A nurse is teaching a client who has angina about nitroglycerin sublingual tablets. Which of the following statements should the nurse include in the teaching?
"Place one tablet under your tongue every 5 minutes for 30 minutes to relieve chest pain."
"Nitroglycerin decreases chest pain by dissolving blood clots that are occluding the arteries."
"You can store the bottle of tablets in your bathroom medicine cabinet."
"Nitroglycerin dilates cardiac blood vessels to deliver more oxygen to the heart."
The Correct Answer is D
Choice A reason: "Place one tablet under your tongue every 5 minutes for 30 minutes to relieve chest pain." is not the correct statement. This is an incorrect and potentially dangerous instruction, as it can cause overdose and severe hypotension. The nurse should instruct the client to place one tablet under the tongue at the first sign of chest pain, and repeat every 5 minutes for up to three doses, if needed. The client should call 911 if the pain is not relieved after the first dose.
Choice B reason: "Nitroglycerin decreases chest pain by dissolving blood clots that are occluding the arteries." is not the correct statement. This is a false and misleading explanation of how nitroglycerin works. Nitroglycerin does not dissolve blood clots, nor does it affect the occlusion of the arteries. Nitroglycerin is a vasodilator that relaxes the smooth muscle of the blood vessels, especially the veins. This reduces the preload and the oxygen demand of the heart, and relieves the chest pain caused by ischemia.
Choice C reason: "You can store the bottle of tablets in your bathroom medicine cabinet." is not the correct statement. This is an inappropriate and unsafe storage recommendation, as it can affect the potency and effectiveness of the medication. The nurse should instruct the client to store the bottle of tablets in a cool, dry, and dark place, away from heat, moisture, and light. The client should also keep the bottle tightly closed and replace it every 6 months, or as directed by the provider.
Choice D reason: "Nitroglycerin dilates cardiac blood vessels to deliver more oxygen to the heart." is the correct statement. This is a simple and accurate description of how nitroglycerin helps to relieve anginal pain. Nitroglycerin dilates the coronary arteries, which supply blood and oxygen to the heart muscle. This improves the blood flow and oxygen delivery to the ischemic areas of the heart, and reduces the pain and discomfort.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A reason: Vomiting is not a specific sign of a hemolytic reaction, as it can be caused by many other factors, such as anesthesia, infection, or medication. Vomiting may occur in other types of transfusion reactions, such as allergic or febrile reactions, but it is not indicative of hemolysis.
Choice B reason: Flushing is not a specific sign of a hemolytic reaction, as it can be caused by many other factors, such as fever, infection, or medication. Flushing may occur in other types of transfusion reactions, such as allergic or febrile reactions, but it is not indicative of hemolysis.
Choice C reason: Dyspnea is a specific sign of a hemolytic reaction, as it indicates that the client is experiencing respiratory distress due to the release of hemoglobin and its breakdown products into the bloodstream. Dyspnea may be accompanied by chest pain, cough, wheezes, or crackles. Dyspnea is a life-threatening symptom that requires immediate intervention.
Choice D reason: Hypotension is not a specific sign of a hemolytic reaction, as it can be caused by many other factors, such as blood loss, dehydration, or medication. Hypotension may occur in other types of transfusion reactions, such as septic or anaphylactic reactions, but it is not indicative of hemolysis.
Correct Answer is C
Explanation
Choice A reason: Weighing the client is not a necessary action before administering digoxin, as it does not affect the dosage or effectiveness of the medication. Weighing the client may be important for monitoring fluid balance and edema, but it is not related to digoxin therapy.
Choice B reason: Measuring the client's blood pressure is not a necessary action before administering digoxin, as it does not affect the dosage or effectiveness of the medication. Digoxin is not a blood pressure-lowering medication, but a cardiac glycoside that increases the contractility and efficiency of the heart. Measuring the blood pressure may be important for monitoring hypertension, but it is not related to digoxin therapy.
Choice C reason: Measuring the client's apical pulse is a necessary action before administering digoxin, as it can help determine the safety and appropriateness of the medication. Digoxin can cause bradycardia (slow heart rate) as a side effect, which can be dangerous and symptomatic. The nurse should check the apical pulse for one full minute and withhold the medication if the pulse is below 60 beats per minute or above 100 beats per minute. The nurse should also report any abnormal or irregular rhythms to the provider.
Choice D reason: Offering the client a light snack is not a necessary action before administering digoxin, as it does not affect the absorption or effectiveness of the medication. Digoxin can be taken with or without food. Offering the client a light snack may be important for maintaining nutrition and hydration, but it is not related to digoxin therapy.
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