A client with angina pectoris is experiencing chest pain that radiates down the left arm. The nurse administers a sublingual nitroglycerin tablet to the client. The client's pain is unrelieved, and the nurse determines that the client needs another nitroglycerin tablet. Which cue is most important for the nurse to check before administering the medication?

Temperature

Oxygen saturation

Blood pressure

Apical pulse rate

Answer and Explanation

The Correct Answer is C

A. Temperature is not directly related to the effects of nitroglycerin or the client’s need for additional doses.

B. While oxygen saturation is important, it does not directly influence the decision to administer nitroglycerin, which primarily works to relieve chest pain by dilating coronary arteries and reducing myocardial oxygen demand.

C. Nitroglycerin is a vasodilator that can lower blood pressure. It is crucial to check the client’s blood pressure before administering another dose of nitroglycerin because excessive drops in blood pressure can lead to dizziness, fainting, or other complications. If the blood pressure is already low, further administration may be contraindicated.

D. Apical pulse rate is important to monitor but is not the most critical cue in this scenario. Nitroglycerin primarily affects blood pressure and coronary circulation rather than directly influencing heart rate.

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Correct Answer is ["B","D"]

Explanation

A. Marking the surgical site with an "X" is not typically done for cardiac catheterization. Instead, the healthcare provider may mark the site if necessary, but this is usually done by the surgeon or interventional cardiologist.

B. Asking about food and fluid intake is crucial because the client will need to be NPO (nothing by mouth) for several hours before the procedure to reduce the risk of aspiration during sedation or anesthesia.

C. Educating the client about keeping their leg straight after the procedure is necessary, but this typically occurs after the procedure, not before. This helps prevent complications such as bleeding or clot formation at the insertion site.

D. Asking about prescribed, over-the-counter, and herbal medications is important because certain medications, especially anticoagulants and blood thinners, need to be stopped before the procedure to minimize the risk of bleeding during catheterization.

E. Prophylactic heparin therapy may be ordered by the provider, but it is not typically administered by the nurse before the procedure unless specifically ordered.

A. "Multiple electrode patches will be placed across your chest and limbs." B. You will need to keep the affected leg straight for 6 hours after C. "It requires lying quietly on one side. D. "You will require sedating medications to help tolerate the exam.

Correct Answer is D

Explanation

A. Electrode patches relate to ECG, not TEE.

B. Keeping a leg straight is relevant for procedures involving femoral access, like cardiac catheterization.

C. Lying quietly on one side is not specific to TEE preparation.

D. Sedation helps patients tolerate the TEE, which involves passing a probe down the esophagus.

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Naxlex Comprehensive Predictor Exams

A nurse is admitting a client who reports chest pain. Exhibits The nurse is preparing the client for the cardiac catheterization (coronary angiography). Which of the following actions should the nurse take? (Select all that apply.)

Correct Answer is ["B","D"]

Explanation

A nurse is preparing a client who is scheduled for a transesophageal echocardiogram (TEE) the following day. Which of the following instructions should the nurse include about the test?

Correct Answer is D

Explanation

The patient diagnosed with primary hypertension asks why it is called primary and not secondary. What is the best explanation for the nurse to provide?

The nurse teaches a client at risk for coronary artery disease about necessary lifestyle changes. The nurse determines that the client understands the education if the client makes which statements? Select all that apply.

A nurse is caring for a client who has thrombophlebitis and is receiving heparin by continuous IV infusion. The client asks the nurse how long it will take for the heparin to dissolve the clot. Which of the following responses should the nurse give?

A patient who has recently started taking simvastatin (Zocor) reports several symptoms to the nurse. Which assessment finding is most important to communicate to the health care provider?

The nurse is planning to teach a client with peripheral arterial disease about measures to limit disease progression. Which items would the nurse include on a list of suggestions for the client? Select all that apply.