Nokea
The nurse is caring for a patient with hyperlipidemia who has a new prescription for colestipol. Which of the following nursing actions is best when giving the medication?
- A. Administer the medication at the patient's bedtime.
- B. Have the patient take this medication with an Aspirin.
- C. Encourage the patient to take the colestipol with a sip of water.
- D. Give the patient's other medications 2 hours after the colestipol.
Correct Answer: D
Rationale: The bile acid sequestrants interfere with the absorption of other drugs, and giving other medications at the same time should be avoided. Taking an aspirin concurrently with the colestipol may increase the incidence of gastrointestinal adverse effects such as heartburn. An increased fluid intake is encouraged for patients taking the bile acid sequestrants to reduce the risk for constipation. For maximum effect, colestipol should be administered with meals.
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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.
The nurse is providing teaching to a patient who has a prescription for transdermal nitroglycerin patches. The patient asks the nurse how often they should remove the previously applied patch. Which of the following information is the basis for the nurse's response?
- A. Every 4 hours while awake
- B. Every 6 hours around the clock
- C. Every 12 hours
- D. Remove at bedtime
Correct Answer: D
Rationale: NTG patches should be applied in the am and removed at bedtime to prevent tolerance.
The nurse is caring for a patient with newly diagnosed Prinzmetal's (variant) angina and has a prescription for amlodipine. Which of the following information is accurate about amlodipine?
- A. Reduce the 'fight or flight' response
- B. Decrease spasm of the coronary arteries
- C. Increase the force of myocardial contraction
- D. Help prevent clotting in the coronary arteries
Correct Answer: B
Rationale: Prinzmetal's angina is caused by coronary artery spasm. Calcium channel blockers (e.g., amlodipine, nifedipine) are a first-line therapy for this type of angina. Platelet inhibitors, such as Aspirin, help prevent coronary artery thrombosis, and β-blockers decrease sympathetic stimulation of the heart. Medications or activities that increase myocardial contractility will increase the incidence of angina by improving oxygen demand.
The nurse is caring for a patient who is 3 days post myocardial infarction and the patient states, 'I just had a little chest pain. As soon as I get out of here, I'm going for my vacation as planned' Which of the following responses should the nurse make?
- A. Where are you planning to go for your vacation?
- B. What do you think caused your chest pain episode?
- C. Sometimes plans need to change after a heart attack.
- D. Recovery from a heart attack takes at least a few weeks.
Correct Answer: B
Rationale: When the patient is experiencing denial, the nurse should assist the patient in testing reality until the patient has progressed beyond this step of the emotional adjustment to MI. Asking the patient about vacation plans reinforces the patient's plan, which is not appropriate in the immediate post-MI period. Reminding the patient in denial about the MI is likely to make the patient angry and lead to distrust of the nursing staff.
The nurse is caring for a patient who has had severe chest pain for several hours and a diagnosis of possible acute myocardial infarction. Which of the following prescribed laboratory tests should the nurse monitor to help determine the diagnosis?
- A. Homocysteine
- B. C-reactive protein
- C. Cardiac-specific troponin
- D. High-density lipoprotein (HDL) cholesterol
Correct Answer: C
Rationale: Troponin levels increase about 3-12 hours after the onset of myocardial infarction (MI). The other laboratory data are useful in determining the patient's risk for developing coronary artery disease (CAD) but are not helpful in determining whether an acute MI is in progress.