b. New-onset angina with minimal exertion
c. Occurs only when the person is recumbent occurs with angina decubitis
d. Characterized by increased duration or severity
e. Usually occurs in response to coronary artery spasm
17. Tachycardia that is a response of the sympathetic nervous system to the pain of
ischemia is detrimental because it increases oxygen demand and
a. increases cardiac output.
b. causes reflex hypotension.
c. may lead to atrial dysrhythmias. tachycardia may result in ventricular dysrhythmias
d. impairs perfusion of the coronary arteries.
18. Which effects contribute to making nitrates the first-line therapy for the treatment of
angina (select all that apply)?
a. Decrease preload
b. Decrease afterload
c. Dilate coronary arteries
d. Decrease heart rate (HR)
e. Prevent thrombosis of plaques
f. Decrease myocardial contractility
19. The patient has used sublingual nitroglycerin (NTG) and various long-acting nitrates
but now has an ejection fraction of 38% and is considered at a high risk for a cardiac
event. Which medication would first be added for vasodilation and to reduce
ventricular remodeling?
inhibitors vasodilate arteries and
a. Captopril ACE
reduce ventricular remodeling
b. Clopidogrel (Plavix) An alternative for a patient unable to use ASA (patients with stent or recent MI)
c. Diltiazem (Cardizem) Decreases vasospasm, not known to reduce ventricular remodeling
d. Metoprolol (Lopressor) Decreases sympathetic nervous response
20. When teaching the patient with angina about taking sublingual NTG tablets, what
should the nurse teach the patient?
a. Lie or sit and place 1 tablet under the tongue when chest pain occurs.
b. Take the tablet with a large amount of water so that it will dissolve right
away.
c. If 1 tablet does not relieve the pain in 15 minutes, the patient should go to
the hospital.
d. If the tablet causes dizziness and a headache, stop the medication and call
the doctor or go to the hospital.
21. Which guidelines should the nurse use to teach an older adult with CAD how to
manage the treatment program for angina??
hypotension caused by
a. To sit for 2 to 5 minutes before standing when getting out of bed orthostatic
antianginal agents
b. To exercise only twice a week to avoid unnecessary strain on the heart
c. That lifestyle changes are not as necessary as they would be in a younger
person
d. That aspirin therapy is contraindicated in older adults because of the risk
for bleeding