Which of the following actions most likely mediated the therapeutic effect of nitrates in the patient's disease?

Correct Answer: B

Rationale: Nitrates, such as nitroglycerin and isosorbide mononitrate, mediate their therapeutic effect in variant angina by increasing blood flow in large epicardial vessels. This vasodilatory effect helps improve oxygen delivery to the heart muscle, relieving angina symptoms. Other options like increased heart rate, cardiac contractility, or left ventricular end-diastolic volume are not the primary mechanisms of action for nitrates in this context.

Correct Answer: A

Rationale: In this question, the correct answer is A) Digoxin. Digoxin is a cardiac glycoside that can exacerbate or accentuate varient (Prinzmetal) angina due to its potential to increase myocardial oxygen demand and trigger coronary artery vasospasm, which can worsen symptoms in patients with this type of angina. Option B) Furosemide is a loop diuretic used to treat conditions like heart failure and edema by promoting diuresis. Furosemide is not known to specifically exacerbate varient angina. Option C) Enalapril is an ACE inhibitor that helps lower blood pressure and reduce strain on the heart. Enalapril is not typically associated with worsening varient angina. Option D) Amrinone is a phosphodiesterase inhibitor with positive inotropic effects. While it can increase myocardial contractility, it is not a common trigger for varient angina. Educationally, understanding the effects of different cardiovascular drugs on various cardiac conditions is crucial for healthcare professionals to make informed decisions when managing patients with cardiovascular diseases. Recognizing the specific actions of drugs like digoxin in exacerbating certain conditions like varient angina can guide appropriate medication selection and monitoring to optimize patient outcomes.

Correct Answer: A

Rationale: The correct answer is A) Enalaprilat. Enalaprilat is the active form of the ACE inhibitor Enalapril and is commonly used in hypertensive emergencies due to its rapid onset of action when administered intravenously. B) Benzalaprilat is not a recognized ACE inhibitor. C) Fosinoprilat is the active form of Fosinopril, but it is not typically used in hypertensive emergencies. D) Quinoprilat is the active form of Quinapril and is not the preferred choice in hypertensive emergencies. In an educational context, understanding the correct ACE inhibitor for hypertensive emergencies is crucial for healthcare professionals managing patients with acute hypertension. Enalaprilat's fast-acting properties make it a suitable choice in these critical situations, where rapid blood pressure control is necessary to prevent complications like stroke or organ damage. It is essential for students and practitioners to be familiar with the pharmacological properties of cardiovascular drugs to make informed decisions in emergency situations.

Correct Answer: A

Rationale: In the context of cardiovascular drugs, organic nitrates are commonly prescribed for angina due to their vasodilatory properties. The correct answer is A) Decreases preload. Organic nitrates primarily work by dilating veins, which leads to a reduction in preload. By decreasing preload, the heart has to work less to pump blood out to the body, which reduces the oxygen demand on the heart muscle and helps alleviate angina symptoms. Option B) Increases afterload is incorrect because organic nitrates do not increase the afterload. Instead, they primarily act on the preload by dilating veins. Option C) Constricts arterioles is incorrect as organic nitrates actually cause vasodilation, including dilation of arterioles, leading to decreased systemic vascular resistance. Option D) Increases preload is incorrect because, as mentioned earlier, organic nitrates decrease preload by dilating veins, which reduces the amount of blood returning to the heart. Understanding the effects of organic nitrates on the cardiovascular system is crucial for healthcare professionals when managing patients with angina. By grasping the mechanism of action of these drugs, healthcare providers can effectively optimize treatment and improve patient outcomes.

Correct Answer: C

Rationale: The correct answer to the question "The nurse is assessing the client's capillary refill. A normal capillary refill time is what?" is C) 5 seconds. Capillary refill time is an important clinical assessment used to evaluate peripheral perfusion and circulation. Normally, when pressure is applied to a nail bed or skin, it should blanch and then return to its original color within 2 seconds. A capillary refill time of 5 seconds or more may indicate compromised circulation or perfusion. Option A) Less than 1 second is incorrect because a capillary refill time of less than 1 second is too quick and may indicate hyperperfusion or inaccurate assessment. Option B) 3 seconds is incorrect because while it is closer to the normal capillary refill time, it is still faster than the expected 2 seconds, indicating potential perfusion issues. Option D) 10 seconds is incorrect as it is beyond the normal range of capillary refill time and suggests significantly compromised circulation. In an educational context, understanding capillary refill time is crucial for nurses and healthcare providers as it provides valuable information about a patient's circulatory status. Timely and accurate assessment can help in early detection of circulatory problems and prompt intervention to prevent complications. Nurses need to be proficient in this skill to provide quality patient care and ensure optimal outcomes.