The nurse is instructing the client on the correct way to take nitroglycerin as needed for chest pain:

Two tablets PO (by mouth) every 15 minutes.

One tablet SL (sublingual) every 15 minutes, up to 5 times.

One tablet PO (by mouth) every one hour, up to 5 times.

One tablet SL (sublingual) every 5 minutes, up to 3 times.

Answer and Explanation

The Correct Answer is D

Choice A reason: Taking two tablets PO every 15 minutes is not the standard protocol for nitroglycerin administration for chest pain. This method could lead to an overdose and significant hypotension (low blood pressure), which can be dangerous.

Choice B reason: One tablet SL every 15 minutes, up to 5 times, is also not the standard protocol. While sublingual administration is correct, the frequency and the total number of doses are higher than recommended, which could result in adverse effects such as headache, dizziness, or a severe drop in blood pressure.

Choice C reason: One tablet PO every one hour, up to 5 times, is not a recommended method for acute chest pain relief from angina. Oral administration does not provide the rapid onset of action required for acute angina relief.

Choice D reason: One tablet SL every 5 minutes, up to 3 times, is the correct protocol for nitroglycerin administration when experiencing chest pain due to angina. If pain persists after the first dose, the patient can take a second dose after 5 minutes, and if needed, a third dose after another 5 minutes. If chest pain continues after three doses in 15 minutes, emergency medical help should be sought immediately.

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Correct Answer is D

Explanation

Choice A reason: Moving the cane 2 feet ahead is too far and can cause imbalance or a fall. The cane should be moved a short distance ahead, about the length of one natural step.

Choice B reason: Holding the cane with the right hand is correct for someone with left-sided weakness. The cane should be used on the stronger side of the body to provide support for the weaker side.

Choice C reason : Taking a step with the left foot first is not correct because the weaker leg should be advanced to the cane to ensure stability and support when moving.

Choice D reason: Advancing the weaker leg forward to the cane is correct. The cane provides support for the weaker leg, helping to maintain balance as the client walks.

A. Heart rate 60/min B. Oxygen saturation 95% C. Blood pressure 90/50 mm Hg D. Respiratory rate 14/min

Correct Answer is C

Explanation

Choice A reason: A heart rate of 60/min is within the normal range for an adult, and while it may be considered on the lower end, it is not in itself an indication to increase dopamine dosage. Dopamine is used to increase heart rate and cardiac output, but a rate of 60/min does not typically warrant an increase in dosage unless accompanied by other signs of inadequate perfusion.

Choice B reason: An oxygen saturation of 95% is within the normal range for arterial blood gases and is not an indication to increase dopamine dosage. Oxygen saturation reflects the percentage of hemoglobin binding sites in the bloodstream occupied by oxygen.

Choice C reason: A blood pressure of 90/50 mm Hg is considered low and can be an indication for increasing the dopamine dosage in a client with hypovolemic shock. Dopamine increases blood pressure by vasoconstriction and increasing cardiac output, which is critical in managing shock.

Choice D reason: A respiratory rate of 14/min is within the normal range for adults and is not an indication to increase dopamine dosage. The respiratory rate should be monitored for changes that could indicate worsening of the client's condition, but on its own, it does not dictate adjustments to dopamine therapy.

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The nurse is instructing the client on the correct way to take nitroglycerin as needed for chest pain:

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is teaching a client who has left-sided weakness how to use a quad cane. Which of the following client actions indicates an understanding of the teaching?

Correct Answer is D

Explanation

A nurse in the emergency department is monitoring a client who is receiving dopamine to treat hypovolemic shock. Which of the following findings should the nurse identify as an indication for increasing the client's dopamine dosage?

Correct Answer is C

Explanation

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