Nokea
A client newly diagnosed with angina pectoris has taken two sublingual nitroglycerin tablets for chest pain. The chest pain is relieved, but the client now reports a headache. The nurse interprets that this most likely represents which response?
- A. An early sign of medication tolerance
- B. An allergic reaction to the nitroglycerin
- C. An expected side effect of the medication
- D. A warning that the medication should not be used again
Correct Answer: C
Rationale: Headache is a frequent side effect of nitroglycerin, because of the vasodilating action of the medication. It usually diminishes in frequency as the client becomes accustomed to the medication and is effectively treated with acetaminophen. The other options are incorrect.
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A client with a history of depression is prescribed sertraline (Zoloft). The nurse should instruct the client to report which of the following side effects?
- A. Insomnia.
- B. Bradycardia.
- C. Hypotension.
- D. Weight loss.
Correct Answer: A
Rationale: Sertraline commonly causes insomnia, which should be reported to manage treatment.
Which of the following conditions is a potential consequence of a prolonged QT interval?
- A. Serious electrolyte imbalance.
- B. Ventricular dysrhythmias.
- C. Heart block.
- D. Atrial dysrhythmias.
Correct Answer: B
Rationale: A prolonged QT interval increases the risk of ventricular dysrhythmias, such as torsades de pointes, which can be life-threatening.
Which of the following is appropriate for a client with metabolic alkalosis?
- A. Monitor serum potassium levels
- B. Maintain the client on bed rest
- C. Have the client inhale carbon dioxide using a paper bag
- D. Administer sodium bicarbonate as ordered
Correct Answer: A
Rationale: Metabolic alkalosis can cause hypokalemia, so monitoring serum potassium levels is appropriate. Bed rest is not indicated, inhaling CO2 is for respiratory alkalosis, and sodium bicarbonate would worsen alkalosis.
A client with a history of type 1 diabetes mellitus is prescribed insulin aspart (NovoLog). The nurse should explain that this insulin:
- A. Provides a steady basal insulin level.
- B. Is administered immediately before meals.
- C. Should be mixed with long-acting insulin.
- D. Is taken once daily at bedtime.
Correct Answer: B
Rationale: Insulin aspart is a rapid-acting insulin administered immediately before meals to control postprandial glucose.
A client with a history of chronic kidney disease is admitted with edema. The nurse should monitor the client for which of the following electrolyte imbalances? Select all that apply.
- A. Hyperkalemia.
- B. Hyponatremia.
- C. Hypocalcemia.
- D. Hypermagnesemia.
- E. Hypophosphatemia.
Correct Answer: A, B, C, D
Rationale: Chronic kidney disease can cause hyperkalemia, hyponatremia, hypocalcemia, and hypermagnesemia due to impaired excretion and filtration.