Deck 27: Drugs for Angina Pectoris and Myocardial Infarction

Question 1

The patient takes nitroglycerine (Nitrostat)for relief of occasional stable angina.The nurse would be most concerned about which statement made by the patient?
1)"I'm getting married tomorrow;I hope my erectile dysfunction isn't a problem."
2)"I'm going water skiing tomorrow;I hope my angina isn't a problem."
3)"I really don't like those little pills.I've heard about patches: can I try them?"
4)"My angina has been a little more frequent.Do I need a painkiller too?"

Answer 1

1

Question 2

The patient is receiving diltiazem (Cardizem)and wants to know why he developed a headache after taking the medication.What is the best response by the nurse?
1)"Diltiazem (Cardizem)causes the blood vessels in your brain to widen;giving you the headache."
2)"Diltiazem (Cardizem)increases prostaglandin synthesis;giving you the headache."
3)"Diltiazem (Cardizem)releases Substance P,activating pain receptors in your brain and giving you the headache."
4)"Diltiazem (Cardizem)causes the blood vessels in your brain to narrow;giving you the headache."

Answer 2

1

Question 3

Following a myocardial infarction,elevations in which of the following cardiac markers would be seen first,and are cardiac tissue-specific?
1)White blood cells
2)Troponin I
3)Myoglobin
4)Creatine kinase

Answer 3

2

Question 4

The primary pharmacologic goal in treating patients experiencing stable angina is to
1)increase venous blood flow to the right atrium.
2)eliminate blockages by using thrombolytics.
3)establish a regular exercise program and diet plan.
4)increase cardiac oxygen supply and reduce cardiac oxygen demand.

Question 5

Which adverse effect listed below is common for patients taking topical nitroglycerin paste?
1)Rash
2)Shortness of breath
3)Headache
4)Ventricular tachycardia

Question 6

The patient in the emergency department experienced an acute myocardial infarction (MI)8 hours ago.The nurse is administering reteplase (Retavase)intravenously (IV).The patient asks the nurse what is being done.What is the best response by the nurse?
1)"This medicine is widening the arteries in your heart so they can get more oxygen."
2)"This medication is dissolving the clot that is causing your heart attack."
3)"This medicine is thinning your blood so more clots will not develop."
4)No response is indicated;the patient is past the time frame where thrombolytic therapy is effective.

Question 7

Which of the following would be the most likely reason that atherosclerotic plaque would be responsible for producing a myocardial infarction?
1)Atherosclerotic plaque builds up on the endocardium,preventing blood from leaving the atriums.
2)Atherosclerotic plaque results in a narrowing of 50% of the coronary arteries.
3)Atherosclerotic plaque impairs the ability of coronary arteries to constrict and dilate.
4)Atherosclerotic plaque causes a blockage that prevents blood from reaching the myocardium.

Question 8

The myocardium receives blood via coronary arteries that attach to
1)the aortic arch.
2)the superior vena cava.
3)the pulmonary vein.
4)the base of the aorta.

Question 9

Which of the following reduce the hearts demand for oxygen by lowering heart rate?
1)Anticoagulants and beta-adrenergic blockers
2)Calcium channel blockers and anticoagulants
3)Organic nitrates and calcium channel blockers
4)Beta-adrenergic blockers and calcium channel blockers

Question 10

The patient is being treated for angina.He asks the nurse if angina is the same thing as having a heart attack.What is the best response by the nurse? Credit will be given only if all correct choices and no incorrect choices are selected.
1)"Severe emotional distress and panic can accompany angina."
2)"A heart attack,or myocardial infarction,means part of your heart has died."
3)"Actually,it depends on what type of angina you mean;there are several types."
4)"They are basically the same,but with angina,part of your heart dies."
5)"Angina is caused by insufficient oxygen to the myocardium."

Question 11

The nurse is preparing to administer nitroglycerine via the intravenous route.What must the nurse plan to do prior to administering this medication?
1)Use gloves to prevent self-administration.
2)Instruct the patient to avoid moving the arm in which the medication is infusing.
3)Cover the intravenous (IV)bottle to decrease light exposure.
4)Darken the room to decrease light exposure.

Question 12

Which of the following most likely would be related to angina as opposed to a myocardial infarction?
1)Chest pain relieved by one sublingual nitroglycerin
2)Chest pain that radiates to the patient's back
3)Chest pain that occurred while the patient was eating breakfast
4)Chest pain accompanied by shortness of breath

Question 13

The patient receives reteplase (Retavase)intravenously (IV).The nurse assesses the patient for orientation and level of consciousness.The patient's wife asks the nurse why this is being done.What does the nurse indicate as the reason for the assessment?
1)The medication can alter fluid balance;this affects orientation and level of consciousness.
2)The medication can cause bleeding in the brain;this affects orientation and level of consciousness.
3)The medication causes hypoglycemia;this affects orientation and level of consciousness.
4)The medication decreases oxygen to the brain;this decreases orientation and level of consciousness.

Question 14

The nurse is teaching a class on antianginal drugs to a group of patients who have experienced myocardial infarctions (MIs).The nurse determines that learning has occurred when a patient makes which statement?
1)"These medications decrease how much oxygen my heart needs."
2)"These medications thin my blood so my heart receives more oxygen."
3)"These medications increase the amount of oxygen my heart receives."
4)"These medications increase oxygen to my heart by increasing nitric oxide production."

Question 15

The nurse is conducting an education class about myocardial blood supply for patients with coronary artery disease (CAD).The nurse determines that learning has occurred when the patients make which statement(s). Credit will be given only if all correct choices and no incorrect choices are selected.
1)"The heart has right and left arteries that arise from the aorta."
2)"The coronary arteries carry blood away from the heart to the right atrium."
3)"Anastomoses are small arteries that supply blood to the heart."
4)"Coronary arteries primarily carry blood to the left ventricle."
5)"The right and left arteries have smaller branches that go around the heart."

Question 16

The patient receives amlodipine (Norvasc)for treatment of angina.What is a primary assessment for the nurse?
1)A sudden weight loss of 5 pounds or more
2)Hypokalemia and hypernatremia
3)Marked increase in international normalized ration (INR)levels
4)A sudden weight gain of 2 pounds or more

Question 17

The nurse is providing care to a patient who has experienced several episodes of angina.What is the primary outcome for this patient?
1)The patient will experience relief of chest pain with anticoagulant therapy.
2)The patient will experience relief of chest pain with nitrate therapy.
3)The patient will experience relief of chest pain with aspirin therapy.
4)The patient will experience relief of chest pain with therapeutic lifestyle changes.

Question 18

The patient says to the nurse,"My doctor said I can't have fried chicken anymore because I have heart disease.I've eaten it all my life and am fine except for some indigestion lately." What is the best response by the nurse?
1)"Did your doctor mention exercise? That is the most important lifestyle change to slow the progression of your heart disease."
2)"Your indigestion is an indication that your body cannot tolerate fatty foods;this causes an increased workload for your heart."
3)"Fried chicken is actually okay,but you must be very careful with the type of fat that you fry the chicken in."
4)"Your indigestion could actually be chest pain caused by narrowed coronary arteries;you will need a low-fat diet."

Question 19

The nurse has completed medication education with the patient who is receiving nitroglycerine (Nitrostat)as therapy for angina.The nurse determines that teaching is effective when the patient makes which statement?
1)"I can keep taking tablets until the pain is gone,but I should not use more than five tablets."
2)"I can take one tablet every 5 minutes,but not more than three tablets in 15 minutes."
3)"I should call my doctor if my pain is not gone after 15 minutes of taking these tablets."
4)"I can take three tablets,one every 10 minutes,but not more than three tablets in 30 minutes."

Question 20

The nurse has completed medication education with a post-myocardial infarction (MI)patient about nifedipine (Adalat).The nurse evaluates the education as effective when the patient makes which statement?
1)"I only need to take this medicine if I plan to do a strenuous activity."
2)"I will need to take this medicine until my stress test is normal."
3)"I only need to take this medicine when I experience chest pain."
4)"I will need to take this medicine for the rest of my life."

Question 21

A patient asks which conditions will cause his heart to need more oxygen.The nurse answers with which statement(s)? Credit will be given only if all correct choices and no incorrect choices are selected.
1)"Increasing physical activity."
2)"Watching a television show."
3)"Emotional stress."
4)"Eating a meal."
5)"Listening to music."

Question 22

The nurse is preparing to teach a patient therapeutic lifestyle changes that can decrease the risk of coronary artery disease.The nurse plans to include which topics in the teaching? Credit will be given only if all correct choices and no incorrect choices are selected.
1)Eliminating the consumption of alcohol
2)Eliminating foods high in cholesterol and saturated fats
3)Maintaining blood pressure within normal levels
4)Exercising and maintaining a healthy weight
5)Decreasing the number of cigarettes smoked

Question 23

The nurse is teaching a patient about the pharmacological management of angina.The nurse plans to include which points in the patient teaching? Credit will be given only if all correct choices and no incorrect choices are selected.
1)The medications increase the heart rate.
2)The medications dilate the veins so that the heart receives less blood.
3)The medications cause the heart to contract with less force.
4)The medications increase blood pressure.
5)The medications increase the ability of the body to produce red blood cells.

Question 24

Which of the following is indicated for the prevention of blood clots?
1)Captopril (Capoten)
2)Reteplase (Retavase)
3)Morphine
4)Abciximab (ReoPro)

Question 25

The nurse knows that the basic strategies of antianginal therapy are Credit will be given only if all correct choices and no incorrect choices are selected.
1)decreased the oxygen consumption of the brain.
2)increased myocardial contractility.
3)increased blood flow to the peripheral blood vessels.
4)increased blood flow to the myocardium.
5)decreased myocardial oxygen demand.

Question 26

The nurse is reviewing the health history for a patient who may be a candidate for thrombolytic therapy for the treatment of an MI.The nurse knows that therapy is contraindicated in which circumstances? Credit will be given only if all correct choices and no incorrect choices are selected.
1)Menses
2)A history of intracranial hemorrhage
3)Hemophilia
4)Liver disease
5)Peptic ulcer disease

Question 27

Which myocardial infarction patient listed below would be a candidate for reteplase (Retavase)therapy?
1)54-year-old female with type 2 diabetes
2)45-year-old female with a 2-week-old cranial artery repair
3)62-year-old with a recent hemorrhagic stroke
4)70-year-old male with active GI bleed

Question 28

The nurse is caring for a patient who is recovering from a myocardial infarction (MI).The nurse anticipates that the patient will be prescribed which medications in order to reduce postÂ?MI mortality? Credit will be given only if all correct choices and no incorrect choices are selected.
1)Aspirin
2)Beta blockers
3)Narcotic analgesics
4)ACE inhibitors
5)Antidysrhythmics