The nurse is aware that the goal of using diltiazem 30 mg PO bid in the collaborative plan of care for a client diagnosed with variant (Prinzmetal's) angina is to:

Increase the SA to AV node conduction time

Decrease coronary artery spasm

Diltiazem causes hyperexcitability in the myocardium

Increase the heart rate

Answer and Explanation

The Correct Answer is B

Choice A reason: Increasing the SA to AV node conduction time is not the goal of using diltiazem for variant angina. Diltiazem is a calcium channel blocker that slows down the conduction of electrical impulses in the heart, but this is not the main mechanism of action for relieving variant angina. Variant angina is caused by spasms of the coronary arteries that reduce blood flow to the heart muscle.

Choice B reason: This is the correct answer. Decreasing coronary artery spasm is the goal of using diltiazem for variant angina. Diltiazem relaxes the smooth muscle of the coronary arteries and prevents them from contracting. This improves the blood supply to the heart and reduces the pain and ischemia associated with variant angina.

Choice C reason: Diltiazem does not cause hyperexcitability in the myocardium. This is a false statement. Diltiazem has the opposite effect of reducing the contractility and excitability of the heart muscle. This lowers the oxygen demand of the heart and helps prevent anginal attacks.

Choice D reason: Increasing the heart rate is not the goal of using diltiazem for variant angina. Diltiazem actually decreases the heart rate by blocking the calcium channels in the sinoatrial node and the atrioventricular node. This reduces the workload of the heart and the oxygen consumption. A high heart rate can worsen angina by increasing the oxygen demand of the heart.

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Correct Answer is A

Explanation

Choice A reason: This is the correct answer. Stool for occult blood is a diagnostic test that detects the presence of hidden blood in the feces. This can indicate bleeding in the gastrointestinal tract, which is the most common cause of chronic iron deficiency anemia. Iron deficiency anemia is a condition where the body does not have enough iron to produce hemoglobin, the protein that carries oxygen in the red blood cells.

Choice B reason: Vitamin B12 level is not the diagnostic test that is used to detect the most common cause of chronic iron deficiency anemia. Vitamin B12 level is a blood test that measures the amount of vitamin B12 in the body. Vitamin B12 is a nutrient that is essential for the production of red blood cells and the maintenance of the nervous system. Vitamin B12 deficiency can cause pernicious anemia, a type of megaloblastic anemia where the red blood cells are large and immature.

Choice C reason: Schilling's test is not the diagnostic test that is used to detect the most common cause of chronic iron deficiency anemia. Schilling's test is a urine test that evaluates the absorption of vitamin B12 in the body. It involves giving the client an oral dose of radioactive vitamin B12 and an intramuscular injection of non-radioactive vitamin B12. The urine is then collected and measured for the amount of radioactive vitamin B12. Schilling's test can help diagnose pernicious anemia and other causes of vitamin B12 malabsorption.

Choice D reason: Bone marrow aspiration study is not the diagnostic test that is used to detect the most common cause of chronic iron deficiency anemia. Bone marrow aspiration study is a procedure that involves taking a sample of bone marrow from the hip or sternum and examining it under a microscope. Bone marrow is the soft tissue inside the bones that produces blood cells. Bone marrow aspiration study can help diagnose various blood disorders, such as leukemia, lymphoma, and aplastic anemia.

A. I can have aspirin 650 mg for pain when the procedure is over. B. The nurse will check the puncture site at least every 4 hours after the procedure. C. I will have some pain that is similar to a toothache. D. I understand that this is a sterile procedure.

Correct Answer is A

Explanation

Choice A reason: The client requires additional teaching if they state that they can have aspirin for pain after the bone marrow aspiration. Aspirin is a drug that inhibits platelet aggregation and increases the risk of bleeding. ¹ The client should avoid aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs) for at least 48 hours after the procedure. ² The client should use acetaminophen or another pain reliever that does not affect blood clotting.

Choice B reason: The client does not require additional teaching if they state that the nurse will check the puncture site at least every 4 hours after the procedure. This is a correct statement, as the nurse should monitor the site for signs of bleeding, infection, or hematoma. ² The nurse should also apply pressure and a sterile dressing to the site and instruct the client to keep it dry and clean for 24 hours.

Choice C reason: The client does not require additional teaching if they state that they will have some pain that is similar to a toothache. This is a correct statement, as the client may experience mild to moderate pain at the site of the aspiration, which may radiate to the hip or back. ² The pain usually subsides within a few hours or days.

Choice D reason: The client does not require additional teaching if they state that they understand that this is a sterile procedure. This is a correct statement, as the bone marrow aspiration is performed under sterile conditions to prevent infection. ² The nurse should wear gloves, gown, mask, and eye protection and use a sterile needle, syringe, and antiseptic solution.

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The nurse is aware that the goal of using diltiazem 30 mg PO bid in the collaborative plan of care for a client diagnosed with variant (Prinzmetal's) angina is to:

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Naxlex Comprehensive Predictor Exams

The nurse recognizes that which diagnostic test is used to detect the most common cause of chronic iron deficiency anemia?

Correct Answer is A

Explanation

The nurse understands that a client who has had a bone marrow aspiration to assist in the diagnosis of aplastic anemia requires additional teaching when they state:

Correct Answer is A

Explanation

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