A nurse is reinforcing teaching with a client who has angina pectoris about starting therapy with nitroglycerin sublingual tablets. Which of the following statements by the client indicates an understanding of the teaching?

"I will take the first tablet when the pain becomes severe."

"I will take no more than four tablets in 10 min."

"I will chew the tablet before swallowing."

"I will dial 911 if one tablet does not relieve my pain."

Answer and Explanation

The Correct Answer is D

A) "I will take the first tablet when the pain becomes severe.": This statement is incorrect because nitroglycerin should be taken at the onset of chest pain, not when it becomes severe. Early administration can help prevent the pain from worsening and reduce the risk of a heart attack. Waiting until the pain is severe may delay relief and increase the risk of serious complications.

B) "I will take no more than four tablets in 10 min.": This is incorrect as the standard protocol for nitroglycerin sublingual tablets typically involves taking one tablet every 5 minutes, up to three doses in 15 minutes, if needed. Taking four tablets in 10 minutes exceeds the recommended dosage and could lead to severe hypotension, dizziness, and fainting. It’s crucial to follow the prescribed limits to avoid these adverse effects.

C) "I will chew the tablet before swallowing.": This is incorrect because nitroglycerin sublingual tablets are designed to dissolve under the tongue for rapid absorption into the bloodstream. Chewing or swallowing the tablet would decrease its effectiveness and delay pain relief. The sublingual route allows the medication to bypass the digestive system and work quickly to relieve chest pain.

D) "I will dial 911 if one tablet does not relieve my pain.": This is the correct response. If chest pain is not relieved within 5 minutes after taking the first nitroglycerin tablet, it may indicate a more serious condition such as a heart attack. The client should call 911 to seek immediate medical assistance. Prompt action is critical in managing potential cardiac events and improving outcomes for the client.

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Correct Answer is D

Explanation

A) Activated partial thromboplastin time (aPTT): This test is primarily used to monitor the effectiveness of heparin therapy, not warfarin. While aPTT measures the intrinsic pathway of coagulation, it is not the standard test for monitoring warfarin, which affects the extrinsic pathway and vitamin K-dependent clotting factors.

B) Platelet count: This test measures the number of platelets in the blood and is used to diagnose and monitor conditions related to platelet function, such as thrombocytopenia. However, it does not provide information about the anticoagulant effect of warfarin, which works by inhibiting vitamin K-dependent clotting factors.

C) White blood cell count (WBC): This test measures the number of white blood cells in the blood and is used to diagnose and monitor infections and inflammatory conditions. It is not relevant for monitoring the anticoagulant effect of warfarin, as WBC levels are not influenced by warfarin therapy.

D) Prothrombin time (PT): This is the correct test to monitor the effect of warfarin therapy. PT measures the extrinsic pathway of coagulation, which is directly influenced by warfarin. The international normalized ratio (INR) is derived from the PT and is used to standardize PT results, making it the most reliable indicator of warfarin’s anticoagulant effect. Regular monitoring of PT/INR helps ensure therapeutic levels are maintained while minimizing the risk of bleeding complications.

A. "I will hold the inhaler with my non-dominant hand." B. "I will hold my breath at least 10 seconds after inhaling the medication." C. "I will tilt my head forward while inhaling the medication." D. "I will wait 10 min between each inhalation."

Correct Answer is B

Explanation

A) "I will hold the inhaler with my non-dominant hand":
While it's not critical which hand the client uses to hold the inhaler, proper coordination between inhalation and activation of the inhaler is essential for effective medication delivery. This statement indicates awareness of physical handling but does not directly address the correct inhalation technique.

B) "I will hold my breath at least 10 seconds after inhaling the medication":
This statement reflects understanding of a crucial step in using a metered-dose inhaler (MDI). Holding the breath for 10 seconds after inhaling the medication allows for optimal deposition of the medication in the airways, enhancing its therapeutic effect in relieving bronchospasm.

C) "I will tilt my head forward while inhaling the medication":
Tilting the head forward is unnecessary and does not contribute to the effective use of an MDI. Instead, tilting the head slightly backward helps to open the airways and facilitates better inhalation of the medication.

D) "I will wait 10 min between each inhalation":
Waiting 10 minutes between inhalations is not typically required for using an albuterol MDI as prescribed. Clients are usually instructed to take the prescribed number of inhalations according to their healthcare provider's instructions without specific time intervals between doses.

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A nurse is reinforcing teaching with a client who has angina pectoris about starting therapy with nitroglycerin sublingual tablets. Which of the following statements by the client indicates an understanding of the teaching?

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Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who has a new prescription for warfarin. The nurse should use the results of which of the following diagnostic tests to monitor the effect of this therapy?

Correct Answer is D

Explanation

A nurse is reinforcing discharge teaching with a client following an episode of status asthmaticus. The client has a prescription for two inhalations from an albuterol metered-dose inhaler. Which of the following statements by the client indicates an understanding of the teaching?

Correct Answer is B

Explanation

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