Exam 1: CAD Practice Questions from Lecture

Question 1

Each of the following statements regarding chronic coronary disease is correct EXCEPT?

A. Stable angina is associated with pain that is increasing in severity and not relieved by NTG

B. Women and patients with diabetes may experience atypical symptoms

C. Angina is discomfort associated with ischemia

D. Prinzmetal’s or variant angina is associated with coronary vasospasm

E. Chronic coronary disease is usually associated with atherosclerosis

Answer 1

A
-Stable angina is associated with stable pain not getting worse
-It is relieved by NTG

Question 2

What is the mechanism of action of Plavix?

A. Blocks activation of factors Xa and IIa

B. Decreases prostaglandin production

C. Blocks synthesis of COX-1 and COX-2 and decreases thromboxane A2 production

D. Selectively blocks synthesis of COX-2 and increases platelet activation

E. Inhibits P2Y12 ADP-mediated platelet activation and aggregation

Answer 2

E

C is high doe aspirin
D is the “coxibs”

*generic name of Plavix is Clopidogrel

Question 3

A 56-year-old patient had coronary artery bypass graft (CABG) surgery performed for refractory symptoms of angina despite maximally tolerated medical therapy and multiple percutaneous coronary interventions. Which of the following medications should be initiated following CABG surgery and continued indefinitely?

A. Aspirin
B. Carvedilol
C. Enalapril
D. Nitroglycerin sublingual
E. Clopidogrel

Answer 3

A. Aspirin

*E. is only continued for 12 months

Question 4

A patient has been prescribed NitroMist PRN for angina. Which of the following are counseling points to tell the patient regarding his nitrate? (Select all that apply):

A. Do not shake

B. Call 911 if the angina is not relieved after first dose

C. Inhale the medication with a quick, deep breath

D. Use twice daily at 7am and 3pm to provide a nitrate free period

E. May cause headache, flushing, or drop in BP

Answer 4

A, B, E

Question 5

What is one counseling point that should be made for Nitrostat 0.4 mg SL?

A. Place 1 tablet under the tongue and swallow with full glass of water

B. T1t at first sign of CP, t1t every 15 minutes until CP resolves

C. Store tablets in the original amber bottle at room temperature

D. You will know it is working if you feel a slight burning sensation

E. T1t TID (8am, 12pm, 4pm)

Answer 5

C

Question 6

A patient with chronic coronary disease is being evaluated for control of angina symptoms. The patient reports experiencing angina symptoms one to two times weekly, unchanged from baseline. Sublingual nitroglycerin use has
increased from 1-2 tablets/week to 3-4 tablets/week. His blood pressure is 132/84 mm Hg, heart rate is 70 beats per minute. Which of the following suggest worsening angina control in this patient?

A. Frequency of angina symptoms

B. Increased blood pressure above goal

C. Increased heart rate above goal

D. Increased sublingual nitroglycerin use

Answer 6

D

Question 7

Which one of the following medications should be taken twice daily, with doses separated by 7 hours? (e.g. at 8am and 3pm)

A. Lopressor
B.Monoket
C. Nifedipine XL
D. Norvasc
E. NTG Patches

Answer 7

B

Question 8

A patient is currently taking: Accupril, Metformin, Trulicity, HCTZ, Coreg, and NitroMist prn

Their vitals are: BP 138/87, HR: 87, RR: 18

Which medication should be added to their regimen to better control their angina?

A. Diltiazem
B. Atenolol
C. Amlodipine
D. Clonidine
E. Aspirin

Answer 8

C