Nokea
A nurse is caring for a client with angina who is receiving diltiazem. In which of the following conditions should the nurse withhold the drug and notify the health care provider?
- A. Client's systolic pressure is 110 mm Hg.
- B. Client exhibits significant weight loss.
- C. Client experiences lightheadedness.
- D. Client's pulse rate is 45 beats per minute
Correct Answer: D
Rationale: The nurse should withhold the drug and notify the health care provider when the client's pulse rate is 45 beats per minute. When calcium channel blockers are administered, there may be a fall in the pulse rate. When the pulse rate falls below 50 beats per minute, the nurse should notify the health care provider.
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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 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.
Prior to administering an antianginal drug, the nurse should assess which of the following? Select all that apply.
- A. Pain
- B. Physical appearance
- C. Lung sounds
- D. Heart sounds
- E. Vital signs
Correct Answer: A,B,C,E
Rationale: Before administering an antianginal agent, the nurse would assess the client's pain, history of medication allergies and disease processes, physical appearance, and lungs for adventitious sounds and obtain a baseline electrocardiogram and vital signs.
When instructing the client on how to use the prescribed nitroglycerin ointment, the nurse would tell the client to use which of the following to determine the amount?
- A. A teaspoon
- B. Length of a finger
- C. Paper applicator
- D. The size of the previous dose
Correct Answer: C
Rationale: The topical ointment is supplied with a paper applicator to determine the amount of drug to be used. No other method is appropriate.
A client is being discharged after being treated with nitroglycerin for an acute anginal attack. Which of the following instructions should the nurse provide the client regarding the administration of nitroglycerin ointment?
- A. Apply a thick layer of the ointment.
- B. Rub the ointment onto the skin.
- C. Use an applicator for applying the ointment.
- D. Apply on the same site during every application.
Correct Answer: C
Rationale: The nurse should instruct the client to use an applicator for applying the nitroglycerin ointment. The ointment should not come in contact with the skin of the person applying it, as it gets easily absorbed. The nurse should instruct the client to apply a thin layer of the ointment on the skin using an applicator.