Deck 25: Drugs Used to Treat Angina Pectoris

Question 1

What will the nurse advise the patient to do to avoid the development of tolerance to nitroglycerin?

A)Use the sublingual form only.
B)Administer subsequent doses parenterally.
C)Allow for a daily 8 to 12 hour nitrate free period.
D)Store the drug in a dark container, free from light and moisture.

Answer 1

Allow for a daily 8 to 12 hour nitrate free period.

Question 2

Which medication combinations may be beneficial in treating angina pectoris?

A)Antidysrhythmics and platelet active agents
B)ACE inhibitors and statins
C)Vasoconstrictors and diuretics
D)Analgesics and thrombolytics

Answer 2

ACE inhibitors and statins

Question 3

The nurse is teaching a patient about nitroglycerin prior to discharge to home.Which instruction will the nurse provide the patient?

A)"Report any headaches following self administration to your health care provider."
B)"Carry the medication in a pocket directly next to the body."
C)"Carry the medication with you at all times."
D)"Store nitroglycerin in a clear glass container with a tight lid."

Answer 3

"Carry the medication with you at all times."

Question 4

When are sustained release nitroglycerin tablets administered?

A)Once a day
B)At bedtime
C)When symptoms of acute angina appear
D)Every 8 to 12 hours

Question 5

Which lifestyle modification(s) will the nurse include when educating the patient with angina pectoris? (Select all that apply.)

A)Weight reduction therapy
B)Low potassium diet
C)Smoking cessation
D)Stress management
E)Independent exercise

Question 6

Which action by the nurse is most accurate when administering nitroglycerin ointment to a patient?

A)Spread the ointment on the patient's legs in a thin, uniform layer.
B)Cover the patch with a clear plastic wrap.
C)Rub the ointment into the skin in a circular motion.
D)Shave the skin prior to application.

Question 7

What is the rationale behind administering calcium channel blockers to patients with angina?

A)They decrease heart rate.
B)They dilate blood vessels.
C)They increase cardiac contractility.
D)They promote fluid excretion.

Question 8

What risk is minimized when the smallest dose of nitroglycerin is used to provide satisfactory results?

A)Allergy
B)Dependence
C)Tolerance
D)Nausea

Question 9

Which therapy(ies) is/are used in the treatment of angina pectoris? (Select all that apply.)

A)ECG
B)Coronary artery bypass
C)Coronary angioplasty
D)Avoidance of caffeine and emotional stress
E)Use of nitrates

Question 10

A patient has been diagnosed with angina pectoris and an elevated LDL cholesterol level.The health care provider has prescribed HMG CoA reductase inhibitor.What is the primary indication in using this medication?

A)Reduce coronary vessel spasm.
B)Simplify oxygen requirements of the cardiac cells.
C)Lower cholesterol levels.
D)Dilate the coronary arteries.

Question 11

Which instruction will the nurse include for a patient prescribed sublingual nitrate PRN for angina?

A)Take a dose routinely at bedtime.
B)Place the tablet under the tongue and swallow immediately.
C)Take one tablet and then seek medical attention if the pain is not relieved within 5 minutes.
D)Take one tablet every 2 to 3 minutes until relief is obtained.

Question 12

What will the nurse include in discharge teaching for patients on nitrate therapy? (Select all that apply.)

A)Increase caffeine in diet
B)Relaxation techniques
C)Proper storage of medications
D)Pain assessment
E)Isometric exercise program

Question 13

The nurse is assisting with a patient admission to the telemetry unit.The patient is diagnosed with angina pectoris.When obtaining information for angina therapy in regard to the central nervous system (CNS), the nurse will document:

A)history of smoking.
B)diet.
C)anxiety level.
D)heart rate.

Question 14

Which instruction will the nurse include when teaching a patient about the administration of translingual nitroglycerin spray?

A)Shake the container to disperse the medication evenly.
B)Inhale the medication slowly over 1 to 2 minutes.
C)Administer the medication under the tongue.
D)Close the mouth and "swallow" the spray.

Question 15

Which response will the nurse provide when a patient complains of a headache when using sublingual nitroglycerin?

A)"This is a common adverse effect that can be managed with acetaminophen."
B)"Discontinue taking this medication."
C)"Try taking this medication at night to minimize the possibility of headaches."
D)"Lie down after using nitroglycerin to avoid a headache."

Question 16

How frequently are nitroglycerin tablets discarded and prescriptions refilled?

A)Monthly
B)Every 3 months
C)Every 6 months
D)Yearly

Question 17

How do beta adrenergic blocking agents reduce myocardial oxygen demand?

A)By inhibiting the stimulation of norepinephrine and epinephrine
B)By increasing the production of dopamine and acetylcholine
C)By delaying the destruction of acetylcholinesterase and cholinesterase
D)By enhancing the sensitivity of alpha receptors and beta receptors

Question 18

The nurse is performing pain assessment on a patient admitted for evaluation of angina.Which type of angina is precipitated by physical exertion and is relieved by rest?

A)Chronic stable
B)Nocturnal
C)Unstable
D)Variant

Question 19

Which statement about ranolazine (Ranexa), a fatty oxidase enzyme inhibitor, is true?

A)It causes coronary artery vasodilation.
B)It causes no gastrointestinal (GI) side effects.
C)It causes QT interval prolongation.
D)It elevates LDL levels.

Question 20

Which statement is true regarding the pain associated with angina?

A)It does not subside until treatment is initiated.
B)It is highly variable in intensity and location.
C)It typically subsides after 1 to 3 minutes.
D)It is directly related to the degree of myocardial damage.

Question 21

What will the nurse include in the teaching plan for a patient with angina who is prescribed a beta adrenergic blocking agent? (Select all that apply.)

A)Goals include reduced frequency of attacks, reduced nitrate use, and improved exercise tolerance.
B)Only some beta blockers are effective in treating angina pectoris.
C)Comorbidities, such as diabetes or COPD, influence the product selection of beta blockers to treat angina.
D)Cardioselective agents minimize pulmonary and peripheral vascular adverse effects.
E)Stress exercise is an effective way to determine the most appropriate dosage.
F)Acebutolol, atenolol, and metoprolol must be taken in divided doses to be effective in treating angina.

Question 22

The nurse transcribes a new order for ranolazine (Ranexa) for a patient with chronic stable angina.Before initiating this medication, the nurse will ensure that which laboratory study result(s) is/are available? (Select all that apply.)

A)Electrocardiography
B)BUN
C)Creatinine
D)Electrolyte levels
E)CBC
F)None of above

Question 23

The nurse is performing a head to toe assessment on a resident in a long term care facility with a history of angina pectoris.When assessing peripheral perfusion, the nurse will perform which intervention(s)? (Select all that apply.)

A)Count heart rate and describe rhythm.
B)Note any loss of hair on lower legs.
C)Auscultate blood pressure.
D)Check pedal pulses.
E)Assess pupil reaction.