American Association of Critical-Care Nurses (AACN) Certification Practice Test

What class of medication is used as a first-line treatment for acute coronary syndrome?

1. Beta blockers

2. Nitrates

3. Calcium channel blockers

4. Sodium channel blockers

The correct answer is: Nitrates

Nitrates are commonly used as a first-line treatment for acute coronary syndrome (ACS) because they effectively relieve chest pain and improve oxygen delivery to the heart. Nitrates achieve this by causing vasodilation, which reduces myocardial oxygen demand and alleviates the strain on the heart. This property makes nitrates particularly beneficial in the management of angina and acute myocardial infarction, where rapid relief of ischemia is critical. While other medication classes such as beta blockers and calcium channel blockers play important roles in the management of heart conditions, they are typically used in later stages of treatment or for different indications. Beta blockers decrease heart rate and myocardial oxygen demand but are usually introduced after the acute phase has stabilized. Calcium channel blockers can also contribute to blood pressure reduction and angina relief, but they are generally not the first line in ACS management. Sodium channel blockers are not standard treatments for acute coronary syndrome. Therefore, nitrates stand out as the preferred initial therapeutic option due to their rapid action and efficacy in relieving symptoms associated with acute coronary syndromes.