A client with congestive heart failure is prescribed a nitrate medication. The nurse should instruct the client to:

Take the medication with food to reduce stomach upset.

Avoid using erectile dysfunction medications while on nitrate therapy.

Avoid grapefruit juice while on nitrate therapy.

Increase the dose if chest pain is not relieved within 15 minutes.

Answer and Explanation

The Correct Answer is B

A) This choice is incorrect because taking the nitrate medication with food is not necessary. Nitrate medications are usually taken sublingually or by mouth and are not associated with significant stomach upset.

B) This choice is correct. Nitrate medications, such as nitroglycerin, can cause a dangerous drop in blood pressure when used concurrently with erectile dysfunction medications, specifically phosphodiesterase type 5 inhibitors (PDE5 inhibitors) like sildenafil (Viagra) or tadalafil (Cialis). Clients should be warned against using these medications together to prevent hypotension and potential cardiovascular complications.

C) This choice is incorrect because grapefruit juice is not typically associated with nitrate medications. Grapefruit juice can interact with certain medications, but it is not a known interaction with nitrates.

D) This choice is incorrect because increasing the nitrate dose without healthcare provider guidance can be dangerous. Clients should be instructed to take nitrate medications as prescribed and seek immediate medical attention if chest pain is not relieved within a specific timeframe, as directed by their healthcare provider.

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Correct Answer is C

Explanation

A) This choice is incorrect because a narrowed mediastinum is not a characteristic finding in congestive heart failure. The mediastinum is the central region of the chest, and its width is not specifically related to CHF.

B) This choice is incorrect because hyperinflated lungs are a characteristic finding in chronic obstructive pulmonary disease (COPD), not congestive heart failure.

C) This choice is correct. Cardiomegaly, an enlarged heart, is a common finding in congestive heart failure. The heart may appear enlarged on a chest X-ray due to fluid accumulation and strain on the heart muscle.

D) This choice is incorrect because a normal cardiac silhouette on a chest X-ray would not be indicative of congestive heart failure. The presence of cardiomegaly is more suggestive of heart failure.

A. Electrolyte imbalances. B. Left-sided heart failure. C. Decreased afterload. D. Microvascular damage.

Correct Answer is D

Explanation

A) This choice is incorrect because while electrolyte imbalances can have cardiovascular implications, they are not directly associated with diabetes mellitus or congestive heart failure.

B) This choice is incorrect because left-sided heart failure is not directly related to uncontrolled diabetes mellitus. However, diabetes can exacerbate heart failure if not well-controlled due to its impact on blood vessels and the heart.

C) This choice is incorrect because decreased afterload is not directly related to uncontrolled diabetes mellitus. Afterload refers to the resistance the heart has to overcome to eject blood into the circulation.

D) This choice is correct. Uncontrolled diabetes mellitus can lead to microvascular damage, particularly in the small blood vessels of the heart. This damage can contribute to heart muscle dysfunction and congestive heart failure. Diabetes is a significant risk factor for developing heart failure.

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A client with congestive heart failure is prescribed a nitrate medication. The nurse should instruct the client to:

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client with suspected congestive heart failure undergoes a chest X-ray. The nurse should anticipate which finding that may be indicative of CHF?

Correct Answer is C

Explanation

A nurse is reviewing a client's medical history and notes a diagnosis of uncontrolled diabetes mellitus. The nurse recognizes this as a significant risk factor for congestive heart failure due to its association with:

Correct Answer is D

Explanation

A nurse is providing education to a client with congestive heart failure about managing fluid intake. The nurse should instruct the client to:

A client with congestive heart failure is prescribed a daily dose of furosemide. The nurse should monitor the client for which potential adverse effect of this medication?

A client with congestive heart failure is prescribed furosemide, a loop diuretic. The nurse should monitor the client for which potential adverse effect of this medication?

A nurse is providing education to a client with congestive heart failure who is prescribed an angiotensin-converting enzyme (ACE) inhibitor. The nurse should instruct the client to:

A nurse is providing discharge teaching to a client diagnosed with congestive heart failure. Which instruction is essential for the client to prevent exacerbation of symptoms?

A client with congestive heart failure presents with swollen ankles, legs, and abdomen. The nurse should document these findings as:

A nurse is providing education to a client with congestive heart failure regarding dietary management. Which instruction is essential for the nurse to include?

A nurse is assessing a client with congestive heart failure. Which finding indicates possible fluid accumulation in the lungs, a common symptom of CHF?