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A client with a diagnosis of angina pectoris is prescribed nitroglycerin tablets. How should the nurse instruct the client to take the medication?
- A. Swallow the tablet whole with water
- B. Place the tablet under the tongue and let it dissolve
- C. Chew the tablet and then swallow
- D. Place the tablet between the cheek and gum
Correct Answer: B
Rationale: Nitroglycerin is most effective when administered sublingually (under the tongue) as it is rapidly absorbed into the bloodstream. Placing the tablet under the tongue allows for quick absorption and faster relief of angina symptoms. Chewing the tablet, swallowing it, or placing it between the cheek and gum would not provide the same rapid onset of action needed during an angina episode.
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The LPN/LVN is assisting in the care of a client with a diagnosis of heart failure who is receiving digoxin (Lanoxin). Which laboratory result should the nurse monitor closely?
- A. Serum sodium
- B. Serum potassium
- C. Serum calcium
- D. Serum glucose
Correct Answer: B
Rationale: The correct answer is serum potassium. Monitoring serum potassium levels is crucial when a client is receiving digoxin (Lanoxin) because low potassium levels can increase the risk of digoxin toxicity. Digoxin and low potassium levels can lead to serious cardiac complications, such as arrhythmias. Therefore, close monitoring of serum potassium is essential to prevent adverse effects and ensure the safe administration of digoxin in clients with heart failure.
A client with a history of myocardial infarction (MI) is being discharged with a prescription for nitroglycerin sublingual tablets. Which instruction should the nurse reinforce?
- A. Store the tablets in a cool, dry place away from light.
- B. Take a tablet every 5 minutes if chest pain occurs.
- C. Place the tablets under the tongue for sublingual absorption.
- D. Take the tablets without water for faster effect.
Correct Answer: A
Rationale: Nitroglycerin tablets are light and moisture-sensitive, so they should be stored in a cool, dry place away from light to maintain their effectiveness. Option B advises taking a tablet every 5 minutes, which may lead to overdose. Option C emphasizes the correct administration route for sublingual tablets. Option D is incorrect as water is not needed for the tablets to take effect.
A client with hypertension is prescribed enalapril (Vasotec). The nurse should monitor the client for which adverse effect?
- A. Hypotension
- B. Hypertension
- C. Tachycardia
- D. Hyperglycemia
Correct Answer: A
Rationale: Enalapril, an ACE inhibitor, can lead to hypotension, particularly following the initial dose or dosage escalation. This effect is due to the medication's mechanism of action in dilating blood vessels, which can result in lowered blood pressure. Monitoring for hypotension is crucial to prevent complications such as dizziness, lightheadedness, or fainting in clients taking enalapril.
The LPN/LVN is assisting in the care of a client who has been prescribed enoxaparin (Lovenox) for the prevention of deep vein thrombosis (DVT). Which instruction should the nurse reinforce with the client?
- A. Avoid consuming foods high in vitamin K while taking this medication.
- B. Administer the injection in the same site each time for consistency.
- C. Report any unusual bleeding or bruising to your healthcare provider.
- D. Do not take aspirin if you experience any mild pain or discomfort.
Correct Answer: C
Rationale: The correct instruction for the nurse to reinforce with the client is to report any unusual bleeding or bruising to their healthcare provider. This is important because unusual bleeding or bruising may indicate excessive anticoagulation, a potential side effect of enoxaparin, and should be promptly addressed by a healthcare provider to prevent complications.
The healthcare provider is reviewing the medication orders for a client with angina pectoris. Which medication is typically prescribed to prevent angina attacks?
- A. Aspirin
- B. Nitroglycerin
- C. Atenolol
- D. Simvastatin
Correct Answer: B
Rationale: Nitroglycerin is the medication typically prescribed to prevent angina attacks. It works by dilating blood vessels, increasing blood flow, and reducing the heart's workload, hence relieving angina symptoms. Aspirin is often used to prevent blood clots, Atenolol is a beta-blocker used to manage high blood pressure and chest pain, and Simvastatin is a statin medication primarily used to lower cholesterol levels.