Nokea
Which drug class has been found to decrease mortality if given within 8 hours of an MI due to a decrease in cardiac workload?
- A. Antiplatelets
- B. Beta-adrenergic blockers
- C. ACE inhibitors
- D. Calcium channel blockers
Correct Answer: B
Rationale: Beta-adrenergic blockers have been shown to decrease mortality when administered within 8 hours of a myocardial infarction (MI). They do so by reducing cardiac workload, which helps improve outcomes post-MI. These drugs work by blocking the effects of adrenaline on the heart, leading to decreased heart rate, blood pressure, and myocardial oxygen demand, thereby protecting the heart muscle from further damage. This makes them a crucial part of the treatment regimen for acute coronary syndromes like MI.
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The client asks the nurse about common side effects of calcium channel blockers. What should the nurse include in client teaching?
- A. Headache
- B. Constipation
- C. Epistaxis
- D. Dysuria
Correct Answer: A
Rationale: One of the common side effects of calcium channel blockers is a headache. This is important information for the nurse to include in client teaching as it helps the client understand potential adverse effects of the medication. Constipation, epistaxis, and dysuria are not typically associated with calcium channel blockers.
What is the first type of medication prescribed to prevent angina pain for a client?
- A. Beta blockers
- B. Alpha blockers
- C. Calcium channel blockers
- D. Organic nitrates
Correct Answer: A
Rationale: Beta blockers are the first-line medication prescribed to prevent angina pain. They work by reducing the heart rate and blood pressure, decreasing the heart's demand for oxygen. This helps in preventing angina attacks by improving blood flow to the heart. Alpha blockers, calcium channel blockers, and organic nitrates are also used in angina treatment but are typically considered after beta blockers.
Why has an ACE inhibitor been prescribed following an MI?
- A. "This medication will lower your potassium level."
- B. "ACE inhibitors have been found to reduce mortality following MI."
- C. "ACE inhibitors are always prescribed with a beta blocker and calcium channel blocker following an MI."
- D. "This medication will treat your hypotension."
Correct Answer: B
Rationale: Following a myocardial infarction (MI), ACE inhibitors are commonly prescribed due to their proven benefit in reducing mortality and improving outcomes post-MI. These medications help by decreasing the workload of the heart, preventing remodeling of the heart chambers, and improving survival rates. While ACE inhibitors may have effects on potassium levels, the primary reason for their prescription post-MI is their mortality-reducing properties.
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 taking nitroglycerin (Nitrostat) complains of a headache. Which conclusion is most appropriate by the nurse?
- A. A headache indicates a serious allergic reaction to nitroglycerin.
- B. The client will not have a headache if the nitroglycerin is taken with a high-fat meal.
- C. Nitroglycerin does not cause a headache.
- D. The most common side effect of nitroglycerin is a headache.
Correct Answer: D
Rationale: Nitroglycerin is known to cause headaches as a common side effect due to its vasodilatory properties. It dilates blood vessels, which can lead to headaches. While a headache can indicate other serious conditions, the most common association with nitroglycerin use is a headache. It is crucial for the nurse to recognize this side effect and provide appropriate education and support to the client.