A physical therapist treats a patient admitted to an acute care hospital with congestive heart failure. Which medication would MOST likely be prescribed for this patient?

1. Lanoxin (digoxin)
2. Coumadin (warfarin)
3. Zocor (simvastatin)
4. Nitrostat (nitroglycerin)

Transcript

Welcome back to the Scorebuilders’ Question and Answer Podcast! This podcast provides members of the Scorebuilders’ team with the opportunity to explore challenging multiple-choice examination questions with students actively preparing for the licensing examination. My name is Scott Giles and I will be your host for today’s journey.

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A physical therapist treats a patient admitted to an acute care hospital with congestive heart failure. Which medication would MOST likely be prescribed for this patient?

1. Lanoxin (digoxin)
2. Coumadin (warfarin)
3. Zocor (simvastatin)
4. Nitrostat (nitroglycerin)

Pharmacology – Congestive Heart Failure

Patients with a diagnosis of congestive heart failure may receive multiple medications to manage this condition. Potential medications include diuretics, digitalis glycosides, angiotensin-converting enzyme (ACE) inhibitors, and beta blockers. Patients may be admitted to the hospital due to an increase of their symptoms (e.g., dyspnea, fatigue, cough, swelling), and the medical team may modify, add, or subtract medications to stabilize the patient.

Let’s explore each of the options:

Option 1 – Lanoxin (digoxin)

Lanoxin (digoxin) is a positive inotropic agent that increases the force and velocity of myocardial contraction, slows the heart rate, decreases conduction velocity through the atrioventricular node, and decreases the degree of activation of the sympathetic nervous system. It’s used to treat heart failure and atrial fibrillation and would most likely be indicated in this scenario.

Option  2 – Coumadin (warfarin)

Coumadin (warfarin) is an anticoagulant agent that inhibits platelet aggregation and thrombus formation. It is used post percutaneous transluminal coronary angioplasty, post coronary artery bypass graft surgery, and for the prevention of venous thromboembolism and cardioembolic events. Additionally, coumadin (warfarin) may be prescribed to those patients in atrial fibrillation due to the risk of blood clot formation given the lack of atrial contraction.

Option 3 – Zocor (simvastatin)

Zocor (simvastatin) is an antihyperlipidemia agent known as a statin. Statins inhibit enzyme action in cholesterol synthesis, break down low-density lipoproteins (LDLs), decrease triglyceride levels, and increase high-density lipoprotein (HDL) levels. High cholesterol is not reported in this scenario.

Option 4 – Nitrostat (nitroglycerin)

Nitrostat (nitroglycerin) is a nitrate agent that decreases ischemia through smooth muscle relaxation and dilation of peripheral vessels. It is primarily used to treat angina pectoris. Chest pain is not reported in this scenario.

The correct answer is Option 1.

Let’s explore the all student data:

49% of students selected Option 1 - Lanoxin (digoxin) – the correct response
17% of students selected Option 2 - Coumadin (warfarin)
18% of students selected Option 3 - Zocor (simvastatin)
16% of students selected Option 4 - Nitrostat (nitroglycerin)

System Classification
This question is a Cardiovascular and Pulmonary Systems question which represents approximately 14% of all exam items.

Content Outline Classification
This question is a Foundations for Evaluation, Differential Diagnosis, and Prognosis question which represents approximately 33% of all exam items.

Level Classification
This question is a Level 1 question since the question requires students to possess basic foundational academic knowledge. Remediation of Level 1 questions occurs through academic review of entry-level content using textbooks, review books, Basecamp, and flash cards.

Academic Focus Area
Looking to review related academic content? Check out pages 413, 426, 466-467 in PTEXAM: The Complete Study Guide.

Thanks for joining us on the Scorebuilders Q and A podcast! See you next week!