A patient is admitted to your telemetry unit with chest pain that has been increasing in intensity and duration. The critical care nurse can identify that this type of angina is called

Correct Answer: D

Rationale: The correct answer is D: Unstable angina. Unstable angina is characterized by chest pain that is increasing in intensity and duration, indicating an imminent heart attack. This type of angina is considered a medical emergency requiring immediate intervention. Stable angina (choice A) is chest pain that occurs predictably with exertion and resolves with rest. Variant angina (choice B) is caused by coronary artery spasm and is typically relieved by medication. Predictable angina (choice C) is not a recognized term in cardiology. Therefore, the critical care nurse should identify the patient's symptoms as consistent with unstable angina due to the escalating nature of the chest pain.

Correct Answer: D

Rationale: The correct answer is D: Reducing afterload. ACE inhibitors reduce afterload by inhibiting the conversion of angiotensin I to angiotensin II, leading to vasodilation and decreased systemic vascular resistance. This reduces the workload on the heart, improves cardiac output, and helps in managing heart failure. A, increasing preload, would worsen heart failure by increasing the volume of blood returning to the heart. B, causing vasoconstriction, is incorrect as ACE inhibitors actually cause vasodilation. C, increasing afterload, would also worsen heart failure by increasing the resistance the heart must pump against.

Correct Answer: C

Rationale: Rationale: 1. Dobutamine is a beta-1 adrenergic agonist. 2. Beta-1 stimulation increases heart rate (tachycardia). 3. Tachycardia is a common adverse effect of dobutamine due to increased cardiac output. 4. Heart failure (choice A) and bradycardia (choice B) are unlikely as dobutamine increases heart rate. 5. Respiratory distress (choice D) is not a direct adverse effect of dobutamine. Summary: - Choice C (Tachycardia) is correct as dobutamine increases heart rate. - Choices A, B, and D are incorrect as they are not commonly associated with dobutamine use.

Correct Answer: B

Rationale: The correct answer is B: Calcium channel blockers decrease the velocity of electrical activity on the AV node. This is because calcium channel blockers specifically target calcium channels in the heart, which are responsible for the influx of calcium ions during the cardiac action potential. By blocking these channels, calcium channel blockers slow down the rate of electrical conduction through the AV node, leading to a decrease in heart rate and potentially a decrease in blood pressure. Explanation of why the other choices are incorrect: A: Calcium channel blockers do not increase the preload on the heart. Preload is the amount of blood that fills the heart before it contracts, and calcium channel blockers do not directly affect this. C: Calcium channel blockers do not block sodium channels in the heart muscle. They primarily target calcium channels. D: Calcium channel blockers do not cause vasoconstriction of coronary arteries. They may actually cause vasodilation in coronary arteries, leading to increased blood flow to the heart muscle.

Correct Answer: D

Rationale: The correct answer is D: Adenosine. Adenosine is the drug of choice for treating paroxysmal supraventricular tachycardia (PSVT) because it works by slowing down conduction through the AV node, effectively terminating the tachycardia. Flecainide (A) and lidocaine (B) are antiarrhythmic drugs used for ventricular arrhythmias, not PSVT. Metoprolol (C) is a beta-blocker that may be used for long-term management of PSVT but is not the first-line acute treatment like adenosine.