Chapter 50: Drugs for Angina Pectoris

Chapter 50: Drugs for Angina Pectoris

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

1. The nurse is teaching a class to cardiac rehabilitation patients. To test their knowledge, the nurse poses the question, “Which class of drugs is considered the treatment of choice for acute anginal attacks?” The correct response should be

a.	ACE inhibitors.
b.	glycoprotein IIb/IIIa inhibitors.
c.	organic nitrates.
d.	antiplatelet agents.

 

 

ANS:   C

Nitroglycerin, an organic nitrate, is the drug of choice for relieving acute anginal attacks.

ACE inhibitors, glycoprotein IIb/IIIa inhibitors, and antiplatelet agents are not indicated for acute anginal attacks.

 

DIF:    Cognitive Level: Application             REF:    p. 581

TOP:    Nursing Process: Evaluation

MSC:   NCLEX Client Needs Category: Physiological Integrity: Pharmacological and Parenteral Therapies

 

2. Which of the following statements made by the nurse during patient education is incorrect regarding the goals of antianginal therapy? “Antianginal drug therapy

a.	can reduce the risk of myocardial infarction and death.”
b.	must be used in conjunction with antihypertensive agents.”
c.	can reduce the intensity of anginal attacks.”
d.	can prevent myocardial ischemia.”

 

 

ANS:   B

Antianginal therapy does not have to be used in conjunction with antihypertensive agents.

Research indicates that antianginal therapy reduces the risk but does not prevent myocardial infarction and death and is intended to reduce the intensity and frequency of anginal attacks which are caused by myocardial ischemia.

 

DIF:    Cognitive Level: Analysis                  REF:    p. 580

TOP:    Nursing Process: Planning

MSC:   NCLEX Client Needs Category: Physiological Integrity: Pharmacological and Parenteral Therapies

 

3. Your patient is being treated for variant angina. She has been taking a long-acting nitrite and is still experiencing transient discomfort in her chest. The nurse anticipates that the patient will be trying a drug from which of the following categories and discontinuing the nitrite?

a.	Beta blockers
b.	Vasodilators
c.	Calcium channel blockers
d.	Organic nitrites

 

 

ANS:   C

A calcium channel blocker or long-acting nitrite is used alone initially for variant angina; because the long-acting nitrite has not proved effective, the calcium channel blocker is the next treatment.

Beta blockers and vasodilators and are not effective against variant angina.

An organic nitrite is not effective against vasospastic angina.

 

DIF:    Cognitive Level: Application             REF:    p. 587

TOP:    Nursing Process: Implementation

MSC:   NCLEX Client Needs Category: Physiological Integrity: Pharmacological and Parenteral Therapies

 

4. A nurse is providing education about the various routes of nitroglycerin (NTG). The nurse correctly states that sublingual NTG can be used in lower dosages than drugs given by other routes, because it

a.	is not directly absorbed into the bloodstream.
b.	bypasses the liver.
c.	is 100 times more potent.
d.	is acid labile.

 

 

ANS:   B

Sublingual (SL) medications are not subject to the first-pass effect of the liver. Oral (PO) nitroglycerin, on the other hand, undergoes rapid inactivation by hepatic enzymes.

SL nitroglycerin is directly absorbed into the bloodstream.

SL nitroglycerin is not 100 times higher than the PO dose; however, it is immediately available to the system, because it is not broken down by the liver.

SL nitroglycerin is not acid labile; it is not even exposed to the gut.

 

DIF:    Cognitive Level: Application             REF:    pp. 584-585

TOP:    Nursing Process: Assessment

MSC:   NCLEX Client Needs Category: Physiological Integrity: Pharmacological and Parenteral Therapies