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The client on nitroglycerin complains of a headache. What is the most appropriate response by the nurse?
- A. Administer acetaminophen as prescribed for the headache.
- B. Hold the next dose of nitroglycerin.
- C. Discontinue the nitroglycerin immediately.
- D. Notify the healthcare provider immediately.
Correct Answer: A
Rationale: The correct response is to administer acetaminophen as prescribed for the headache. This is because headaches are a common side effect of nitroglycerin due to vasodilation. Acetaminophen can help relieve the headache without interfering with the therapeutic effects of nitroglycerin. Holding the next dose (B) is not appropriate as it can lead to inadequate treatment of the client's condition. Discontinuing nitroglycerin (C) abruptly can be dangerous as it may cause rebound hypertension. Notifying the healthcare provider (D) is not necessary unless the headache persists or worsens.
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This is a chronic condition where the heart is unable to pump enough blood to meet the body's needs.
- A. Heart failure
- B. Cardiomyopathy
- C. Myocarditis
- D. Pericarditis
Correct Answer: A
Rationale: The correct answer is A: Heart failure. In heart failure, the heart is unable to pump enough blood to meet the body's needs, leading to symptoms such as shortness of breath and fatigue. This condition can result from various causes like hypertension or heart attacks. Cardiomyopathy (B) refers to diseases of the heart muscle, which can lead to heart failure but is not the same thing. Myocarditis (C) is inflammation of the heart muscle, and pericarditis (D) is inflammation of the pericardium, both of which can cause heart failure but are not the primary condition described in the question.
Which procedure is used to restore a normal heart rhythm in patients with arrhythmias, typically using electrical shocks?
- A. Cardioversion
- B. Defibrillation
- C. Ablation
- D. Angioplasty
Correct Answer: A
Rationale: Sure! Cardioversion is the correct answer because it is the procedure used to restore normal heart rhythm in patients with arrhythmias by delivering synchronized electrical shocks. This method is specifically used for irregular heart rhythms that are not immediately life-threatening. Defibrillation, while also using electrical shocks, is used for life-threatening arrhythmias such as ventricular fibrillation. Ablation involves the destruction of abnormal heart tissue causing arrhythmias, and angioplasty is a procedure to open blocked arteries, not related to restoring heart rhythm.
The nurse is caring for a client with atrial fibrillation on dabigatran (Pradaxa). What is the most important instruction to give to the client?
- A. Take the medication with food to prevent stomach upset.
- B. Do not miss a dose and take it at the same time each day.
- C. Avoid consuming alcohol while on this medication.
- D. Monitor for signs of bleeding.
Correct Answer: B
Rationale: Step-by-step rationale:
1. Dabigatran is an anticoagulant used to prevent blood clots.
2. Consistent dosing is crucial to maintain therapeutic levels.
3. Missing doses increases the risk of clot formation.
4. Taking it at the same time daily helps to ensure effectiveness.
Summary:
A: Taking with food is not essential for dabigatran.
C: Alcohol does not directly interact with dabigatran.
D: Monitoring for bleeding is important, but consistent dosing is the priority for efficacy.
What is the patient with primary hypertension likely to report?
- A. No symptoms
- B. Cardiac palpitations
- C. Dyspnea on exertion
- D. Dizziness and vertigo
Correct Answer: A
Rationale: Primary hypertension often lacks overt symptoms.
You are the charge nurse for the coronary care step-down unit. Which patient is best to assign to an RN who has floated for the day from the general medical-surgical unit?
- A. Patient requiring discharge teaching about coronary artery stenting prior to going home with spouse today.
- B. Patient receiving IV furosemide (Lasix) to treat acute left ventricular failure.
- C. Patient just transferred from the radiology department after a coronary angioplasty.
- D. Patient just admitted with unstable angina and who has orders for a heparin infusion and aspirin
Correct Answer: A
Rationale: Discharge teaching is less complex and allows the floating RN to focus on educating without needing extensive cardiac experience.