Progressive Care Nursing Certification (PCCN) Practice Exam

Which medication should be anticipated for a patient using cocaine who develops non-radiating chest pain and ECG abnormalities?

1. Beta-blocker

2. Calcium channel blocker

3. Thrombolytic agent

4. Benzodiazepine

The correct answer is: Benzodiazepine

In cases where a patient has used cocaine and presents with non-radiating chest pain along with ECG abnormalities, the use of benzodiazepines is a appropriate choice. Cocaine can cause significant cardiovascular stress, leading to complications such as hypertension, tachycardia, and increased myocardial oxygen demand. Benzodiazepines are effective in managing acute anxiety and can help reduce sympathetic nervous system activity, thereby alleviating stress on the heart. They also help with sedation, which can be beneficial in calming a patient who may be agitated or panicking due to chest pain or altered mental status. Using benzodiazepines does not eliminate the risk of myocardial ischemia associated with cocaine use, but they play a key role in symptom management. They help mitigate the anxiety and agitation that can exacerbate cardiovascular issues, allowing for better assessment and further management of the patient. In contrast, other medication classes may not be as safe or effective in this scenario. Beta-blockers, while often used in various cardiac conditions, can exacerbate the vasoconstrictive effects of cocaine. Calcium channel blockers may help with heart rate control and could relieve some ischemic symptoms but could also lead to hypotension when combined with the vasodilatory effects of benzodiazepines.