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 C

Explanation

A. Nitroglycerin is often taken preventatively before activities that may trigger chest pain, in addition to being used when chest pain occurs. The statement is incorrect because nitroglycerin can be used both preventatively and acutely.

B. A headache is a common side effect of nitroglycerin due to vasodilation. However, the client’s primary concern should be relief of chest pain, and the statement does not demonstrate a proper response to the medication’s therapeutic effect.

C. This statement indicates understanding of the correct action if chest pain is unrelieved after taking the maximum recommended dose of nitroglycerin (three tablets, 5 minutes apart). If pain persists, it may indicate a myocardial infarction, and the client should seek emergency medical help immediately by calling an ambulance.

D. Nitroglycerin may cause vasodilation and potentially reduce respiratory rate, but it does not directly reduce the respiratory rate in a therapeutic sense. This statement misrepresents the expected effect of the drug.

A. Be careful not to injure the legs or feet B. Wear tight compression stockings as often as possible. C. Try to walk often to increase circulation in the legs, resting if cramping occurs. D. Decrease saturated fats, trans fats, and cholesterol in daily diet E. Apply ice packs to the legs to help relieve pain.

Correct Answer is ["A","C","D"]

Explanation

A. Preventing injury is critical in PAD, as poor circulation makes it more difficult for the body to heal wounds. Injuries or cuts can lead to severe infections or ulcers, which may progress to amputation in severe cases.

B. Wearing tight compression stockings can worsen PAD by restricting blood flow. Loose-fitting stockings or compression socks may be beneficial, but tight stockings should be avoided.

C. Regular walking improves circulation in the legs and can help manage PAD. Resting when cramping occurs allows the muscles to receive blood flow again, reducing the risk of further damage.

D. Reducing intake of saturated fats, trans fats, and cholesterol is essential to prevent further progression of PAD, as these substances contribute to the buildup of plaque in the arteries, leading to narrowing and reduced blood flow.

E. Applying ice to the legs can worsen symptoms of PAD, as it may further restrict blood flow. Heat therapy may be more appropriate for pain relief, but this should be done cautiously to avoid burns or worsening circulatory issues.

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Naxlex Comprehensive Predictor Exams

The nurse has finished teaching a patient diagnosed with chronic stable angina about the use of sublingual nitroglycerin (Nitrostat). Which patient statement indicates that the teaching has been effective?

Correct Answer is C

Explanation

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.

Correct Answer is ["A","C","D"]

Explanation

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A patient who has chest pain is admitted to the emergency department (ED), and all of the following are ordered. Which one should the nurse arrange to be completed first?

A nurse at a provider's office receives a phone call from a client who reports nausea and unrelieved chest pain after taking a nitroglycerin tablet 5 min ago. Which of the following is an appropriate response by the nurse?

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