The client, diagnosed with coronary artery disease and a recent myocardial infarction, is being discharged. The client has a medical prescription for nitroglycerin sublingual as needed. Which nursing instruction is correct?
Swallow 1 nitroglycerin tablet with a full glass of water and repeat in 5 minutes.
Apply 1 nitroglycerin transdermal patch to your chest, ensuring to remove any previous patches.
Place 3 nitroglycerin tablets under the tongue and notify physician if pain is not relieved.
Take 1 tablet of nitroglycerin and call 911 or go to emergency department if chest pain is not relieved in 5 minutes, and repeat medication for a total of 3 tablets at 5 minute intervals.
The Correct Answer is D
A. Nitroglycerin should be placed sublingually and not swallowed.
B. This instruction pertains to transdermal nitroglycerin, not sublingual tablets.
C. The recommended use for sublingual nitroglycerin involves one tablet every 5 minutes, up to a total of 3 tablets if pain is not relieved, not placing multiple tablets at once.
D. If chest pain is not relieved by one sublingual nitroglycerin tablet, the patient should take up to a total of 3 tablets at 5-minute intervals and seek emergency help if pain persists.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
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Correct Answer is D
Explanation
A. Clopidogrel is an antiplatelet medication and does not require aPTT monitoring.
B. Warfarin requires monitoring of the INR, not aPTT.
C. Enoxaparin, a low-molecular-weight heparin, generally does not require aPTT monitoring.
D. Heparin therapy requires monitoring of the activated partial thromboplastin time (aPTT) to ensure therapeutic levels and to adjust dosage as necessary.
Correct Answer is C
Explanation
A. Levels in this range are generally considered therapeutic for lithium.
B. Levels in this range are typically below the therapeutic range for lithium.
C. Lithium levels in the range of 1.5 mEq/L to 2 mEq/L are considered toxic and require intervention.
D. Levels in this range are generally within the therapeutic range for lithium.
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