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The nurse is teaching a client about newly prescribed nitroglycerin (NTG) sublingual tablets. Which statement, if made by the client, would indicate a correct understanding of the teaching?
- A. I should allow this tablet to dissolve in my cheek.
- B. I should keep the tablets in the dark bottle.
- C. I should take this medication standing up to prevent indigestion.
- D. I should take one tablet every 7 to 10 minutes if I get chest pain.
Correct Answer: B
Rationale: Nitroglycerin sublingual tablets should be kept in a dark bottle to protect from light degradation, indicating correct understanding. They dissolve under the tongue, not in the cheek, are taken every 5 minutes for chest pain (up to 3 doses), and standing is not required.
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The nurse reviews newly prescribed laboratory tests and medications for the following clients. Which of the laboratory tests and prescriptions should the nurse question?
- A. Liver function tests (LFTs) for a client prescribed atorvastatin
- B. International normalized ratio (INR) for a client prescribed rivaroxaban
- C. Serum creatinine level for a client prescribed lisinopril
- D. Glycosylated hemoglobin (HgbA1C) level for a client prescribed olanzapine
Correct Answer: B
Rationale: INR monitoring is not typically required for rivaroxaban, a direct oral anticoagulant, as it does not affect INR. LFTs for atorvastatin, creatinine for lisinopril, and HgbA1C for olanzapine are appropriate monitoring tests.
The nurse is caring for a client who is taking prescribed sildenafil. After reviewing the client's other medications, the nurse recognizes which medication would contraindicate sildenafil?
- A. furosemide
- B. isosorbide
- C. atorvastatin
- D. losartan
Correct Answer: B
Rationale: Sildenafil is contraindicated with nitrates like isosorbide due to the risk of severe hypotension. Furosemide, atorvastatin, and losartan do not have significant interactions with sildenafil.
The nurse is caring for a client with an exacerbation of congestive heart failure (CHF). The client has generalized edema, dyspnea, and jugular venous distention. The nurse should anticipate a prescription for which medication?
- A. Mannitol
- B. Furosemide
- C. Diltiazem
- D. Verapamil
Correct Answer: B
Rationale: Furosemide, a loop diuretic, is used to treat fluid overload in CHF, addressing edema, dyspnea, and jugular venous distention. Mannitol, diltiazem, and verapamil are not appropriate.
While reviewing a client's medication list, the nurse understands which prescribed medication(s) is/are classified as calcium channel blockers. Select all that apply.
- A. Nifedipine
- B. Propranolol
- C. Verapamil
- D. Hydralazine
- E. Digoxin
Correct Answer: A,C
Rationale: Nifedipine and verapamil are calcium channel blockers used to treat hypertension and angina. Propranolol is a beta-blocker, hydralazine is a vasodilator, and digoxin is a cardiac glycoside.
The nurse is preparing to administer prescribed medications to a client. After reviewing the client's vital signs below, the nurse plans on holding which prescribed medication? Click to view the exhibit for additional client information.
- A. Amlodipine 5 mg PO
- B. Diltiazem 60 mg PO
- C. Ibuprofen 500 mg PO
- D. Ciprofloxacin 500 mg PO
Correct Answer: A
Rationale: Without specific vital signs, amlodipine (a calcium channel blocker) may be held if the client has hypotension, as it lowers blood pressure. Diltiazem may also lower blood pressure but is less likely to be held unless bradycardia is present. Ibuprofen and ciprofloxacin are less dependent on vital signs.