When administering sublingual nitroglycerin for emergency treatment of angina or chest pain, the nurse monitors for which common adverse effect?
Nausea.
Bradycardia.
Hypertension.
Headache.
The Correct Answer is D
The correct answer is Choice D: Headache.
Choice A rationale: Nausea is not a common adverse effect of sublingual nitroglycerin. Nausea may occur in some patients, but it is usually mild and transient. Nausea may be related to the vasodilatory effects of nitroglycerin, which can cause hypotension and reflex tachycardia1. Nausea may also be caused by other factors, such as anxiety, stress, or food intolerance. Nausea is not a specific indicator of nitroglycerin toxicity or overdose2.
Choice B rationale: Bradycardia is not a common adverse effect of sublingual nitroglycerin. Bradycardia is a slow heart rate, usually defined as less than 60 beats per minute. Bradycardia may occur in some patients who take nitroglycerin, especially in combination with other drugs that affect the heart rate, such as beta-blockers, calcium channel blockers, or digoxin3. Bradycardia may also be caused by other factors, such as vagal stimulation, hypothyroidism, or electrolyte imbalance. Bradycardia is not a specific indicator of nitroglycerin toxicity or overdose2.
Choice C rationale: Hypertension is not a common adverse effect of sublingual nitroglycerin. Hypertension is a high blood pressure, usually defined as more than 140/90 mmHg. Hypertension may occur in some patients who take nitroglycerin, especially in those who have a history of hypertension, renal impairment, or volume overload4. Hypertension may also be caused by other factors, such as stress, pain, or caffeine intake. Hypertension is not a specific indicator of nitroglycerin toxicity or overdose2.
Choice D rationale: Headache is a common adverse effect of sublingual nitroglycerin. Headache may occur in up to 80% of patients who take nitroglycerin, especially during the first few days of therapy or after an increase in dose5. Headache may be related to the vasodilatory effects of nitroglycerin, which can cause cerebral vasodilation and increased intracranial pressure. Headache may also be caused by other factors, such as dehydration, sinusitis, or migraine. Headache is usually mild to moderate in intensity and can be relieved by analgesics, such as acetaminophen or aspirin. Headache is not a specific indicator of nitroglycerin toxicity or overdose
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
PT stands for prothrombin time, which is a measure of how long it takes the blood to clot. INR stands for international normalized ratio, which is a standardized way of reporting the PT result. Warfarin is a blood thinner that works by slowing down the clotting process.Therefore, people who take warfarin need to have their PT/INR monitored regularly to make sure they are getting the right dose and not bleeding too much or too little.
Choice A is wrong because PTT stands for partial thromboplastin time, which is another measure of blood clotting that is not affected by warfarin.PTT is used to monitor heparin, another type of blood thinner.
Choice C is wrong because CBC stands for complete blood count, which is a test that measures the number and types of cells in the blood, such as red blood cells, white blood cells and platelets.CBC can show if there is anemia, infection or bleeding, but it does not measure the effect of warfarin on clotting.
Choice D is wrong because LFTs stand for liver function tests, which are a group of tests that check how well the liver is working.
LFTs can show if there is liver damage or disease, which can affect how warfarin is metabolized and cleared from the body.However, LFTs do not directly measure the effect of warfarin on clotting.
The normal range for PT/INR varies depending on the laboratory and the reason for taking warfarin.
Generally, the normal range for PT is 10 to 13 seconds, and the normal range for INR is 1.1 or below for healthy people.For people taking warfarin, the target INR range depends on their condition and risk factors, but it is usually between 2.0 and 3.0.
Correct Answer is B
Explanation
Class IV antidysrhythmics or calcium channel blockers have the action ofdecreasing the flow of calcium ionsinto the cardiac and vascular smooth muscle cells, thusdecreasing heart rate and contractions.
This leads to vasodilation and myocardial depression, which can help control arrhythmias, hypertension and angina.
Choice A is wrong because calcium channel blockers do not increase blood vessel spasm, but rather relax them by inhibiting the calcium influx that causes contraction.
Choice C is wrong because calcium channel blockers do not promote platelet aggregation, but rather inhibit it by interfering with the calcium-dependent binding of fibrinogen to platelets.
Choice D is wrong because calcium channel blockers do not enhance sympathetic nervous system activity, but rather counteract it by reducing the cardiac output and peripheral resistance.
Some normal ranges for reference are:
• Heart rate: 60-100 beats per minute
• Blood pressure: 120/80 mmHg
• Calcium: 8.5-10.5 mg/dL
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