A patient has been diagnosed with coronary artery disease (CAD) and was told she has a small plaque in the lumen of a coronary artery. The patient is placed on an EKG monitor during her chest pain episode and develops these vital signs: BP 110/70, HR 120, RR 18. What physiologic mechanism is most likely responsible for the tachycardia?

Decrease in circulating epinephrine.

Sympathetic nervous system (SNS) activity.

Increase in circulating acetylcholine.

Parasympathetic nervous system (PNS) activity.

Answer and Explanation

The Correct Answer is B

A. A decrease in circulating epinephrine would not cause tachycardia; it would likely lead to a reduction in heart rate.

B. Sympathetic nervous system activity is responsible for the increased heart rate (tachycardia) in response to stress, pain, or decreased perfusion, especially during episodes of chest pain in CAD.

C. An increase in circulating acetylcholine, associated with parasympathetic activity, would generally result in a decreased heart rate.

D. Parasympathetic nervous system activity would lead to a decrease in heart rate and would not account for the tachycardia observed in this patient.

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Correct Answer is C

Explanation

A. Although pursed-lip breathing may indirectly aid oxygen intake by preventing airway collapse, its primary benefit is to help with carbon dioxide removal.

B. Pursed-lip breathing does not directly strengthen respiratory muscles; it primarily helps with breath control.

C. In emphysema, air trapping occurs due to loss of lung elasticity. Pursed-lip breathing helps slow exhalation, which creates back pressure and assists in expelling trapped carbon dioxide.

D. Mucus removal is more effectively facilitated by other techniques like controlled coughing; pursed-lip breathing focuses on prolonged exhalation.

A. increase platelet adhesion to prevent plaque development. B. increase preload to increase cardiac workload. C. constrict coronary arteries to decrease ischemia. D. decrease afterload to maximize cardiac output (CO).

Correct Answer is D

Explanation

A. Medications in unstable angina aim to prevent platelet aggregation and thrombus formation, not increase platelet adhesion.

B. Increasing preload would increase cardiac workload, which is counterproductive in managing unstable angina, as the goal is to reduce workload on the heart.

C. Constricting coronary arteries would worsen ischemia and exacerbate unstable angina, not help it.

D. Decreasing afterload (the resistance the heart must pump against) reduces the workload on the heart, helping to improve cardiac output and alleviate ischemia in unstable angina.

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Naxlex Comprehensive Predictor Exams

A nurse is teaching a patient diagnosed with emphysema to use the pursed-lip method of breathing. The purpose of this method of breathing is to promote

Correct Answer is C

Explanation

A nurse caring for a patient with unstable angina will most likely need to give medications to

Correct Answer is D

Explanation

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