Nokea
The physician has prescribed nitroglycerin to a client with angina. The client also has closed-angle glaucoma. The nurse contacts the physician to discuss the potential for:
- A. Decreased intraocular pressure
- B. Increased intraocular pressure
- C. Hypotension
- D. Hypertension
Correct Answer: B
Rationale: Nitroglycerin can increase intraocular pressure, which is a concern in closed-angle glaucoma, potentially worsening the condition. Hypotension is a common side effect but not specific to glaucoma.
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A client with a history of gastroesophageal reflux disease (GERD) is admitted with chest pain. The nurse should prioritize which of the following interventions?
- A. Obtain a 12-lead ECG.
- B. Administer omeprazole.
- C. Position the client supine.
- D. Administer an antacid.
Correct Answer: A
Rationale: Chest pain in GERD may mimic cardiac pain, so obtaining a 12-lead ECG rules out myocardial infarction.
The nurse is teaching a client with asthma about the use of a peak flow meter. Which of the following instructions should be included?
- A. Use the meter only when symptoms are present.
- B. Record the highest of three readings.
- C. Clean the meter with soap and water weekly.
- D. Blow into the meter as slowly as possible.
Correct Answer: B, C
Rationale: Recording the highest of three readings ensures accuracy, and cleaning the meter weekly prevents contamination.
A client with a history of stroke is at risk for aspiration. Which intervention is most appropriate?
- A. Offer thin liquids.
- B. Position upright during meals.
- C. Provide large bites of food.
- D. Encourage rapid eating.
Correct Answer: B
Rationale: Positioning upright during meals reduces aspiration risk by aiding swallowing and gravity.
A client has been given a prescription for propantheline as adjunctive treatment for peptic ulcer disease. How should the nurse tell the client to take this medication?
- A. With meals
- B. With antacids
- C. Just after meals
- D. Thirty minutes before meals
Correct Answer: D
Rationale: Propantheline is an antimuscarinic anticholinergic medication that decreases gastrointestinal secretions. It should be administered 30 minutes before meals to reduce acid secretion before food intake stimulates gastric acid production. Administering with meals or just after meals would reduce its effectiveness, and taking it with antacids could interfere with its absorption.
The mother of a child with newly diagnosed Duchenne's muscular dystrophy asks how her child developed the disease. The nurse formulates a response incorporating which of the following statements about its transmission?
- A. It is an autosomal recessive genetic disorder
- B. It is a genetic disorder carried by males and transmitted to male children
- C. It is a disorder primarily transmitted by males in the family
- D. It is a disorder usually carried by females and transmitted to male children
Correct Answer: D
Rationale: Duchenne's muscular dystrophy is an X-linked recessive disorder, typically carried by females and transmitted to male children, who are more likely to express the disease.