Which drug classes are NOT typically used to treat angina?
- A. Calcium channel blockers
- B. Organic nitrates
- C. Alpha blockers
- D. Beta blockers
Correct Answer: C
Rationale: Angina is primarily treated with calcium channel blockers, organic nitrates, and beta blockers. Alpha blockers are not commonly used in the treatment of angina. Calcium channel blockers help dilate blood vessels, decreasing the workload on the heart. Organic nitrates relax and widen blood vessels, improving blood flow and reducing the heart's workload. Beta blockers reduce the heart rate and blood pressure, decreasing the heart's demand for oxygen. Alpha blockers are more commonly used to treat conditions like hypertension and benign prostatic hyperplasia.
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Following a stroke, a client has been started on clopidogrel (Plavix). Why is this medication being administered?
- A. To prevent stroke in high-risk patients, such as those with prosthetic heart valves
- B. To decrease blood pressure
- C. To increase heart rate
- D. To provide antiplatelet activity in patients who cannot tolerate aspirin
Correct Answer: D
Rationale: Clopidogrel (Plavix) is an antiplatelet medication that inhibits platelet aggregation, reducing the risk of blood clots. It is commonly used in patients who have had a stroke and cannot tolerate aspirin due to allergies or intolerances. Choosing clopidogrel in these cases helps prevent further clot formation and reduces the risk of recurrent strokes.
The nurse is caring for a client who has chronic angina. Treatment for the condition has been unsuccessful. Which medication does the nurse anticipate will be prescribed?
- A. Atenolol (Tenormin)
- B. Nitroglycerin (Nitrostat)
- C. Sildenafil (Viagra)
- D. Ranolazine (Ranexa)
Correct Answer: D
Rationale: In cases of chronic angina where initial treatment has not been successful, Ranolazine (Ranexa) is often prescribed. This medication helps by reducing the frequency of angina episodes. Atenolol, Nitroglycerin, and Sildenafil are also used in angina management but Ranolazine is more specifically indicated in cases of refractory angina where other treatments have failed.
A client presents in the Emergency Department with a suspected MI. Which medication should NOT be given as soon as possible?
- A. Clopidogrel (Plavix)
- B. Morphine
- C. Aspirin (ASA)
- D. Metoprolol (Lopressor)
Correct Answer: A
Rationale: In the setting of a suspected myocardial infarction (MI), the priority medications to administer as soon as possible include aspirin (ASA) and possibly morphine to manage pain and anxiety. Clopidogrel (Plavix) is not typically administered immediately in the emergency setting for MI management. Metoprolol (Lopressor) is indicated after aspirin administration and stabilization of the patient. Therefore, in this scenario, clopidogrel should NOT be given as a first-line medication for a suspected MI.
When a client is discharged with nitroglycerin (Nitrostat), what should the nurse include in client education?
- A. "Your chest pain should go away with one tablet."
- B. "If your chest pain doesn't go away after three tablets, call 911; you might be having a heart attack."
- C. "If your chest pain doesn't go away with one tablet, you can repeat the dose as many times as you need to."
- D. "Be sure to call 911 before you take any tablets."
Correct Answer: B
Rationale: The correct answer instructs the client on the appropriate use of nitroglycerin. Nitroglycerin is used to relieve chest pain or angina. If the chest pain does not subside after taking one tablet, the client should take a maximum of three tablets at 5-minute intervals. If the pain persists after three tablets, it could indicate a heart attack, and emergency medical help should be sought. This education is crucial to ensure the client knows when to seek immediate medical attention.
A client taking nitroglycerin (Nitrostat) for angina asks the nurse to explain possible side effects. What should NOT be included in client teaching?
- A. Reflex tachycardia
- B. Dizziness
- C. Hyponatremia
- D. Hypotension
Correct Answer: C
Rationale: Hyponatremia is not a common side effect associated with nitroglycerin use. Nitroglycerin typically causes side effects such as reflex tachycardia, dizziness, and hypotension due to its vasodilatory effects. Therefore, it is important for the nurse to educate the client about these potential side effects to promote understanding and appropriate management.