A client with a history of angina reports the onset of chest pain. The nurse determines that the heart rate is 104 beats/minute and the blood pressure is 138/86 mm Hg. A transdermal nitroglycerin patch was applied 30 minutes ago to the right upper chest. Which action should the nurse take?

Obtain another transdermal patch and position it on the client’s left upper chest.

Withhold further doses of nitroglycerin until contacting the healthcare provider.

Leave the patch in place and administer a PRN dose of sublingual nitroglycerin.

Reassure the client that the patch will begin to take effect within a few minutes.

Answer and Explanation

The Correct Answer is C

A) Applying another transdermal patch is not recommended without healthcare provider approval. Doubling the dose of nitroglycerin could increase the risk of hypotension and other adverse effects.

B) Withholding further doses of nitroglycerin without healthcare provider guidance may lead to inadequate control of angina symptoms. However, in this scenario, the client has already received a dose of transdermal nitroglycerin, so withholding further doses may not be appropriate if the client’s symptoms persist.

C) Leaving the patch in place and administering a sublingual dose of nitroglycerin is the correct action in this situation. Sublingual nitroglycerin provides rapid relief of angina symptoms by dilating blood vessels and improving myocardial oxygen supply. The transdermal patch may not have reached therapeutic levels yet, but the sublingual form can provide more immediate relief.

D) While it’s important to reassure the client, especially during an episode of chest pain, relying solely on the transdermal patch to take effect may not provide timely relief. Administering sublingual nitroglycerin allows for faster absorption and symptom relief.

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Correct Answer is A

Explanation

A) Feverfew may interact with aspirin or nonsteroidal anti-inflammatory drugs: This information is crucial to include in the teaching plan because feverfew has been reported to interact with medications such as aspirin and nonsteroidal anti-inflammatory drugs (NSAIDs), potentially increasing the risk of bleeding. Clients need to be aware of potential drug interactions to prevent adverse effects and ensure safe use of feverfew.

B) Those with allergies to chamomile, ragweed, or yarrow should not take feverfew: While this is important information to consider, it may not be as immediately relevant to the client's current situation of experiencing fewer headaches with feverfew use. However, it is still important to assess for allergies and sensitivities to prevent allergic reactions.

C) Increased anxiety and nervousness have been reported by those taking feverfew: Although this is a potential side effect of feverfew, it may not be the most important information to include in the teaching plan for a client who is experiencing fewer headaches with feverfew use. The focus should be on the client's positive response to the herbal remedy and potential interactions with other medications.

D) Abdominal pain, gas, nausea, vomiting, and diarrhea can occur when taking feverfew: While this is important information regarding potential side effects of feverfew, it may not be as immediately relevant to the client's current situation of experiencing fewer headaches with feverfew use. However, clients should be informed about possible adverse effects to monitor for and report to their healthcare provider if they occur.

A. Be aware that difficulty sleeping and weight loss may occur. B. Administer each dose with at least 8 ounces (240 ml) of water. C. Consume tyramine-free foods while taking the medicine. D. Notify the healthcare provider if experiencing changes in taste.

Correct Answer is A

Explanation

A) Be aware that difficulty sleeping and weight loss may occur: This is the correct answer. Bupropion is associated with potential side effects such as insomnia and weight loss. It is essential for the nurse to inform the client about these possible adverse effects to ensure they are aware and can monitor for them. By being informed, the client can report any concerns promptly to their healthcare provider.

B) Administer each dose with at least 8 ounces (240 ml) of water: While it is generally advisable to take medications with a full glass of water, this instruction is not specifically related to bupropion. Therefore, it is not the most pertinent information for discharge teaching regarding this medication.

C) Consume tyramine-free foods while taking the medicine: This instruction is not relevant to bupropion. Tyramine restriction is typically associated with monoamine oxidase inhibitors (MAOIs), not bupropion.

D) Notify the healthcare provider if experiencing changes in taste: Changes in taste are not commonly associated with bupropion use. While it is important to monitor for and report any unusual symptoms while taking medication, difficulty sleeping and weight loss are more commonly observed adverse effects of bupropion that should be emphasized in discharge teaching for a client prescribed this medication to reduce nicotine cravings.

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A client with a history of angina reports the onset of chest pain. The nurse determines that the heart rate is 104 beats/minute and the blood pressure is 138/86 mm Hg. A transdermal nitroglycerin patch was applied 30 minutes ago to the right upper chest. Which action should the nurse take?

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Naxlex Comprehensive Predictor Exams

A client who experiences migraine headaches reports having fewer headaches since using the herbal remedy feverfew. Which information is most important for the nurse to include in a teaching plan for this client?

Correct Answer is A

Explanation

A client with a history of smoking cigarettes for many years arrives to the clinic and expresses a desire to stop smoking. The client receives a prescription for bupropion to reduce nicotine cravings. Which information should the nurse include in the discharge teaching?

Correct Answer is A

Explanation

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