AANP Family Nurse Practitioner (FNP) Certification ExamPlanHard
A 55-year-old male with a history of chronic stable angina presents for a follow-up. He reports occasional chest discomfort during moderate exertion, which resolves with rest. He is currently taking aspirin and a statin. Which of the following pharmacological management strategies is most appropriate to add to his regimen to prevent anginal symptoms?
- AInitiate a non-dihydropyridine calcium channel blocker.
- BPrescribe sublingual nitroglycerin for acute symptom relief.
- CAdd a long-acting nitrate.
- DStart a beta-blocker.
Show answer & explanationAnswer & explanation
Correct answer: D. Start a beta-blocker.
Beta-blockers are considered first-line therapy for chronic stable angina to reduce myocardial oxygen demand and prevent anginal symptoms by decreasing heart rate and contractility. They are crucial for improving exercise tolerance and quality of life.
Why the other options are wrong
- A. Non-dihydropyridine calcium channel blockers are alternative or add-on therapy if beta-blockers are contraindicated or not tolerated, but not typically first-line for prevention.
- B. Sublingual nitroglycerin is for acute symptom relief, not for long-term prevention of anginal episodes.
- C. Long-acting nitrates are often used as add-on therapy or if beta-blockers are contraindicated, but beta-blockers are generally preferred as first-line for prevention.
Chronic Stable Angina Pharmacological Prevention
Medications used to reduce the frequency and severity of anginal episodes by decreasing myocardial oxygen demand or increasing supply.
- Beta-blockers are first-line to reduce demand.
- Calcium channel blockers and nitrates are alternatives/add-ons.
- Aspirin and statins address underlying atherosclerosis.
Memory trick: Block the Beta, Beat the Pain!