A patient with angina has been given 0.4 mg of nitroglycerin SL. The patient reports continued chest pain 5 min later. The nurse assesses a heart rate of 84 beats per minute and a blood pressure of 88/68 mm Hg. The nurse will take which action?
Notify the provider of the patient's vital signs,
Give nitroglycerin by translingual spray.
Administer 0.4 mg of nitroglycerin SL.
Administer 0.3 mg of nitroglycerin SL.
The Correct Answer is A
A. Notify the provider of the patient's vital signs: The patient’s blood pressure is low (88/68 mm Hg), and administering additional nitroglycerin could worsen hypotension and lead to dizziness, syncope, or shock. Immediate provider notification is necessary before giving further doses.
B. Give nitroglycerin by translingual spray: Administering another form of nitroglycerin without addressing the hypotension risk could further lower blood pressure. Changing the route does not mitigate the danger of giving vasodilators to a hypotensive patient.
C. Administer 0.4 mg of nitroglycerin SL: Repeating the same SL dose while the patient is hypotensive may precipitate severe hypotension, syncope, or cardiovascular collapse. Further nitroglycerin must be held until guidance is obtained.
D. Administer 0.3 mg of nitroglycerin SL: Even a slightly lower dose could still dangerously reduce blood pressure. Administering additional nitroglycerin without provider approval is unsafe in the context of the patient’s current vital signs.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. Heart rate of 88 beats per minute and regular: This rate is within normal limits and does not indicate digitalis toxicity. Regular rhythm with a normal heart rate suggests stable cardiac function.
B. Heart rate of 52 beats per minute and irregular: Digitalis can cause bradycardia and arrhythmias, making this finding concerning. A slow, irregular pulse may indicate early toxicity and requires immediate evaluation before administering further doses.
C. Heart rate of 100 beats per minute and irregular: While an irregular rhythm warrants monitoring, the rate is not dangerously low. Tachyarrhythmias can occur with many conditions and are less indicative of digitalis toxicity than bradycardic rhythms.
D. Heart rate of 60 beats per minute and regular: This rate is at the lower end of normal but still acceptable. It does not suggest impaired conduction or toxicity associated with digitalis use.
Correct Answer is B
Explanation
A. Vitamin K: Vitamin K supports bone health by aiding osteocalcin activation, but it does not significantly improve calcium absorption from the gut. Its role is secondary and not typically recommended as the primary adjunct for osteoporosis prevention.
B. Vitamin D: Vitamin D enhances intestinal absorption of calcium, allowing more of the supplemented calcium to enter the bloodstream and be utilized for bone mineralization. Adequate vitamin D levels help maintain bone strength and reduce long-term osteoporosis risk. Pairing it with calcium provides the most effective preventive strategy.
C. Vitamin A: Vitamin A is not involved in calcium absorption and, in excess, can even contribute to bone loss. High intake may interfere with bone remodeling and increase fracture risk. It does not complement calcium in preventing osteoporosis.
D. Vitamin E: Vitamin E functions mainly as an antioxidant and has no direct role in bone mineral density or calcium utilization. Supplementing it would not enhance the effectiveness of calcium for bone health. It therefore offers no meaningful benefit in osteoporosis prevention.
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