After the nurse teaches the patient about the use of atenolol (Tenormin) in preventing anginal episodes, which statement by a patient indicates that the teaching has been effective?
"Atenolol will increase the strength of my heart muscle.”.
"It is important not to suddenly stop taking the atenolol.”.
"I can expect to feel short of breath when taking atenolol.”.
"Atenolol will improve the blood flow to my coronary arteries.”.
The Correct Answer is B
Choice A rationale
Atenolol is a selective beta-1 adrenergic antagonist, meaning it blocks the effects of epinephrine on the heart. Rather than increasing the strength of the heart muscle, it actually has a negative inotropic effect, which reduces the force of myocardial contraction. This helps decrease the heart's workload and oxygen demand. The patient's statement suggesting an increase in muscle strength is physiologically incorrect and indicates a misunderstanding of how the medication functions to prevent angina.
Choice B rationale
Abrupt withdrawal of beta-blockers like atenolol can trigger a phenomenon known as rebound hypertension or a thyroid storm-like state. This occurs because the heart's beta receptors become hypersensitized during therapy. Suddenly stopping the drug can lead to severe tachycardia, intensified angina, or even myocardial infarction due to an exaggerated response to circulating catecholamines. Therefore, emphasizing that the medication should never be stopped suddenly is a critical and accurate component of patient teaching for safety.
Choice C rationale
Shortness of breath is a potential adverse effect of beta-blockers, particularly if they lose selectivity and affect beta-2 receptors in the lungs, causing bronchoconstriction. However, this is not a normal or expected outcome that a patient should simply accept. If a patient feels short of breath while taking atenolol, it may indicate a worsening of heart failure or an underlying reactive airway issue. The goal of teaching is to identify side effects to report, not to expect respiratory distress.
Choice D rationale
While atenolol helps manage angina by reducing the oxygen demand of the heart, it does not primarily work by improving blood flow through the coronary arteries. Nitrates are the class of drugs typically responsible for coronary vasodilation. Atenolol works by slowing the heart rate and reducing blood pressure, which allows more time for the heart to rest between beats. Misunderstanding the primary mechanism of action as a vasodilator suggests that the patient requires further clarification on pharmacological effects.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A rationale
The emergency department is reserved for red-tagged patients who require immediate life-saving interventions for salvageable conditions. During a mass casualty incident with 44 casualties, resources are extremely limited and must be allocated to those with the highest probability of survival. A patient with no pulse or respirations is physiologically deceased or non-salvageable in a disaster context. Performing resuscitation on such individuals would divert critical staff and equipment away from salvageable victims.
Choice B rationale
Off-site clinics for the walking wounded are designated for green-tagged patients who have minor injuries such as abrasions, small lacerations, or simple fractures. These individuals are hemodynamically stable and capable of ambulation. A patient lacking a pulse or spontaneous respirations does not meet the criteria for minor care. Such patients require no further medical intervention in a triage system designed to maximize the number of survivors within a population during a disaster.
Choice C rationale
Minor care areas are intended for patients with non-life-threatening injuries that can wait for treatment without significant risk of clinical deterioration. Examples include simple sprains or minor burns. Because this patient is already in a state of cardiopulmonary arrest, there is no physiological baseline to maintain in a minor care setting. Triage protocols mandate that those who are already deceased or have injuries incompatible with life be bypassed to prioritize active treatment.
Choice D rationale
In disaster triage, the black tag category is used for patients who are either deceased or have injuries so severe that survival is unlikely even with maximal care. This patient has no pulse or respirations, meeting the criteria for being non-salvageable. Moving them to a morgue or holding area allows the medical team to focus exclusively on those with a chance of survival, adhering to the ethical principle of providing the greatest good for the greatest number.
Correct Answer is C
Explanation
Choice A rationale
This sequence incorrectly places obtaining vital signs (step 4) before securing airway and oxygenation. In trauma management, the primary survey must follow the ABC (Airway, Breathing, Circulation) sequence. Assessing vitals and inserting a Foley catheter are part of the secondary survey or the end of the primary survey. Failing to stabilize the airway and breathing before taking a full set of vitals could lead to patient deterioration in an emergency rollover scenario.
Choice B rationale
This sequence starts with vital signs, which violates the fundamental principles of trauma resuscitation. In a rollover accident, the nurse must first address life-threatening airway and breathing issues. Moving directly to removing clothing (step 5) before ensuring the patient is breathing or has a clear airway is inappropriate. The priorities must focus on immediate physiological stabilization before moving to assessment tasks that do not directly treat hypoxia or airway obstruction in the trauma patient.
Choice C rationale
This sequence correctly follows the trauma primary survey (ABCDE).
Step 1 assesses breathing, followed by step 7 to open the airway if needed.
Step 2 provides oxygen for breathing support.
Step 6 addresses circulation by starting IVs for fluid resuscitation.
Step 5 involves exposure to check for hidden injuries.
Step 4 obtains vitals once life-threats are managed, and step 3 (Foley) is a later intervention. This represents the most scientific and systematic approach to trauma care.
Choice D rationale
Starting the intervention by removing clothing (step 5) and taking vital signs (step 4) ignores the immediate life-saving needs of airway and breathing management. A patient in a rollover accident may have a compromised airway or tension pneumothorax. Delaying airway opening (step 7) and oxygen administration (step 2) while focusing on vitals and exposure increases the risk of hypoxic brain injury and cardiac arrest, making this sequence unsafe and clinically unsound.
Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.
Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today
Report Wrong Answer on the Current Question
Do you disagree with the answer? If yes, what is your expected answer? Explain.
Kindly be descriptive with the issue you are facing.