Try Naxlex NCLEX-RN (Free-Trial)

The nurse has provided discharge teaching to the client to manage his chest pain at home. Which 2 statements from the client should the nurse recognize as a need for further education?

I will chew my nitroglycerin tabs as soon as pain begins.

I will lie down or sit if I start to feel any chest discomfort.

I will keep my nitroglycerin tablets with me all the time.

I will call 911 if there is no improvement in my chest pain after taking nitroglycerin.

I will wear a medication alert bracelet to indicate my history of heart problems.

I will take the nitroglycerin 1 or 2 more times 10 minutes apart if pain does not get better.

I will wait 5 minutes after taking my nitroglycerin to see if the pain improves.

Answer and Explanation

Correct Answer : A,F

A. Nitroglycerin is highly susceptible to the "first-pass effect," meaning if it is swallowed or chewed and enters the digestive system, the liver will metabolize and inactivate it before it reaches the heart. It must be administered sublingually (under the tongue) to be absorbed directly into the systemic circulation through the oral mucosa.

B. Nitroglycerin is a potent vasodilator. A common side effect is a sudden drop in blood pressure (orthostatic hypotension), which can cause dizziness, syncope (fainting), and falls. Sitting or lying down before taking the medication ensures patient safety. Additionally, resting reduces the oxygen demand on the heart.

C. Anginal pain often occurs during physical exertion or emotional stress (as seen when the patient was mowing the lawn). Immediate access to the medication is critical to stop the progression of ischemia and prevent myocardial infarction.

D. If the pain does not subside after the first dose, it may indicate a myocardial infarction (heart attack) rather than stable angina. Timely activation of Emergency Medical Services (EMS) is the most critical step in reducing heart muscle damage.

E. In the event the patient becomes unconscious or unresponsive, a medical alert bracelet provides first responders with vital information regarding his cardiac history and medications, allowing for faster and more accurate emergency treatment.

F. This statement contains two errors. First, the interval between doses should be 5 minutes, not 10. Second, the patient should not wait to take three doses before calling 911. Current guidelines suggest calling 911 if pain is unrelieved or worsening 5 minutes after the first dose.

G. Sublingual nitroglycerin typically begins to work within 1 to 3 minutes. Waiting 5 minutes allows enough time for the medication to reach peak effect before deciding if an additional dose or emergency intervention is required.

Nursing Test Bank

Test Bank #1: RN Pharmacology Exams Test Bank #2: RN Medical-Surgical Exams Test Bank #3: RN Fundamentals Exams Test Bank #4: RN Maternal-Newborn Exams Test Bank #5: RN Anatomy and Physiology Exams Test Bank #6: RN Obstetrics and Pediatrics Exams Test Bank #7: RN Fluid and Electrolytes Exams Test Bank #9: RN Adult Health Test Bank #10: RN Dosage Calculation Test Bank #11: RN Community Health Exams Test Bank #12: RN Psychology Exams Test Bank #13: RN Nursing Care Of Children Test Bank #14: RN Foundations of Nursing Exams

Get 100+ Naxlex Exit Exams for $79 Try Naxlex NCLEX-RN (14 Day Free-Trial)

Naxlex Comprehensive Predictor Exams

Exam #1: RN Comprehensive predictor 2023 proctored exam Exam #2: Ati rn vati comprehensive predictor proctored exam Exam #3: Ati Rn Comprehensive Predictor Proctored Exam 2023 Exam #4: Rn Comprehensive Predictor 2023 Proctored Exam - St. Joseph Exam #5: RN Comprehensive Predictor Proctored Exam (National U CA San Diego) Exam #6: Ati rn comprehensive predictor 2023 retake proctored exam Exam #7: RN Hesi Exit Proctored Exam Exam #8: Hesi RN Exit proctored exam Exam #9: Hesi rn exit proctored exam Exam #10: Hesi Rn compass exit B proctored exam

Free Nursing Study Resources

Correct Answer is "{\"xRanges\":[67.52494131455398,86.30428403755869],\"yRanges\":[37.5,61.30952380952381]}"

Explanation

Rhinorrhea is the drainage of fluid from the nasal cavity. In cases of suspected CSF leak (often after head trauma, skull base fracture, or neurosurgery), CSF can escape through the nose. The nurse would collect fluid from the nares for testing (commonly the halo test or laboratory analysis for glucose or beta‑2 transferrin).

A. Serum hepatic enzyme elevations. B. Blood urea nitrogen (BUN) and serum creatinine elevations. C. White blood cell count below 5,000/mm3 (5 x 109/L). D. Blood pressure for hypotension.

Correct Answer is B

Explanation

A. Elevations in hepatic enzymes indicate liver dysfunction but are not specific to kidney transplant rejection. While abnormal labs should be monitored, they are not the primary indicators of graft rejection.

B. This is the most significant finding. Elevations in BUN and serum creatinine indicate impaired kidney function, which is a key sign of kidney transplant rejection. Prompt reporting allows the healthcare provider to initiate diagnostic testing (e.g., biopsy) and adjust immunosuppressive therapy to prevent further graft damage.

C. A WBC count below 5,000/mm³ indicates leukopenia, which may increase infection risk, often related to immunosuppressive therapy. While important, it is not a direct indicator of transplant rejection.

D. Hypotension is a general concern for perfusion but is not a specific or sensitive marker of kidney transplant rejection. Monitoring blood pressure is important for overall cardiovascular stability but does not confirm rejection.

View Question and Answer

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

The nurse has provided discharge teaching to the client to manage his chest pain at home. Which 2 statements from the client should the nurse recognize as a need for further education?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

In caring for a client following a head injury, the nurse plans to assess for rhinorrhea so that a sample can be tested for the presence of cerebrospinal fluid (CSF). At which location should the nurse observe for this finding? (Click the chosen location. To change, click on the new location.)

Correct Answer is "{\"xRanges\":[67.52494131455398,86.30428403755869],\"yRanges\":[37.5,61.30952380952381]}"

Explanation

The nurse is caring for a client who received a kidney transplant 2 years ago and is now showing signs of rejection. Which assessment findings should the nurse report to the healthcare provider? Reference Range: White Blood Cell (WBC) [5000 to 10,000/mm3 (5 to 10 x 109/L)]

Correct Answer is B

Explanation

A client with Guillain-Barré syndrome reports increasing weakness in the legs. Which statement by the nurse describes this symptom?

The nurse is providing education to the client. For each teaching point, click to indicate whether it should be included or not included. Each row must have one response option selected.

Following a total knee arthroplasty, the client is discharged from the hospital with a prescription for warfarin. In reviewing discharge teaching, the client recounts to the nurse the need to avoid eating foods high in potassium, such as bananas and melon. How should the nurse respond?

The nurse is caring for a client with aortic valve regurgitation. Which finding is most important for the nurse report to the healthcare provider?

Which intervention is most important for the nurse to include in the plan of care for a client who is 12 hours post-thyroidectomy?

After considering the report from the ED, the nurse identifies abnormal findings that require further evaluation and assessment. Drag from the Word Choices to complete the sentence. The nurse identifies abnormal findings includingdropdown,dropdownanddropdown

A client with leukemia who is receiving a myelosuppressive chemotherapy has a platelet count of 25,000/mm3 (25 x 109/L). Which intervention is most important for the nurse to include in this client's plan of care? Reference Range: Platelet count [150,000 to 400,000/mm3 (150 to 400 x 109/L)]