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A client taking nitroglycerin (Nitrostat) complains of a headache. Which conclusion is most appropriate by the nurse?
- A. A headache indicates a serious allergic reaction to nitroglycerin.
- B. The client will not have a headache if the nitroglycerin is taken with a high-fat meal.
- C. Nitroglycerin does not cause a headache.
- D. The most common side effect of nitroglycerin is a headache.
Correct Answer: D
Rationale: Nitroglycerin is known to cause headaches as a common side effect due to its vasodilatory properties. It dilates blood vessels, which can lead to headaches. While a headache can indicate other serious conditions, the most common association with nitroglycerin use is a headache. It is crucial for the nurse to recognize this side effect and provide appropriate education and support to the client.
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How can the nurse best explain the difference between angina and a myocardial infarction to a client presenting with severe chest pain?
- A. "Angina usually resolves with rest, and is rarely fatal, while a myocardial infarction necessitates immediate treatment and can be life-threatening."
- B. "There is a clear distinction between the two. You will receive treatment based on the diagnosis of a myocardial infarction."
- C. "Both conditions result from a clot obstructing the coronary arteries. Angina occurs with the blockage of a small vessel, whereas a myocardial infarction occurs with a blockage of a large vessel."
- D. "Angina may not cause as intense chest pain, whereas a myocardial infarction always presents with severe chest pain."
Correct Answer: A
Rationale: When educating a client about the differences between angina and a myocardial infarction, it is crucial to emphasize key distinguishing factors. Angina typically improves with rest and is not usually life-threatening, whereas a myocardial infarction requires urgent intervention as it can be life-threatening. This explanation helps the client understand the urgency and severity associated with a myocardial infarction compared to angina.
The client makes which statement about lifestyle changes to reduce the development and progression of coronary artery disease that indicates the need for further teaching?
- A. "I will check my weight regularly for any gain or loss."
- B. "I'll make sure to take my high blood pressure medications."
- C. "I am attending a smoking cessation class."
- D. "As long as I exercise, stress at my job will not bother me."
Correct Answer: D
Rationale: The client stating, 'As long as I exercise, stress at my job will not bother me,' indicates a misunderstanding of the relationship between exercise and stress management. It is important to clarify that while exercise can help reduce stress, it may not eliminate all stressors, especially those related to work. Further teaching is needed to ensure the client understands the multifactorial approach required to address stress and its impact on coronary artery disease.
The client asks the nurse about common side effects of calcium channel blockers. What should the nurse include in client teaching?
- A. Headache
- B. Constipation
- C. Epistaxis
- D. Dysuria
Correct Answer: A
Rationale: One of the common side effects of calcium channel blockers is a headache. This is important information for the nurse to include in client teaching as it helps the client understand potential adverse effects of the medication. Constipation, epistaxis, and dysuria are not typically associated with calcium channel blockers.
Following a stroke, a client has been started on clopidogrel (Plavix). Why is this medication being administered?
- A. To prevent stroke in high-risk patients, such as those with prosthetic heart valves
- B. To decrease blood pressure
- C. To increase heart rate
- D. To provide antiplatelet activity in patients who cannot tolerate aspirin
Correct Answer: D
Rationale: Clopidogrel (Plavix) is an antiplatelet medication that inhibits platelet aggregation, reducing the risk of blood clots. It is commonly used in patients who have had a stroke and cannot tolerate aspirin due to allergies or intolerances. Choosing clopidogrel in these cases helps prevent further clot formation and reduces the risk of recurrent strokes.
A client asks the nurse to explain the difference between stable and unstable angina. What is the best response by the nurse?
- A. "Stable angina is predictable in its frequency, intensity, and duration. Unstable angina is when angina episodes become more frequent or severe, and occur during periods of rest."?
- B. "Unstable angina is caused by spasms of the coronary arteries. Stable angina is when angina episodes become more frequent or severe, and occur during periods of rest."?
- C. "Unstable angina is predictable in its frequency, intensity, and duration. Stable angina is when angina episodes become more frequent or severe, and occur during periods of rest."?
- D. "Stable angina is caused by spasms of the coronary arteries. Unstable angina is when angina episodes become more frequent or severe, and occur during periods of rest."?
Correct Answer: A
Rationale: Stable angina is typically triggered by physical exertion or emotional stress and is predictable in its frequency, intensity, and duration. In contrast, unstable angina is characterized by angina episodes that are unexpected, more severe, prolonged, and can occur at rest. Understanding these differences can help healthcare providers assess and manage angina episodes effectively, ensuring appropriate interventions are implemented promptly based on the type of angina present.