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OMSB_OEN Exam - Topic 6 Question 35 Discussion

Actual exam question for OMSB's OMSB_OEN exam
Question #: 35
Topic #: 6
[All OMSB_OEN Questions]

A patient with a history angina pectoris brought by to the Emergency Department complaining of severe chest pain. The patient informs the nurse that he did not take nitroglycerine tablet.

Which of the following assessment findings must concern the nurses MOST before administering nitroglycerine?

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Suggested Answer: D

Patient History: The patient has angina pectoris, which means they have episodes of chest pain due to reduced blood flow to the heart muscle. Nitroglycerin is a common medication used to relieve this pain by dilating blood vessels.

Nitroglycerin Mechanism: Nitroglycerin works by relaxing and widening blood vessels, which decreases the workload on the heart and increases blood flow to the heart muscle. This process typically lowers blood pressure.

Assessment Concerns:

Heart rate of 90 bpm: This is within the normal range and does not typically contraindicate the use of nitroglycerin.

Blood sugar of 12 mmol/L: Elevated blood sugar is concerning but not directly affected by nitroglycerin administration.

Blood pressure of 190/110 mmHg: This is high and nitroglycerin can help reduce it. High blood pressure is often treated with nitroglycerin.

Blood pressure of 80/60 mmHg: This is hypotension (low blood pressure). Since nitroglycerin lowers blood pressure further, administering it to a patient with already low blood pressure can lead to severe hypotension, which is life-threatening.

Conclusion: The most concerning finding is the low blood pressure (80/60 mmHg) because administering nitroglycerin in this situation can further lower the blood pressure to dangerous levels. Reference: NCLEX-RN review guides, pharmacology textbooks, clinical guidelines on the management of angina pectoris and nitroglycerin use.


by Lizette at Nov 19, 2025, 11:49 AM

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Penney
9 hours ago
I thought high BP would be more concerning, but low BP makes sense.
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Olga
6 days ago
Totally agree, that's way too low for nitro.
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Kenneth
11 days ago
B) Blood sugar of 12 mmol/L? That's way too high! The patient must be a professional candy taster or something.
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Idella
16 days ago
I agree, D) is the right answer. Low blood pressure is a major red flag and could be life-threatening if nitroglycerine is given.
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Aracelis
21 days ago
Haha, the patient should have taken the nitro before coming to the ER. That's like forgetting your wallet when you go to the bank!
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Frederica
26 days ago
D) Blood pressure of 80/60 mmHg is the most concerning finding. Giving nitroglycerine to a patient with low blood pressure could lead to further hypotension and shock.
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Fallon
1 month ago
I’m a bit confused about the heart rate; I thought it was more about the blood pressure when it comes to nitroglycerine.
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Alpha
1 month ago
I feel like we practiced a question similar to this, and I think the really low blood pressure would be the priority to address before giving nitroglycerine.
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Chaya
1 month ago
I’m not entirely sure, but I think a blood pressure of 190/110 mmHg could be a problem too, especially if the patient has angina.
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Rolande
2 months ago
I remember we discussed how nitroglycerine can lower blood pressure, so I think the low blood pressure option might be the most concerning.
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Nickie
2 months ago
I'm pretty confident that the low blood pressure of 80/60 mmHg is the assessment finding that should concern the nurses the most. Administering nitroglycerine with that hypotension could cause a dangerous drop in blood pressure.
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Katlyn
2 months ago
Okay, I think the key here is to focus on the patient's hemodynamic stability before giving any vasodilating medication like nitroglycerine. The low blood pressure of 80/60 mmHg is the biggest risk factor we need to address first.
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Lynelle
2 months ago
Blood pressure of 80/60 mmHg is a big red flag!
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Jodi
2 months ago
C) Blood pressure of 190/110 mmHg is the correct answer. Administering nitroglycerine to a patient with high blood pressure could cause a dangerous drop in blood pressure.
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Terina
3 months ago
I think D is the most concerning. Low BP is risky.
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Garry
3 months ago
I'm a bit confused - is the high blood pressure of 190/110 mmHg also a concern, or is the low blood pressure the real red flag? I want to make sure I understand this properly.
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Juliana
3 months ago
The blood pressure of 80/60 mmHg is definitely the most concerning finding here. That low blood pressure could be dangerous if we give nitroglycerine.
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Hoa
3 months ago
Hmm, this seems like a tricky one. I'll need to think carefully about the potential risks before administering nitroglycerine.
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Steffanie
2 months ago
I think blood pressure of 80/60 mmHg is really concerning.
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