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

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Which cerebroselective calcium channel blocker is known to improve cerebral perfusion pressure in patients with subarachnoid hemorrhage?

Diltiazem
Nifedipine
Nimodipine
Amlodipine

The correct answer is: Nimodipine

Nimodipine is particularly effective in improving cerebral perfusion pressure in patients with subarachnoid hemorrhage due to its cerebroselective effects. This means that it preferentially affects the blood vessels in the brain, which can help to enhance blood flow and prevent complications such as vasospasm, a common issue following subarachnoid hemorrhages. By dilating the cerebral blood vessels, nimodipine can mitigate the reduction in perfusion pressure that may occur after a hemorrhagic event. In contrast, while other calcium channel blockers may have general effects on blood pressure and vascular tone throughout the body, they do not have the same level of cerebroselectivity. This makes them less effective in addressing the specific needs of cerebral circulation in this clinical scenario. Nimodipine's unique profile as a dihydropyridine calcium channel blocker, with a strong affinity for the cerebral vasculature, is what makes it the drug of choice for improving cerebral perfusion pressure in these patients.