Which of the following drugs is most likely to accentuate varient (Prinzmetal) angina?

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: 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.

Correct Answer: B

Rationale: In this scenario, the correct answer is B) Increase in exercise tolerance. Captopril is an ACE inhibitor that works by dilating blood vessels, reducing the workload on the heart and improving cardiac output. This leads to improved exercise tolerance in patients with congestive heart failure. Hydrochlorothiazide is a diuretic that helps reduce fluid retention, further aiding in the management of heart failure symptoms. Option A) Increase in blood pressure is incorrect because these medications would actually lower blood pressure due to their mechanisms of action. Option C) Increase in vascular resistance is also incorrect because captopril, as an ACE inhibitor, would decrease vascular resistance. Option D) Increase in venous tone is incorrect because captopril and hydrochlorothiazide would actually reduce venous tone, helping to decrease the workload on the heart. Educationally, understanding the mechanisms of action of cardiovascular drugs is crucial for healthcare providers to make informed decisions about patient care. Recognizing how specific medications impact the cardiovascular system enables healthcare professionals to optimize therapy and improve patient outcomes.

Correct Answer: D

Rationale: In this scenario, the correct answer is D) Timolol. Timolol is a non-selective beta-adrenergic antagonist that reduces intraocular pressure by decreasing the production of aqueous humor in the eye. This mechanism of action is particularly effective in managing open-angle glaucoma, the condition described in the question. Acetazolamide (Option A) is a carbonic anhydrase inhibitor that reduces aqueous humor production but is not typically used as a first-line treatment for glaucoma. Brimonidine (Option B) and Latanoprost (Option C) work by different mechanisms, primarily by increasing the outflow of aqueous humor rather than reducing its production. While these medications are commonly used in glaucoma treatment, they are not the most likely choice based on the description provided in the question. Educationally, understanding the mechanisms of action of various medications used in treating glaucoma is crucial for healthcare professionals, especially ophthalmologists and pharmacists. This knowledge helps in selecting the most appropriate treatment based on the underlying pathology of the patient's condition. By reasoning through the pharmacological actions of each drug, healthcare providers can make informed decisions to optimize patient care and outcomes.