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: Albuterol is not used to treat acute allergies. It is a bronchodilator that relaxes the smooth muscles of the airways and improves airflow. Antihistamines are the drugs of choice for acute allergies.
Choice B reason: Albuterol is not used to treat nasal congestion. It is a bronchodilator that acts on the lungs, not the nose. Decongestants are the drugs of choice for nasal congestion.
Choice C reason: Albuterol is not used to treat dyspnea on exertion. It is a bronchodilator that is used for acute or chronic respiratory conditions, such as asthma or chronic obstructive pulmonary disease (COPD). Dyspnea on exertion is a symptom of various cardiac or pulmonary disorders that require further evaluation and treatment.
Choice D reason: Albuterol is used to treat acute bronchospasm. It is a bronchodilator that quickly relieves the symptoms of bronchoconstriction, such as wheezing, coughing, and shortness of breath. It is often prescribed as a rescue inhaler for patients with asthma or COPD.
Correct Answer is D
Explanation
Choice A reason: This is not the action that the nurse should take. Instructing the patient to monitor weight daily is not relevant to the patient's dizziness. Weight monitoring is more useful for patients with fluid retention or heart failure, which are not caused by calcium channel blockers.
Choice B reason: This is not the action that the nurse should take. Informing the patient to discontinue the medication is not appropriate, as this can cause rebound hypertension and other complications. The patient should not stop taking the medication without consulting their health care provider.
Choice C reason: This is not the action that the nurse should take. Advising the patient to increase dietary sodium is not helpful, as this can worsen the hypertension and increase the risk of cardiovascular events. The patient should follow a low-sodium diet and avoid salt substitutes that contain potassium.
Choice D reason: This is the action that the nurse should take. Encouraging the patient to sit down if feeling faint is a simple and effective way to prevent falls and injuries. Dizziness is a common side effect of calcium channel blockers, especially when the patient changes position or stands up quickly. This is due to the orthostatic hypotension (a drop in blood pressure when standing up) caused by the vasodilation effect of the medication. However, this side effect is usually mild and transient, and can be prevented by rising slowly from a sitting or lying position, drinking plenty of fluids, and avoiding alcohol.
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