Nokea
The nurse is caring for a patient who has recently started taking crestor who reports all of these symptoms to the nurse. Which of the following finding is most important to communicate to the health care provider?
- A. Generalized muscle aches and weakness
- B. Skin flushing after taking the medications
- C. Dizziness when changing positions quickly
- D. Nausea when taking the drugs before eating
Correct Answer: A
Rationale: Muscle aches and weakness may indicate myopathy and rhabdomyolysis, which have caused acute renal failure and death in some patients who have taken the statin medications. These symptoms indicate that the rosuvastatin may need to be discontinued. The other symptoms are common adverse effects when taking niacin, and although the nurse should follow up with the patient, they do not indicate that a change in medication is needed.
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The nurse is caring for a patient who has survived a sudden cardiac death (SCD) event and has no evidence of an acute myocardial infarction. After the patient has recovered, which of the following information should the nurse teach the patient?
- A. That sudden cardiac death events rarely reoccur
- B. About the purpose of outpatient Holter monitoring
- C. How to self-administer low-molecular-weight heparin
- D. To limit activities after discharge to prevent future events
Correct Answer: B
Rationale: Holter monitoring is used to determine whether the patient is experiencing dysrhythmias such as ventricular tachycardia during normal daily activities. SCD is likely to recur. Heparin will not have any effect on the incidence of SCD, and SCD can occur even when the patient is resting.
The nurse is administering a fibrinolytic agent to a patient with an acute myocardial infarction. Which of the following assessments should cause the nurse to stop the drug infusion?
- A. Bleeding from the gums
- B. Surface bleeding from the IV site
- C. A decrease in level of consciousness
- D. A non-sustained episode of ventricular tachycardia
Correct Answer: C
Rationale: The change in level of consciousness indicates that the patient may be experiencing intracranial bleeding, a possible complication of fibrinolytic therapy. Bleeding of the gums and prolonged bleeding from IV sites are expected adverse effects of the therapy. The nurse should address these by avoiding any further injuries, but they are not an indication to stop infusion of the fibrinolytic medication. A non-sustained episode of ventricular tachycardia is a common reperfusion dysrhythmia and may indicate that the therapy is effective.
Which of the following information given by a patient admitted with persistent stable angina will help the nurse confirm this diagnosis?
- A. The patient rates the pain at a level 3-5 (0-10 scale)
- B. The patient states that the pain 'wakes me up at night.'
- C. The patient says that the frequency of the pain has increased over the last few weeks.
- D. The patient states that the pain is resolved after taking one sublingual nitroglycerin tablet.
Correct Answer: D
Rationale: Persistent stable angina is typically relieved by rest or nitroglycerin administration. The level of pain is not a consistent indicator of the type of angina. Pain occurring at rest or with increased frequency is typical of unstable angina.
Which of the following causes is the most common cause for sudden cardiac death?
- A. Ventricular tachycardia
- B. Aortic stenosis
- C. Hypertrophic cardiomyopathy
- D. Angina
Correct Answer: A
Rationale: Acute ventricular dysrhythmias (e.g., ventricular tachycardia, ventricular fibrillation) cause the majority of cases of SCD. Less commonly, SCD occurs because of a primary left ventricular outflow obstruction (e.g., aortic stenosis, hypertrophic cardiomyopathy) or extreme slowing of the heart (bradycardia).
The nurse is providing teaching to a patient about the use of atenolol in preventing anginal episodes. Which of the following patient statements indicate that the teaching has been effective?
- A. It is important not to suddenly stop taking the atenolol.
- B. Atenolol will increase the strength of my heart muscle.
- C. I can expect to feel short of breath when taking atenolol.
- D. Atenolol will improve the blood flow to my coronary arteries.
Correct Answer: A
Rationale: Patients who have been taking β-blockers can develop intense and frequent angina if the medication is suddenly discontinued. Atenolol decreases myocardial contractility. Shortness of breath that occurs when taking β-blockers for angina may be due to bronchospasm and should be reported to the health care provider. Atenolol works by decreasing myocardial oxygen demand, not by increasing blood flow to the coronary arteries.