A patient with new-onset exertional angina has taken three ...

[cool]

A patient with new-onset exertional angina has taken three nitroglycerin sublingual tablets at 5-minute intervals, but the pain has intensified.
 
  The nurse notes that the patient has a heart rate of 76 beats per minute and a blood pressure of 120/82 mm Hg. The electrocardiogram is normal. The patient's lips and nail beds are pink, and there is no respiratory distress. The nurse will anticipate providing: a. an angiotensin-converting enzyme (ACE) inhibitor.
  b. intravenous nitroglycerin and a beta blocker.
  c. ranolazine (Ranexa) and quinidine.
  d. supplemental oxygen and intravenous morphine.

Question 2

The student is providing a presentation to the class regarding concepts in pharmacodynamics. Which statement made by a student in the class best demonstrates the need for further teaching?
 
  a. Excretion and metabolism are components of pharmacodynamics.
  b. Receptor binding and potency are components of pharmacodynamics.
  c. Age and gender are components of pharmacodynamics.
  d. Routes of administration are components of pharmacodynamics.

[kiamars2010]

Answer to Question 1

B
This patient has unstable angina, and the next step, when pain is unrelieved by sublingual ni-troglycerin, is to give intravenous nitroglycerin and a beta blocker. ACE inhibitors should be given to patients with persistent hypertension if they have left ventricular dysfunction or conges-tive heart failure (CHF). Ranolazine is a first-line angina drug, but it should not be given with quinidine because of the risk of increasing the QT interval. Supplemental oxygen is indicated if cyanosis or respiratory distress is present. IV morphine may be given if the pain is unrelieved by nitroglycerin.

Answer to Question 2

B
Receptor binding and potency are components of pharmacodynamics.
Excretion and metabolism are components of pharmacokinetics.
Age and gender are biologic/physiologic variations.
Routes of administration are considered pharmacokinetics.

DIF: Cognitive Level: Comprehension REF: p. 3
TOP: Nursing Process: Evaluation
MSC: NCLEX Client Needs Category: Physiological Integrity: Pharmacological and Parenteral Therapies