A 51-year-old male presents with recurrent chest pain on exertion. He is diagnosed with angina pectoris. When he asks what causes the pain, how should the nurse respond? The pain occurs when
Cardiac output has fallen below normal levels.
The vagus nerve is stimulated.
Myocardial stretch has exceeded the upper limits.
The myocardial oxygen supply has fallen below demand.
The Correct Answer is D
Choice A reason: Cardiac output has not fallen below normal levels. Cardiac output is the amount of blood pumped by the heart per minute. It is affected by the heart rate and the stroke volume. Angina pectoris does not directly affect the cardiac output, but it can reduce the stroke volume due to impaired ventricular filling.
Choice B reason: The vagus nerve is not stimulated. The vagus nerve is a cranial nerve that innervates the heart and other organs. It is part of the parasympathetic nervous system, which slows down the heart rate and lowers the blood pressure. Angina pectoris does not activate the vagus nerve, but it can trigger the sympathetic nervous system, which increases the heart rate and blood pressure.
Choice C reason: Myocardial stretch has not exceeded the upper limits. Myocardial stretch is the degree of tension or load on the cardiac muscle fibers. It is determined by the end-diastolic volume, which is the amount of blood in the ventricle at the end of relaxation. Angina pectoris does not cause excessive myocardial stretch, but it can impair the myocardial contractility due to ischemia.
Choice D reason: The myocardial oxygen supply has fallen below demand. This is the main cause of angina pectoris. It occurs when the coronary arteries, which supply blood and oxygen to the heart muscle, are narrowed or blocked by atherosclerosis or spasm. This creates an imbalance between the oxygen demand of the heart, which increases during exertion, and the oxygen supply, which is reduced by the obstruction.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A reason: This is not a symptom of right heart failure. Hypertension is a risk factor for developing heart failure, but it does not indicate the severity or location of the heart failure.
Choice B reason: This is not a symptom of right heart failure. Dyspnea upon exertion is a symptom of left heart failure, which occurs when the left ventricle fails to pump blood effectively to the lungs.
Choice C reason: This is a symptom of right heart failure. Significant edema to both lower legs and feet is a result of increased pressure in the systemic circulation, which occurs when the right ventricle fails to pump blood effectively to the rest of the body. This causes fluid to accumulate in the dependent areas, such as the lower extremities.
Choice D reason: This is not a symptom of right heart failure. Decreased urine output is a symptom of left heart failure, which occurs when the left ventricle fails to pump blood effectively to the aorta and the rest of the body. This causes reduced renal perfusion and oliguria.
Correct Answer is C
Explanation
Choice A reason: Exudative fluid is not the type of fluid drained from the patient. Exudative fluid is a high-protein fluid that results from inflammation or infection of the pleura. It is usually cloudy and contains white blood cells, bacteria, or blood.
Choice B reason: Purulent fluid is not the type of fluid drained from the patient. Purulent fluid is a thick, yellow-green fluid that results from a bacterial infection of the pleura. It is also known as empyema and contains pus and dead tissue.
Choice C reason: Transudative fluid is the type of fluid drained from the patient. Transudative fluid is a low-protein fluid that results from increased hydrostatic pressure or decreased oncotic pressure in the pleural space. It is usually clear and contains few cells or organisms. It can be caused by conditions such as heart failure, cirrhosis, or nephrotic syndrome.
Choice D reason: Infectious fluid is not the type of fluid drained from the patient. Infectious fluid is a general term that can refer to any fluid that contains microorganisms that cause disease. It can be exudative or purulent, depending on the type and severity of the infection.
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