is correct?

A) Apply the ointment on the skin on the forearm.
B) Apply the ointment only in the case of a mild angina episode.
C) Remove the old ointment before new ointment is applied.
D) Massage the ointment gently into the skin, and then cover the area with plastic wrap.