Diltiazem (Cardizem) has been prescribed for a patient newly diagnosed with Prinzmetal’s (variant) angina. What accurate action of diltiazem should the nurse include in the teaching plan?

It increases the contractile force of the heart.

It reduces heart palpitations.

It decreases coronary artery spasms.

It prevents the formation of plaque in the coronary arteries.

Answer and Explanation

The Correct Answer is C

Choice A rationale
Diltiazem does not increase the contractile force of the heart. In fact, it is classified as a negative inotrope, meaning it decreases the force of heart contractions.
Choice B rationale
While diltiazem can affect heart rhythm, it does not specifically reduce heart palpitations. Its primary effect is to slow the heart rate and relax the blood vessels.
Choice C rationale
Diltiazem is a calcium channel blocker used to manage cardiovascular conditions such as hypertension, chronic stable angina, atrial fibrillation, and Prinzmetal’s angina. It works by inhibiting the calcium influx into cardiac and vascular smooth muscle during depolarization. This results in vasodilation, or the widening of blood vessels, which can help decrease coronary artery spasms, a characteristic feature of Prinzmetal’s angina.
Choice D rationale
Diltiazem does not prevent the formation of plaque in the coronary arteries. It primarily acts to relax the blood vessels and slow the heart rate.

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Correct Answer is A

Explanation

Choice A rationale
Bleeding from the gums is a sign of excessive bleeding, which can be a side effect of thrombolytic therapy. Thrombolytic agents work by dissolving blood clots, but they can also interfere with the body’s normal clotting mechanism, leading to bleeding. If a patient experiences unusual or excessive bleeding, it may be necessary to stop the infusion of the thrombolytic agent.
Choice B rationale
An increase in blood pressure is not typically a reason to stop the infusion of a thrombolytic agent in a patient with an acute myocardial infarction. While blood pressure should be monitored closely during thrombolytic therapy, an increase in blood pressure is not a common side effect.
Choice C rationale
A nonsustained episode of ventricular tachycardia is not typically a reason to stop the infusion of a thrombolytic agent in a patient with an acute myocardial infarction. While arrhythmias can occur during a myocardial infarction, they are not a common side effect of thrombolytic therapy.
Choice D rationale
A decreased level of consciousness can be a sign of many serious conditions, including bleeding in the brain. However, it is not typically a reason to stop the infusion of a thrombolytic agent unless it is accompanied by other signs of excessive bleeding.

A. Heberden’s nodes. B. Bouchard’s nodes. C. Janeway lesions. D. Tophi.

Correct Answer is C

Explanation

Choice A rationale
Heberden’s nodes are bony swellings that occur at the distal interphalangeal finger joint, a sign of osteoarthritis. They are not associated with infective endocarditis (IE).
Choice B rationale
Bouchard’s nodes are similar to Heberden’s nodes but occur at the proximal interphalangeal finger joint. They are also a sign of osteoarthritis and not associated with IE.
Choice C rationale
Janeway lesions are flat, painless, red or purple spots on the palms of the hands or the soles of the feet. They are associated with IE and are caused by septic emboli which are small clots filled with bacteria. These emboli can lodge in small blood vessels, causing these characteristic lesions.
Choice D rationale
Tophi are hard, uric acid deposits under the skin. They are a sign of chronic gout, not IE.

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Diltiazem (Cardizem) has been prescribed for a patient newly diagnosed with Prinzmetal’s (variant) angina. What accurate action of diltiazem should the nurse include in the teaching plan?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

What patient data would indicate to the nurse that the infusion of a thrombolytic agent should be stopped in a patient with an acute myocardial infarction?

Correct Answer is A

Explanation

The nurse is conducting a physical assessment on a client with infective endocarditis (IE). The nurse observes flat, reddened, non-tender maculae on the hands and feet. What does the nurse understand these to be?

Correct Answer is C

Explanation

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