The nurse has provided discharge teaching to a client prescribed nitroglycerin SL. Which statement, made by the client, indicates that the teaching has been effective? I will:
throw away any tablets that fizzle under my tongue, it means they are ineffective.
keep my bottle of nitroglycerin at home in the medicine cabinet.
call 911 if I get chest pain that doesn't go away after one tablet and I will take another tablet.
remove the tablets from the bottle and keep them in a plastic bag in my handbag.
The Correct Answer is A
Choice A reason: Throwing away any tablets that fizzle under my tongue, it means they are ineffective is not a statement that indicates an understanding of the discharge teaching. This statement is incorrect and dangerous, as fizzling or tingling is a normal sensation that indicates that the tablet is working. The client should not discard or waste the medication, but keep it in a dark, dry, and cool place.
Choice B reason: Keeping my bottle of nitroglycerin at home in the medicine cabinet is not a statement that indicates an understanding of the discharge teaching. This statement is impractical and risky, as the client may need the medication when they are away from home. The client should always carry the medication with them and have it readily available in case of chest pain.
Choice C reason: Calling 911 if I get chest pain that doesn't go away after one tablet and I will take another tablet is a statement that indicates an understanding of the discharge teaching. This statement is correct and safe, as it follows the standard protocol for using nitroglycerin SL for angina. The client should take one tablet under the tongue at the onset of chest pain, wait five minutes, and repeat if the pain persists. If the pain is not relieved after three tablets, the client should seek emergency medical attention.
Choice D reason: Removing the tablets from the bottle and keeping them in a plastic bag in my handbag is not a statement that indicates an understanding of the discharge teaching. This statement is inappropriate and harmful, as it exposes the medication to light, moisture, and heat, which can reduce its potency and effectiveness. The client should keep the tablets in their original container and close it tightly after each use.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A reason: Vitamin B12 does not contribute to the increased production of RBCs after significant blood loss. Vitamin B12 is a type of vitamin that is essential for the normal formation and maturation of red blood cells (RBCs), which carry oxygen throughout the body. ¹ However, vitamin B12 does not increase the production of RBCs in response to blood loss. That is the role of erythropoietin, a hormone that stimulates the bone marrow to produce more RBCs. ²
Choice B reason: Vitamin B12 is not needed to prevent excessive production of red blood cells. Vitamin B12 is needed for the normal production of red blood cells, not for the prevention of overproduction. Excessive production of red blood cells, also known as polycythemia, can cause the blood to become thick and viscous, increasing the risk of clotting and stroke. ³ Polycythemia can be caused by various factors, such as smoking, dehydration, or genetic mutations, but not by a lack of vitamin B12.
Choice C reason: Vitamin B12 is not needed to prevent RBCs from sticking together. Vitamin B12 is needed for the normal formation and maturation of RBCs, not for the prevention of aggregation. RBCs can stick together and form clumps, also known as rouleaux, which can impair blood flow and oxygen delivery. Rouleaux can be caused by various factors, such as inflammation, infection, or cancer, but not by a lack of vitamin B12.
Choice D reason: Vitamin B12 is needed for the normal formation and maturation of RBCs, but it cannot be absorbed by the body without a substance called intrinsic factor. Intrinsic factor is a protein that is produced by the stomach and binds to vitamin B12, allowing it to be absorbed by the small intestine. ¹ Pernicious anemia is a type of anemia that occurs when the stomach does not produce enough intrinsic factor, leading to vitamin B12 deficiency. The only way to treat pernicious anemia is by giving vitamin B12 injections, which bypass the need for intrinsic factor.
Correct Answer is D
Explanation
Choice A reason: Decreased hair is most likely a hereditary condition and nail changes are related to fungus is not the statement that describes the cause of this finding. This statement is not based on evidence and does not explain the relationship between peripheral vascular disease and the observed changes in the legs and feet.
Choice B reason: A blood clot may be forming and the client needs immediate intervention is not the statement that describes the cause of this finding. This statement is an alarmist and inaccurate interpretation of the finding. A blood clot would cause more acute and severe symptoms, such as pain, swelling, redness, and warmth in the affected area.
Choice C reason: Decreased oxygen to the tissues causes changes in hair growth and nail texture is the statement that describes the cause of this finding. This statement is based on the pathophysiology of peripheral vascular disease, which is a chronic condition that reduces the blood flow to the extremities due to atherosclerosis or inflammation of the blood vessels. The reduced blood flow leads to tissue ischemia and necrosis, which can manifest as hair loss, thickening and yellowing of the nails, skin ulcers, and gangrene.
Choice D reason: Depending on the client's age, the findings may be normal is not the statement that describes the cause of this finding. This statement is a vague and dismissive response that does not address the underlying problem of peripheral vascular disease. The findings are not normal for any age group and require further assessment and intervention.
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