The nurse is caring for a patient with a history of angina and is treated with a calcium channel blocker. Which of the following would suggest a positive therapeutic response to the medication?
Decreased swelling in the ankles and feet
Patient denies dizziness.
Absence of chest pain
Patient states that she feels stronger
The Correct Answer is C
A. Decreased swelling in the ankles and feet: While some calcium channel blockers may cause peripheral edema, reduction in swelling is not a primary indicator of therapeutic effect for angina. Edema changes are more related to adverse effects than efficacy.
B. Patient denies dizziness.: Avoiding dizziness may indicate tolerability of the medication but does not reflect improvement in angina symptoms or cardiac oxygen supply.
C. Absence of chest pain: Relief or prevention of angina attacks is the main therapeutic goal of calcium channel blockers in patients with angina. Reduction in chest pain indicates effective myocardial oxygen delivery and successful management of ischemic episodes.
D. Patient states that she feels stronger: Feeling stronger may reflect general well-being but is not a specific measure of angina control. The absence of chest pain is a more direct and clinically relevant indicator of therapeutic response.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. Request an order for a blood glucose level: TMP-SMX does not typically cause acute changes in blood glucose, so testing glucose would not clarify the cause of petechiae. Petechial rashes suggest a possible blood dyscrasia such as thrombocytopenia rather than a metabolic disturbance.
B. Hold the dose and notify the provider.: A petechial rash can signal a serious hypersensitivity reaction or drug-induced thrombocytopenia. Giving another dose could worsen the reaction and increase the risk of bleeding or systemic complications. Holding the medication and seeking immediate evaluation is the safest intervention.
C. Request an order for a BUN and creatinine level.: Although TMP-SMX can affect renal function, petechiae primarily indicate a hematologic problem rather than isolated kidney dysfunction. Checking kidney values does not address the risk for severe allergic or platelet-related complications.
D. Request an order for diphenhydramine (Benadryl): Antihistamines can help mild allergic reactions but may mask symptoms of a more serious underlying condition such as thrombocytopenia. Giving it without stopping the medication could delay correct diagnosis and treatment.
Correct Answer is B
Explanation
A. Hypernatremia: Hydrochlorothiazide promotes sodium excretion, so high sodium levels are unlikely. The medication tends to lower sodium, making hypernatremia an uncommon concern in this combination therapy.
B. Hypokalemia: Hydrochlorothiazide increases renal potassium excretion, which can lower serum potassium levels. Low potassium enhances the risk of digoxin toxicity, including arrhythmias, making close monitoring essential. This electrolyte imbalance is the most significant concern with this drug combination.
C. Hypocalcemia: Thiazide diuretics like hydrochlorothiazide actually decrease calcium excretion, so low calcium levels are not expected. Monitoring calcium is not a primary concern for this patient.
D. Hypermagnesemia: Hydrochlorothiazide increases magnesium excretion, but high magnesium levels are unlikely. Hypermagnesemia is not a common side effect of this therapy and is not a priority for monitoring in this scenario.
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