Nokea
In which of the following situations would a nurse withhold the antianginal medication and contact the physician? Select all that apply.
- A. Heart rate above 50 bpm
- B. Heart rate below 50 bpm
- C. Systolic blood pressure below 90 mm Hg
- D. Diastolic blood pressure below 90 mm Hg
- E. Respiratory rate below 20 breaths per minute
Correct Answer: B,C
Rationale: A nurse would withhold the antianginal medication and contact the physician if a client's heart rate was below 50 bpm or systolic blood pressure drops below 90 mm Hg.
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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.
Which of the following does the nurse need to include as part of the physical assessment of a client with anginal pain? Select all that apply.
- A. Blood pressure
- B. Apical pulse
- C. Oxygen saturation
- D. Radial pulse
- E. Respiratory rate
Correct Answer: A,B,D,E
Rationale: The nurse's physical assessment of a client with angina should include blood pressure, respiratory rate, and apical and radial pulses. The physical assessment may also include weight, inspection of the extremities for edema, and auscultation of the lungs, depending on the type of heart failure.
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.
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.
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.