The chest pain that occurs intermittently over a long period with the same pattern of onset, duration, and in… - RRB Nsg. Superintendent - 29 April 2025 (Shift-3rd)

RRB Nsg. Superintendent - 29 April 2025 (Shift-3rd)

Medical & Surgical Nursing

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Appeared in: RRB Nsg. Superintendent - 29 April 2025 (Shift-3rd)

Explanation

Chronic stable angina is defined by chest pain that is predictable and occurs intermittently over a long duration.
The key feature is the consistency in the pattern of onset, duration, and intensity of symptoms, which are typically triggered by exertion or stress.
This type of angina is caused by a stable atherosclerotic plaque in a coronary artery, leading to an imbalance between myocardial oxygen supply and demand during increased activity.
The pain is characteristically relieved by rest or the administration of nitroglycerin.

Option A: Prinzmetal's angina, or variant angina, is caused by coronary artery spasm, not a fixed blockage. It characteristically occurs at rest and is not related to a consistent pattern of exertion.
Option B: Angina decubitus is a specific type of angina that occurs when the person is lying down (recumbent) and is relieved by sitting or standing up. It is defined by its positional trigger, not the overall long-term pattern described.
Option C: Unstable angina is the opposite of what is described. It is characterized by a changing or worsening pattern. The pain is new in onset, occurs with less exertion than previous angina, or happens at rest. It is unpredictable and a medical emergency.

Visual 1: Diagram: Comparison chart showing the triggers, duration, and underlying pathology of stable angina, unstable angina, and Prinzmetal's angina.
Visual 2: Flowchart: Illustrating the pathophysiology of stable angina, starting from coronary artery disease leading to fixed stenosis, then increased myocardial demand (exertion), resulting in ischemia and chest pain, which is then relieved by rest.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Types of Angina Pectoris as background academic context rather than a clinical decision trigger.
Nurses must be able to differentiate between types of angina to recognize medical emergencies. Unstable angina is an acute coronary syndrome requiring immediate intervention, whereas chronic stable angina is managed on an outpatient basis.
Patient education is a key nursing role. For patients with chronic stable angina, nurses teach them to recognize their personal triggers, how to use nitroglycerin correctly, and when to seek emergency help (e.g., if pain is not relieved by rest and nitroglycerin).
What if? If the patient reported that their usual exertional chest pain now occurs while watching TV and lasts longer, the condition would no longer be 'stable.' This change in pattern signifies a progression to unstable angina, a medical emergency requiring immediate evaluation.

How to Approach the Question

First, analyze the keywords in the question stem: 'intermittently,' 'long period,' and 'same pattern.'
These keywords point to a condition that is chronic and predictable.
Evaluate each option against these keywords.
Recognize that 'unstable' angina implies an unpredictable or changing pattern, which is the opposite of the question's description.
'Prinzmetal's' and 'decubitus' refer to specific triggers (vasospasm at rest and lying down, respectively), not the overall long-term pattern.
Conclude that 'Chronic stable angina' is the only option that matches the description of a predictable, long-term, and consistent pattern of chest pain.

Concept Tested & Keywords

Concept Tested: Types of Angina Pectoris
Stem keywords: chest pain, intermittently, long period, same pattern, onset, duration, intensity
Lead-in keywords: is called

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