A nurse is teaching a client who has a new prescription for nitroglycerin sublingual tablets for treating angina. Which of the following instructions should the nurse include in the teaching?

"Call 911 if pain persists 30 minutes after taking one tablet."

"Place the tablet under the tongue until dissolved."

"Store the tablets in a refrigerator in a plastic container."

"Take a tablet every 10 minutes until the pain subsides."

Answer and Explanation

The Correct Answer is B

A) "Call 911 if pain persists 30 minutes after taking one tablet": This instruction is not accurate and could potentially delay appropriate medical intervention for angina. Nitroglycerin sublingual tablets are rapid-acting vasodilators used to relieve acute angina symptoms. If chest pain persists after taking one tablet, the client should take another tablet after 5 minutes. If the pain persists after a total of three tablets, the client should seek emergency medical assistance.

B) "Place the tablet under the tongue until dissolved": This instruction is correct. Nitroglycerin sublingual tablets should be placed under the tongue and allowed to dissolve completely. Sublingual administration allows for rapid absorption of the medication into the bloodstream, providing quick relief of angina symptoms.

C) "Store the tablets in a refrigerator in a plastic container": This instruction is incorrect. Nitroglycerin sublingual tablets should be stored in their original container at room temperature, away from moisture and heat. Storing them in the refrigerator could alter their effectiveness.

D) "Take a tablet every 10 minutes until the pain subsides": This instruction is incorrect and potentially dangerous. Nitroglycerin sublingual tablets should be taken as directed by the healthcare provider or based on the client's angina management plan. Typically, the client should take one tablet at the onset of angina symptoms and repeat the dose every 5 minutes if the pain persists, up to a maximum of three tablets within 15 minutes. Taking a tablet every 10 minutes without regard to symptom relief or maximum dosage limits could lead to hypotension and other adverse effects.

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Correct Answer is D

Explanation

D) Calcium: Calcium supplements can interfere with the absorption of levothyroxine when taken concurrently. Levothyroxine absorption can be significantly reduced if taken with calcium-containing supplements or foods high in calcium. Therefore, clients should wait at least 4 hours after taking levothyroxine before consuming calcium supplements to ensure optimal absorption of the thyroid medication.

A) Zinc: Zinc supplements do not significantly interfere with the absorption of levothyroxine. While zinc can bind to levothyroxine and potentially decrease its absorption, the effect is minimal compared to calcium. However, it is generally recommended to take zinc supplements at least 4 hours apart from levothyroxine to avoid any potential interaction.

B) Vitamin C: Vitamin C supplements do not interfere with the absorption of levothyroxine and can be taken concurrently without significant interactions. There is no need for clients to wait a specific amount of time between taking levothyroxine and vitamin C supplements.

C) Ginkgo biloba: Ginkgo biloba supplements have not been shown to have a significant impact on the absorption of levothyroxine. However, given the variability in individual responses to supplements, it is still prudent to separate the administration of levothyroxine and ginkgo biloba by at least 4 hours to minimize any potential interactions.

A. Grasp skin between thumb and forefinger throughout the injection. B. Aspirate the syringe prior to injecting the heparin. C. Use the Z-track method to administer the medication. D. Gently massage the site following the injection.

Correct Answer is A

Explanation

A) Grasp skin between thumb and forefinger throughout the injection: This is the correct answer. Grasping the skin between the thumb and forefinger creates tension, which helps to stabilize the tissue during the injection. This technique reduces the risk of tissue damage and minimizes bleeding following the injection of heparin subcutaneously.

B) Aspirate the syringe prior to injecting the heparin: Aspiration is not necessary for subcutaneous injections, as the risk of intravascular injection is minimal. Aspirating the syringe can increase discomfort for the client and is not recommended for subcutaneous injections.

C) Use the Z-track method to administer the medication: The Z-track method is used for intramuscular injections to minimize medication leakage into the subcutaneous tissue. However, heparin is typically administered subcutaneously, and the Z-track method is not appropriate for this route of administration.

D) Gently massage the site following the injection: Massaging the site following a subcutaneous injection of heparin can increase the risk of bleeding and hematoma formation. Therefore, this action should be avoided to minimize bleeding at the injection site.

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A nurse is teaching a client who has a new prescription for nitroglycerin sublingual tablets for treating angina. Which of the following instructions should the nurse include in the teaching?

Nursing Test Bank

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Correct Answer is D

Explanation

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Correct Answer is A

Explanation

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