Question 1

The client has diabetes mellitus type I. The physician has prescribed metoprolol (Lopressor) for this client. Which symptoms would the nurse recognize as most significant to report to the physician?&#10;A) blurred vision, fatigue, and dry mouth&#10;B) pulse of 60, anxiety, and bleeding gums&#10;C) palpitations, diaphoresis, and anxiety&#10;D) dizziness upon standing, and insomnia

Accepted Answer

Metoprolol is a beta-blocker medication that can mask symptoms of hypoglycemia in individuals with diabetes. Therefore, symptoms such as palpitations, diaphoresis, and anxiety may indicate hypoglycemia and need to be reported to the physician. The other symptoms listed may be side effects of the medication but are not as significant in relation to the client's diabetes.

Question 2

The nurse is conducting an education class about myocardial blood supply for clients with coronary artery disease (CAD). The nurse determines that learning has occurred when the clients make which statement(s). Select all that apply.

A) "The coronary arteries carry blood away from the heart to the right atrium."
B) "The right and left arteries have smaller branches that go around the heart."
C) "Coronary arteries primarily carry blood to the left ventricle."
D) "Anastomoses are small arteries that supply blood to the heart."
E) "The heart has right and left arteries that arise from the aorta."

"The right and left arteries have smaller branches that go around the heart."
"Anastomoses are small arteries that supply blood to the heart."
"The heart has right and left arteries that arise from the aorta."

Accepted Answer

A) This statement is incorrect as the coronary arteries carry blood towards the heart, not away from it.
B) This statement is correct as the right and left coronary arteries have smaller branches that supply blood to all parts of the heart, including the muscles that surround the heart.
C) This statement is incorrect as the coronary arteries predominantly supply blood to the myocardium, which includes the left and right ventricles.
D) This statement is correct as anastomoses are small arteries that connect the branches of the coronary arteries, providing collateral blood supply to the heart muscle.
E) This statement is correct as the heart has right and left coronary arteries that originate from the aorta and supply blood to the heart's muscles.

Question 3

The nurse has completed medication education with a post -myocardial infarction (MI) client about nifedipine (Adalat). The nurse evaluates the education as effective when the client makes which statement?

A) "I only need to take this medicine when I experience chest pain."
B) "I will need to take this medicine until my stress test is normal."
C) "I will need to take this medicine for the rest of my life."
D) "I only need to take this medicine if I plan to do a strenuous activity."

"I will need to take this medicine for the rest of my life."

Accepted Answer

Nifedipine is a calcium channel blocker that is commonly used to treat hypertension and angina. It works by relaxing the blood vessels and increasing the supply of oxygen and blood to the heart. It is important to take this medicine as directed by the healthcare provider, which may be for the rest of the client's life. Option A is not correct because nifedipine is not a rescue medication and should not be taken only when chest pain is experienced. Option B is not correct because the duration of therapy is not determined by the stress test results. Option D is not correct because nifedipine should be taken routinely and not only before strenuous activities.

Question 4

The client is being treated for angina. He asks the nurse if angina is the same thing as having a heart attack. What is the best response by the nurse? Select all that apply.&#10;A) &#34;Actually, it depends on what type of angina you mean; there are several types.&#34;&#10;B) &#34;They are basically the same, but with angina, part of your heart dies.&#34;&#10;C) &#34;Severe emotional distress and panic can accompany angina.&#34;&#10;D) &#34;Angina is caused by insufficient oxygen to the myocardium.&#34;&#10;E) &#34;A heart attack, or myocardial infarction, means part of your heart has died.&#34;

Accepted Answer

The answer of The client is being treated for angina....

Question 5

The nurse is providing care to a client who has experienced several episodes of angina. What is the primary outcome for this client?&#10;A) The client will experience relief of chest pain with nitrate therapy.&#10;B) The client will experience relief of chest pain with therapeutic lifestyle changes.&#10;C) The client will experience relief of chest pain with anticoagulant therapy.&#10;D) The client will experience relief of chest pain with aspirin therapy.

Accepted Answer

The primary outcome for a client experiencing angina is to experience relief of chest pain. Nitrate therapy is a common treatment for angina and is effective in relieving chest pain by dilating blood vessels and increasing blood flow to the heart. Therapeutic lifestyle changes, anticoagulant therapy, and aspirin therapy may also be part of the client's treatment plan, but their primary outcome is not relief of chest pain.

Question 6

The client says to the nurse &#34;My doctor said I can't have fried chicken anymore because I have heart disease. I've eaten it all my life and am fine except for some indigestion lately.&#34; What is the best response by the nurse?&#10;A) &#34;Fried chicken is actually okay, but you must be very careful with the type of fat that you fry the chicken in.&#34;&#10;B) &#34;Did your doctor mention exercise? That is the most important lifestyle change to slow the progression of your heart disease.&#34;&#10;C) &#34;Your indigestion could actually be chest pain caused by narrowed coronary arteries; you will need a low -fat diet.&#34;&#10;D) &#34;Your indigestion is an indication that your body cannot tolerate fatty foods; this causes an increased workload for your heart.&#34;

Accepted Answer

The client's indigestion could be a symptom of coronary artery disease, which is typically caused by a buildup of plaque in the arteries that supply blood to the heart. A low-fat diet is an important aspect of managing this condition, and the nurse should emphasize the importance of adhering to the doctor's recommendations. Option A is incorrect because fried chicken is typically high in saturated and trans fats, which can contribute to heart disease. Option B is also incorrect because while exercise is important, dietary changes are also crucial for managing heart disease. Option D is incorrect because indigestion is not necessarily a sign of increased workload for the heart.

Question 7

The client takes nitroglycerine (Nitrostat) for relief of occasional stable angina. The nurse would be most concerned about which statement made by the client?&#10;A) &#34;I'm getting married tomorrow; I hope my erectile dysfunction isn't a problem.&#34;&#10;B) &#34;I really don't like those little pills. I've heard about patches, can I try them?&#34;&#10;C) &#34;My angina has been a little more frequent. Do I need a painkiller too?&#10;D) &#34;I'm going water skiing tomorrow; I hope my angina isn't a problem.&#34;

Accepted Answer

Nitroglycerine taken with medications for erectile dysfunction (such as sildenafil) can lead to a rapid drop in blood pressure, which can be life-threatening. The client should avoid taking these medications together. The other statements may warrant further assessment or education but are not immediate concerns for the client's safety.

Question 8

The nurse is teaching a class on antianginal drugs to a group of clients who have experienced myocardial infarctions (MIs). The nurse determines that learning has occurred when a client makes which statement?

A) "These medications increase oxygen to my heart by increasing nitric oxide production."
B) "These medications increase the amount of oxygen my heart receives."
C) "These medications thin my blood so my heart receives more oxygen."
D) "These medications decrease how much oxygen my heart needs".

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Accepted Answer

Antianginal drugs work by decreasing the oxygen demand of the heart, not by increasing oxygen supply. Option A is incorrect because antianginal drugs work by dilating coronary arteries, not by increasing nitric oxide production. Option B is incorrect because these medications do not increase the amount of oxygen that the heart receives. Option C is incorrect because antianginal drugs do not thin the blood, and thinning the blood would not necessarily increase the amount of oxygen that the heart receives.

Question 9

The client receives reteplase (Retavase) intravenously (IV). The nurse assesses the client for orientation and level of consciousness. The client's wife asks the nurse why this is being done. What does the nurse indicate as the reason for the assessment?

A) The medication can alter fluid balance; this affects orientation and level of consciousness.
B) The medication causes hypoglycemia; this affects orientation and level of consciousness.
C) The medication decreases oxygen to the brain; this decreases orientation and level of consciousness.
D) The medication can cause bleeding in the brain; this affects orientation and level of consciousness.

Accepted Answer

Reteplase (Retavase) is a thrombolytic agent used to dissolve blood clots, which can potentially cause bleeding in the brain (intracranial hemorrhage). Monitoring the patient's orientation and level of consciousness helps in early detection of such serious side effects.

Question 10

The nurse is preparing to administer nitroglycerine via the intravenous route. What must the nurse plan to do prior to administering this medication?&#10;A) Darken the room to decrease light exposure.&#10;B) Instruct the client to avoid moving the arm in which the medication is infusing.&#10;C) Cover the intravenous (IV) bottle to decrease light exposure.&#10;D) Use gloves to prevent self -administration.

Accepted Answer

The answer of The nurse is preparing to administer nitroglycerine...

Question 11

The client receives amlodipine (Norvasc) for treatment of angina. What is a primary assessment for the nurse?&#10;A) hypokalemia and hypernatremia&#10;B) a sudden weight loss of 2.5 kilograms or more&#10;C) a sudden weight gain of 1 kilogram or more&#10;D) marked increase in international normalized ration (INR) levels

Accepted Answer

The answer of The client receives amlodipine (Norvasc) for treatment...

Question 12

The nurse has completed medication education with the client who is receiving nitroglycerine (Nitrostat) as therapy for angina. The nurse determines that teaching is effective when the client makes which statement?

A) "I should call my doctor if my pain is not gone after 15 minutes of taking these tablets."
B) "I can keep taking tablets until the pain is gone, but I should not use more than 5 tablets."
C) "I can take 3 tablets, one every 10 minutes, but not more than 3 tablets in 30 minutes."
D) "I can take 1 tablet every 5 minutes, but not more than 3 tablets in 15 minutes."

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Accepted Answer

The answer of The nurse has completed medication education with...

Question 13

The client is receiving diltiazem (Cardizem) and wants to know why he developed a headache after taking the medication. What is the best response by the nurse?&#10;A) &#34;Diltiazem (Cardizem) increases prostaglandin synthesis; giving you the headache.&#34;&#10;B) &#34;Diltiazem (Cardizem) causes the blood vessels in your brain to widen; giving you the headache.&#34;&#10;C) &#34;Diltiazem (Cardizem) causes the blood vessels in your brain to narrow; giving you the headache.&#34;&#10;D) &#34;Diltiazem (Cardizem) releases Substance P, activating pain receptors in your brain and giving you the headache.&#34;

Accepted Answer

The answer of The client is receiving diltiazem (Cardizem) and...

Question 14

The nurse has completed medication education with a post -myocardial infarction (MI) client about nifedipine (Adalat). The nurse evaluates the education as effective when the client makes which statement?

A) "I only need to take this medicine when I experience chest pain."
B) "I will need to take this medicine until my stress test is normal."
C) "I will need to take this medicine for the rest of my life."
D) "I only need to take this medicine if I plan to do a strenuous activity."

"I will need to take this medicine for the rest of my life."

Accepted Answer

The answer of The nurse has completed medication education with...

Question 15

The client in the emergency department experienced an acute myocardial infarction (MI) four hours ago. The nurse is administering reteplase (Retavase) intravenously (IV). The client asks the nurse what is being done. What is the best response by the nurse?

A) "This medicine is widening the arteries in your heart so they can get more oxygen."
B) No response is indicated; the client is past the timeframe where thrombolytic therapy is effective.
C) "This medicine is thinning your blood so more clots will not develop."
D) "This medication is dissolving the clot that is causing your heart attack."

Accepted Answer

The answer of The client in the emergency department experienced...

Deck 23: Drugs for Angina Pectoris, Myocardial Infarction, and Cerebrovascular Accident