Nokea
The nurse is giving nitroglycerin sublingually for chest pain. What is the most important instruction to give to the client?
- A. Place the tablet under the tongue and let it dissolve completely.
- B. Swallow the tablet whole with a glass of water.
- C. Chew the tablet and then swallow it.
- D. Take one tablet every 5 minutes until pain is relieved.
Correct Answer: A
Rationale: The correct answer is A: Place the tablet under the tongue and let it dissolve completely. Nitroglycerin is absorbed quickly through the oral mucosa, providing rapid relief for chest pain. Placing it under the tongue allows for direct absorption into the bloodstream. Swallowing the tablet whole (B) would delay absorption. Chewing the tablet (C) would cause rapid absorption and possibly lead to a drop in blood pressure. Taking one tablet every 5 minutes (D) is not recommended as it can lead to hypotension. Therefore, option A is the most appropriate instruction for the client.
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Priority Decision: A patient is hospitalized after a successful resuscitation of an episode of sudden cardiac death (SCD). During the care of the patient, what nursing intervention is most important?
- A. Continuous ECG monitoring
- B. Auscultation of the carotid arteries
- C. Frequent assessment of heart sounds
- D. Monitoring of airway status and respiratory patterns
Correct Answer: A
Rationale: Continuous monitoring detects dysrhythmias.
Which condition involves the enlargement and weakening of the left ventricle of the heart, leading to reduced pumping ability?
- A. Dilated cardiomyopathy
- B. Hypertrophic cardiomyopathy
- C. Restrictive cardiomyopathy
- D. Pericarditis
Correct Answer: A
Rationale: The correct answer is A: Dilated cardiomyopathy. This condition involves the enlargement and weakening of the left ventricle, leading to reduced pumping ability. This results in the heart being unable to pump blood efficiently, causing symptoms like fatigue and shortness of breath. Hypertrophic cardiomyopathy (B) is the thickening of the heart muscle, not enlargement. Restrictive cardiomyopathy (C) involves stiffening of the heart muscle, not weakening. Pericarditis (D) is inflammation of the pericardium, not the heart muscle itself.
What is the condition where the body's immune system attacks its tissues, causing inflammation and damage?
- A. Autoimmune disease
- B. Infectious disease
- C. Allergic reaction
- D. Degenerative disease
Correct Answer: A
Rationale: The correct answer is A: Autoimmune disease. In autoimmune diseases, the immune system mistakenly attacks the body's tissues, leading to inflammation and damage. This occurs due to a breakdown in immune tolerance, resulting in the immune system targeting self-antigens. This leads to chronic inflammation and tissue damage. In contrast, infectious diseases are caused by pathogens, allergic reactions are responses to harmless substances, and degenerative diseases involve the gradual deterioration of tissues over time. Therefore, autoimmune disease best fits the description provided in the question.
The client is on nitroglycerin patches. What should the nurse include in the client's education?
- A. Rotate the application site with each new patch.
- B. Apply the patch at the same time each day.
- C. Leave the patch on for 24 hours, then remove it for 12 hours before applying a new one.
- D. Apply the patch to the same site each time.
Correct Answer: A
Rationale: The correct answer is A: Rotate the application site with each new patch. This is important to prevent skin irritation and tolerance development. Rotating sites ensures consistent drug absorption and reduces the risk of skin reactions. Applying the patch at the same site each time (choice D) can lead to localized skin irritation. Applying the patch at the same time each day (choice B) is not as crucial as rotating sites. Leaving the patch on for 24 hours and then removing it for 12 hours (choice C) can disrupt the therapeutic effect of the medication.
What is the accumulation of fatty deposits along the walls of arteries, leading to reduced blood flow?
- A. Atherosclerosis
- B. Arteriosclerosis
- C. Aneurysm
- D. Thrombosis
Correct Answer: A
Rationale: Atherosclerosis is the correct answer because it specifically refers to the accumulation of fatty deposits in arteries, causing reduced blood flow. Arteriosclerosis is a general term for thickening and hardening of arteries, not necessarily due to fatty deposits. Aneurysm is a localized, abnormal dilation of a blood vessel, not related to fatty deposits. Thrombosis is the formation of a blood clot within a blood vessel, not the accumulation of fatty deposits.