A nurse is reinforcing teaching with a client who uses a nitroglycerine patch to treat angina. The client now has a new prescription for nitroglycerin sublingual tablets. Which of the following instructions should the nurse include?

Swallow the tablet whole with an 8 oz glass of water.

Store the medication in a pill box at the bedside.

Take the medication at the first indication of chest pain.

Remove the nitroglycerine patch before taking the sublingual tablet.

Answer and Explanation

The Correct Answer is C

(A) Swallow the tablet whole with an 8 oz glass of water.
Sublingual nitroglycerin tablets should not be swallowed. They need to be placed under the tongue where they can dissolve and be absorbed quickly to provide rapid relief from angina.

(B) Store the medication in a pill box at the bedside.
Nitroglycerin sublingual tablets should be stored in their original container and kept tightly closed to protect them from light and moisture. Storing them in a pill box at the bedside could lead to degradation of the medication.

(C) Take the medication at the first indication of chest pain.
This is the correct instruction. Nitroglycerin sublingual tablets should be taken at the first sign of chest pain to provide prompt relief. The rapid onset of action helps to alleviate angina symptoms quickly.

(D) Remove the nitroglycerine patch before taking the sublingual tablet.
It is not necessary to remove the nitroglycerin patch before taking a sublingual tablet. The two forms of nitroglycerin can be used together, as the patch provides a continuous dose while the sublingual tablet offers rapid relief of acute symptoms.

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Correct Answer is D

Explanation

A. Insert the IV catheter:

Inserting an IV catheter is necessary to administer IV fluids and medications. However, it is not the most immediate need. The priority is to address the client's oxygenation status first to stabilize them before proceeding with other interventions.

B. Obtain a blood sample:

Obtaining a blood sample for cardiac enzyme levels is important to diagnose a myocardial infarction. Nevertheless, this step should be taken after ensuring the client is receiving adequate oxygen, as hypoxia needs to be addressed immediately.

C. Attach the leads for a 12-lead ECG:

Attaching the leads for a 12-lead ECG is crucial for diagnosing the client's cardiac condition. However, it should be done after initiating oxygen therapy, as improving the client's oxygenation status is more urgent and can help stabilize the client for further diagnostic procedures.

D. Initiate oxygen therapy:

Initiating oxygen therapy is the most critical first action. The client is experiencing severe chest pain, shortness of breath, and signs of cyanosis, indicating that their oxygen levels are insufficient. Providing oxygen at 4 L/min via nasal cannula will help alleviate hypoxia, improve the client's condition, and provide time for further diagnostic and therapeutic interventions.

A. Ferrous sulfate B. Heparin C. Prednisone D. Vitamin K

Correct Answer is D

Explanation

A. Ferrous sulfate: Ferrous sulfate is an iron supplement used to treat or prevent low blood levels of iron (such as those caused by anemia or pregnancy). It is not used to treat high INR levels.

B. Heparin: Heparin is an anticoagulant, or blood thinner, that prevents the formation of blood clots. It would not be used to treat a high INR level, as it could potentially increase the INR even further.

C. Prednisone: Prednisone is a corticosteroid that reduces inflammation in the body. It is not used to treat high INR levels.

D. Vitamin K: This is correct. Vitamin K is used to help blood clot and is given to patients who have a high INR level to reduce the risk of bleeding. Warfarin works by blocking the effects of vitamin K, so giving vitamin K can help reverse the effects of warfarin and lower the INR.

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A nurse is reinforcing teaching with a client who uses a nitroglycerine patch to treat angina. The client now has a new prescription for nitroglycerin sublingual tablets. Which of the following instructions should the nurse include?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Correct Answer is D

Explanation

A nurse is caring for a client who has been taking warfarin and has an international normalized ratio (INR) time of 5. Which of the following medications should the nurse anticipate the provider to prescribe?

Correct Answer is D

Explanation

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