The nurse is aware that the goal of using diltiazem 30 mg PO bid in the collaborative plan of care for a client diagnosed with variant (Prinzmetal's) angina is to:

Increase the SA to AV node conduction time

Decrease coronary artery spasm

Diltiazem causes hyperexcitability in the myocardium

Increase the heart rate

Answer and Explanation

The Correct Answer is B

Choice A reason: Increasing the SA to AV node conduction time is not the goal of using diltiazem for variant angina. Diltiazem is a calcium channel blocker that slows down the conduction of electrical impulses in the heart, but this is not the main mechanism of action for relieving variant angina. Variant angina is caused by spasms of the coronary arteries that reduce blood flow to the heart muscle.

Choice B reason: This is the correct answer. Decreasing coronary artery spasm is the goal of using diltiazem for variant angina. Diltiazem relaxes the smooth muscle of the coronary arteries and prevents them from contracting. This improves the blood supply to the heart and reduces the pain and ischemia associated with variant angina.

Choice C reason: Diltiazem does not cause hyperexcitability in the myocardium. This is a false statement. Diltiazem has the opposite effect of reducing the contractility and excitability of the heart muscle. This lowers the oxygen demand of the heart and helps prevent anginal attacks.

Choice D reason: Increasing the heart rate is not the goal of using diltiazem for variant angina. Diltiazem actually decreases the heart rate by blocking the calcium channels in the sinoatrial node and the atrioventricular node. This reduces the workload of the heart and the oxygen consumption. A high heart rate can worsen angina by increasing the oxygen demand of the heart.

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Correct Answer is A

Explanation

Choice A reason: Exertional dyspnea is a common symptom of unstable angina, which is caused by reduced blood flow to the heart muscle. Carvedilol is a beta-blocker that reduces the workload of the heart and improves its oxygen supply. Therefore, resolving exertional dyspnea indicates that the medication has been effective.

Choice B reason: A heart rate of 50 beats/minute is not a desired outcome of carvedilol therapy. It may indicate that the dose is too high or that the client has a conduction problem. A normal resting heart rate for adults is between 60 and 100 beats/minute.

Choice C reason: A regular heart rhythm is not a specific indicator of carvedilol effectiveness. Carvedilol can prevent or treat some arrhythmias, but it is not the primary goal of therapy for unstable angina. A regular heart rhythm may also be influenced by other factors such as electrolytes, hydration, and stress.

Choice D reason: A blood pressure of 120/90 is not a sign of carvedilol effectiveness. Carvedilol can lower blood pressure, but it is not the main purpose of treatment for unstable angina. A blood pressure of 120/90 is considered prehypertension, which may increase the risk of cardiovascular complications.

A. Fried chicken, baked beans, French fries, and cake B. Tomato soup, fried flounder, white rice, and a grapefruit C. Barbecue pulled pork sandwich, fresh green beans, mashed potatoes, and ice cream D. Baked tuna, fresh broccoli, brown rice, and fresh cantaloupe

Correct Answer is D

Explanation

Choice A reason: This is a high-fat, high-sodium, and high-calorie meal that is not suitable for a client with hypertension. Fried foods, processed meats, and baked beans are sources of saturated fat and sodium that can raise blood pressure and cholesterol levels. Cake is a source of added sugar that can contribute to obesity and diabetes.

Choice B reason: This is a moderate-fat, moderate-sodium, and moderate-calorie meal that is not ideal for a client with hypertension. Fried flounder and tomato soup are sources of fat and sodium that can increase blood pressure. White rice is a refined carbohydrate that can spike blood sugar levels and increase the risk of diabetes.

Choice C reason: This is a high-fat, high-sodium, and high-calorie meal that is not appropriate for a client with hypertension. Barbecue pulled pork sandwich, mashed potatoes, and ice cream are sources of saturated fat and sodium that can elevate blood pressure and cholesterol levels. Fresh green beans are the only healthy component of this meal.

Choice D reason: This is a low-fat, low-sodium, and low-calorie meal that is suitable for a client with hypertension. Baked tuna, fresh broccoli, brown rice, and fresh cantaloupe are sources of lean protein, fiber, complex carbohydrates, vitamins, minerals, and antioxidants that can lower blood pressure and cholesterol levels, prevent obesity and diabetes, and promote cardiovascular health.

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The nurse is aware that the goal of using diltiazem 30 mg PO bid in the collaborative plan of care for a client diagnosed with variant (Prinzmetal's) angina is to:

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is evaluating the effects of the prescribed carvedilol 6.25 mg PO daily for a client with a history of unstable angina. Which of the following reflects that the medication has been effective?

Correct Answer is A

Explanation

The nurse is assisting a client diagnosed with hypertension with menu selection. Which items should the nurse suggest?

Correct Answer is D

Explanation

In conducting a health history for a client with erythema, the nurse would include which question?

The client says to the nurse, "I get a headache every time I put on my Nitropatch." Which response by the nurse would be most appropriate?

The nurse is reviewing the chart of a client with an indication of myocardial infarction or unstable angina. Which laboratory test result(s) should the nurse recognize as an indication of myocardial injury? (Select all that apply)

The nurse is conducting dietary teaching for a client diagnosed with coronary artery disease. Which statement made by the client indicates an understanding of fat sources and the need to limit saturated fats?

The nurse is providing medication teaching to a client prescribed lisinopril 10 mg PO daily. Which side effect of the medication will the nurse explain to the client is most common?

The nurse is caring for a client who just returned to the nursing unit following a cardiac angiogram and stent insertion. Which action should the nurse implement first?

The nurse prepares to administer digoxin 0.125 mg PO to a client who has chronic heart failure. The laboratory report reveals a digoxin level of 2.5 mg/mL. Which nursing action is most appropriate at this time?