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A client with chronic stable angina is prescribed nitroglycerin (Nitrostat) for chest pain. The nurse should include which instruction when teaching the client about this medication?
- A. Take nitroglycerin at the first sign of chest pain.
- B. Swallow the tablet whole with water.
- C. Take nitroglycerin with meals to prevent stomach upset.
- D. Store nitroglycerin in a cool, dry place.
Correct Answer: A
Rationale: The correct instruction when teaching a client about nitroglycerin (Nitrostat) is to take it at the first sign of chest pain. Nitroglycerin works rapidly to dilate blood vessels, improving blood flow to the heart muscle. Taking it promptly can help alleviate symptoms quickly and prevent the condition from worsening. Choice B is incorrect because nitroglycerin is usually taken sublingually (under the tongue) and not swallowed. Choice C is incorrect because nitroglycerin is not typically taken with meals. Choice D is incorrect because nitroglycerin should be stored in its original container away from heat and light.
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The nurse is assisting in the care of a client experiencing an acute myocardial infarction (MI). Which medication would the nurse expect to be administered to help reduce myocardial oxygen demand?
- A. Aspirin
- B. Morphine
- C. Atropine
- D. Lidocaine
Correct Answer: B
Rationale: In the context of an acute myocardial infarction (MI), morphine is administered to relieve pain and reduce myocardial oxygen demand. By alleviating pain and anxiety, morphine helps reduce oxygen demand on the heart, which is beneficial in the setting of an MI. Aspirin, commonly used for its antiplatelet effects, helps inhibit platelet aggregation and is crucial in the management of MI to prevent further clot formation. Atropine is a medication used to treat symptomatic bradycardia by increasing heart rate, not commonly indicated in the management of acute MI. Lidocaine is used for ventricular dysrhythmias and is not typically given to reduce myocardial oxygen demand in an acute MI scenario.
A client has a new prescription for propranolol. Which of the following instructions should be included?
- A. Take the medication with food.
- B. Monitor heart rate daily.
- C. Increase intake of potassium-rich foods.
- D. Avoid consuming dairy products.
Correct Answer: B
Rationale: The correct answer is to monitor heart rate daily. Propranolol is a beta-blocker that can lower heart rate and blood pressure, so it is essential to monitor heart rate regularly to detect any signs of bradycardia, a potential side effect of the medication. Choice A is incorrect because propranolol can be taken with or without food. Choice C is incorrect as increasing potassium-rich foods is not specifically required with propranolol. Choice D is also incorrect as there is no need to avoid consuming dairy products with propranolol.
The client is reinforcing teaching for peripheral artery disease (PAD). Which statement by the client indicates correct understanding?
- A. I will keep my legs elevated on pillows while resting.
- B. I will avoid crossing my legs when sitting.
- C. I will wear tight compression stockings to improve circulation.
- D. I will apply heat to my legs to relieve pain and improve circulation.
Correct Answer: B
Rationale: The correct answer is B. Crossing the legs can further impede blood flow in clients with PAD, worsening symptoms. Avoiding leg crossing helps maintain adequate blood flow and reduces the risk of complications associated with peripheral artery disease. Choices A, C, and D are incorrect because elevating the legs, wearing tight compression stockings, and applying heat can exacerbate symptoms in PAD by restricting blood flow or causing potential harm.
The client with a history of angina pectoris is being discharged after coronary artery bypass graft (CABG) surgery. Which statement by the client indicates a need for further teaching?
- A. I will avoid lifting heavy objects for at least 6 weeks.
- B. I will call the doctor if I develop a fever or drainage from my incisions.
- C. I will take my pain medication before doing any activities that might cause discomfort.
- D. I can resume my normal activities, including driving, as soon as I feel like it.
Correct Answer: D
Rationale: The correct answer is D because after CABG surgery, patients need to follow specific guidelines for resuming activities, and driving is typically restricted for a certain period to ensure safety and proper recovery. Resuming normal activities too soon, including driving, can pose risks to the client's health and safety. It is essential to emphasize to the client the importance of following the healthcare provider's recommendations regarding activity restrictions post-surgery to prevent complications and promote optimal recovery. Choices A, B, and C are correct statements that align with post-CABG discharge instructions, emphasizing the importance of avoiding heavy lifting, monitoring for signs of infection, and managing pain effectively.
The client is receiving digoxin (Lanoxin) for heart failure. Which symptom would indicate digoxin toxicity?
- A. Increased appetite
- B. Yellow or blurred vision
- C. Increased urination
- D. Diarrhea
Correct Answer: B
Rationale: Yellow or blurred vision can be a sign of digoxin toxicity. These visual disturbances are concerning as they indicate a potential adverse reaction to the medication. Recognizing this symptom promptly is crucial to prevent serious complications. Increased appetite, increased urination, and diarrhea are not typically associated with digoxin toxicity. Therefore, option B is the correct choice in this scenario.