A patient with a history of atherosclerosis complains of chest pain that is consistent at rest. The pain does not improve after sublingual Nitroglycerin. The likely cause of this pain is:
Hypotension
Stable angina
Unstable angina
Coronary vasodilation
The Correct Answer is C
Choice A reason:
Hypotension is not the likely cause of chest pain that does not improve after sublingual Nitroglycerin in a patient with a history of atherosclerosis. While hypotension can cause symptoms, the description of chest pain at rest that does not respond to Nitroglycerin suggests a more severe cardiac issue.
Choice B reason:
Stable angina typically occurs with exertion and is relieved by rest or Nitroglycerin. Chest pain consistent at rest that does not improve with Nitroglycerin suggests unstable angina, which is a more serious condition and requires immediate medical attention.
Choice C reason:
Unstable angina is the correct answer. It occurs when chest pain happens at rest and is not relieved by Nitroglycerin, indicating that the blood flow to the heart is severely restricted. This condition is a medical emergency as it can lead to a myocardial infarction.
Choice D reason:
Coronary vasodilation would typically relieve chest pain by increasing blood flow to the heart. The pain described is more consistent with unstable angina, where there is a significant reduction in blood flow to the heart that does not respond to vasodilation.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A reason:
Morphine is not most effective when given orally due to the high first-pass effect. The first-pass effect refers to the metabolism of a drug in the liver immediately after it enters the bloodstream from the gastrointestinal tract, significantly reducing the amount of active drug that reaches systemic circulation. Therefore, oral administration of morphine is not the most effective route because much of it is metabolized before it can exert its effect.
Choice B reason:
Morphine will be more effective when given via a non-enteral route such as intravenous (IV) or subcutaneous (SQ) because these routes bypass the liver, thereby avoiding the first-pass metabolism. This allows a higher concentration of the active drug to reach the systemic circulation, providing a more potent and effective pain relief.
Choice C reason:
Oral and IV administration of morphine do not have the same effect due to the first-pass metabolism. When morphine is administered orally, a significant amount is metabolized by the liver before it reaches the systemic circulation, whereas IV administration delivers the drug directly into the bloodstream, bypassing the liver and allowing a higher active concentration.
Choice D reason:
Morphine is not primarily excreted by the lungs; it is mainly metabolized by the liver and excreted by the kidneys. This statement does not accurately demonstrate an understanding of the first-pass effect or the pharmacokinetics of morphine.
Correct Answer is C
Explanation
Choice A reason:
Amoxicillin is an antibiotic used to treat bacterial infections. It has no role in the management of atrial fibrillation, which is a cardiac rhythm disorder. Antibiotics do not address the prevention of thromboembolism or the control of heart rate or rhythm.
Choice B reason:
Reglan (metoclopramide) is a medication used to treat gastroesophageal reflux disease (GERD) and gastroparesis. It does not have any indication for use in atrial fibrillation. The management of atrial fibrillation focuses on rate or rhythm control and anticoagulation.
Choice C reason:
Rivaroxaban (Xarelto) is an anticoagulant that is commonly prescribed for patients with atrial fibrillation to prevent stroke and systemic embolism. Since atrial fibrillation increases the risk of thromboembolism, anticoagulation is a crucial component of the treatment plan to reduce the risk of stroke.
Choice D reason:
Omeprazole is a proton pump inhibitor used to treat acid-related stomach issues such as GERD. It is not relevant to the management of atrial fibrillation. The primary concerns in managing atrial fibrillation are controlling the heart rate and preventing thromboembolism, which omeprazole does not address.
Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.
Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today
Report Wrong Answer on the Current Question
Do you disagree with the answer? If yes, what is your expected answer? Explain.
Kindly be descriptive with the issue you are facing.