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 D
Explanation
Choice A reason: This is not the cause of airway obstruction in asthma. Collapse of the cartilaginous rings in the bronchi is a feature of tracheobronchomalacia, a condition in which the airways are weak and floppy.
Choice B reason: This is not the cause of airway obstruction in asthma. Type II alveolar cell injury and decreased surfactant are associated with acute respiratory distress syndrome (ARDS), a condition in which the alveoli are damaged and filled with fluid.
Choice C reason: This is not the cause of airway obstruction in asthma. Alveolar changes and pulmonary congestion are seen in chronic obstructive pulmonary disease (COPD), a condition in which the alveoli are enlarged and lose their elasticity.
Choice D reason: This is the correct cause of airway obstruction in asthma. Asthma is a chronic inflammatory disorder of the airways, characterized by mucus secretion, bronchoconstriction, and airway edema. These factors reduce the diameter of the airways and increase the resistance to airflow.
Correct Answer is B
Explanation
Choice A reason: Montelukast does not increase vessel permeability. It blocks the effects of leukotrienes, which are inflammatory mediators that cause vessel permeability, bronchoconstriction, and mucus secretion. By blocking leukotrienes, montelukast reduces vessel permeability and inflammation.
Choice B reason: Montelukast reduces bronchoconstriction and mucus secretion. It blocks the effects of leukotrienes, which are inflammatory mediators that cause bronchoconstriction and mucus secretion. By blocking leukotrienes, montelukast improves airflow and reduces asthma symptoms.
Choice C reason: Montelukast does not increase inflammation. It blocks the effects of leukotrienes, which are inflammatory mediators that cause inflammation, bronchoconstriction, and mucus secretion. By blocking leukotrienes, montelukast reduces inflammation and prevents asthma exacerbations.
Choice D reason: Montelukast does not increase bronchoconstriction. It blocks the effects of leukotrienes, which are inflammatory mediators that cause bronchoconstriction, mucus secretion, and inflammation. By blocking leukotrienes, montelukast reduces bronchoconstriction and improves airflow.
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