Nokea
A nurse is caring for a client who is prescribed transdermal nitroglycerin for angina. The nurse instructs the client to apply the patch for how long?
- A. 4 to 6 hours
- B. 6 to 8 hours
- C. 10 to 12 hours
- D. 12 to 14 hours
Correct Answer: C
Rationale: The transdermal nitroglycerin patch should be applied every day for 10 to 12 hours. If the patch is applied for a shorter time, the therapeutic dosage may not be delivered. Applying the patch for a longer time will result in the development of tolerance to the antianginal effects.
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The nurse instructs a client suffering from frequent anginal attacks to keep a record of each attack. Which of the following would the nurse instruct the client to record? Select all that apply.
- A. Blood pressure
- B. Date of attack
- C. Time of attack
- D. Drug used to relieve the acute pain
- E. Dose of drug used to relieve the acute pain
Correct Answer: B,C,D,E
Rationale: Clients should keep a record of the frequency of acute anginal attacks including date of attack, time of attack, and drug and dose used to relieve the acute pain. The client should bring this record to each physician visit.
A client receiving amlodipine for angina is complaining of dizziness. Which of the following interventions should the nurse implement to help alleviate the condition?
- A. Apply a cold cloth over the forehead.
- B. Instruct the client to lie down.
- C. Instruct the client to drink more water.
- D. Reduce the dosage of amlodipine.
Correct Answer: B
Rationale: Dizziness is a common central nervous system adverse effect seen with calcium channel blocker use. The nurse should instruct the client to lie down until the dizziness passes. Applying a cold cloth over the forehead will not relieve the dizziness.
A client is receiving treatment for angina with a vasodilator. The nurse instructs the client to notify his primary health care provider about which of the following?
- A. Weight loss of 2 lb in a week
- B. Swelling of the extremities
- C. Episodes of dyspnea
- D. Heart rate increased by about 10 bpm
- E. Fainting
Correct Answer: B,C,E
Rationale: The primary health care provider should be notified if the client experiences a heart rate of 20 bpm or more above the normal rate, rapid weight gain of 5 lb or more; unusual swelling of the extremities, face, or abdomen, dyspnea; angina; severe indigestion; or fainting.
After teaching a group of nursing students about antianginal drugs, the instructor determines that the teaching was successful when the students identify which of the following as a calcium channel blocker?
- A. Minoxidil
- B. Hydralazine
- C. Isosorbide
- D. Nifedipine
Correct Answer: D
Rationale: Nifedipine is a calcium channel blocker used to treat angina. Minoxidil and hydralazine are peripheral vasodilators. Isosorbide is a nitrate.
The nurse assesses for which of the following in a client receiving a calcium channel blocker? Select all that apply.
- A. Crackles
- B. Bradycardia
- C. Wheezing
- D. Dyspnea
- E. Peripheral edema
Correct Answer: A,D,E
Rationale: A client receiving a calcium channel blocker should be monitored for signs of heart failure (dyspnea, weight gain, peripheral edema, abnormal lung sounds such as crackles or rales, and jugular vein distention). The physician should be notified immediately if any of these signs develop.