Question 1

Which adverse effect is common for clients prescribed topical nitroglycerin paste?&#10;A) Rash&#10;B) Shortness of breath&#10;C) Headache&#10;D) Ventricular tachycardia

Accepted Answer

Headache is a common adverse effect for clients prescribed topical nitroglycerin paste. Rash, shortness of breath, and ventricular tachycardia are less common and more serious adverse effects.

Question 2

Which information should the nurse include in the education for a client prescribed a transdermal nitroglycerin patch? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A) Place the patch on the upper arm or leg.
B) Rotate sites of application.
C) Remove the patch for an hour each day.
D) Cleanse the skin under the patch after removal.
E) Triple wrap the patch in plastic wrap for disposal.

Rotate sites of application.
Cleanse the skin under the patch after removal.

Accepted Answer

It is important for the client to rotate sites and cleanse the skin under the patch after removal to prevent skin irritation and ensure proper absorption of the medication. Placing the patch on the upper arm or leg (A) is not necessarily the only option, and removing the patch for an hour each day (C) is not recommended as it may cause a rebound effect of angina symptoms. Triple wrapping the patch for disposal (E) is not necessary, but it should be disposed of properly according to instructions from the healthcare provider or pharmacist.

Question 3

A client receiving diltiazem (Cardizem) asks the nurse why they get a headache after taking the prescription. Which response should the nurse provide the client?&#10;A) &#34;Diltiazem (Cardizem) causes the blood vessels in your brain to widen, giving you the headache.&#34;&#10;B) &#34;Diltiazem (Cardizem) increases prostaglandin synthesis, giving you the headache.&#34;&#10;C) &#34;Diltiazem (Cardizem) releases Substance P, activating pain receptors in your brain and giving you the headache.&#34;&#10;D) &#34;Diltiazem (Cardizem) causes the blood vessels in your brain to narrow, giving you the headache.&#34;

Accepted Answer

Diltiazem (Cardizem) is a calcium channel blocker that widens the blood vessels in the body, including those in the brain. This vasodilation can cause a headache as a side effect.

Question 4

Which symptom is most likely to be related to angina as opposed to a myocardial infarction?&#10;A) Chest pain relieved by one sublingual nitroglycerin&#10;B) Chest pain that radiates to the patient's back&#10;C) Chest pain that occurred while the patient was eating breakfast&#10;D) Chest pain accompanied by shortness of breath

Accepted Answer

Chest pain relieved by one sublingual nitroglycerin is a classic symptom of angina, as nitroglycerin works to dilate the coronary arteries and relieve chest pain associated with angina. Chest pain that radiates to the back or is accompanied by shortness of breath is more indicative of a myocardial infarction, while chest pain that occurs during activities such as eating breakfast may suggest stable angina.

Question 5

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

Accepted Answer

Nitroglycerine is light sensitive and should be protected from light exposure. Covering the IV bottle will help decrease the amount of light that the medication is exposed to. Gloves should be used when handling medication, but not for the purpose of preventing self-administration. Instructing the client to avoid moving the arm is not necessary for the administration of nitroglycerine. Darkening the room is also not necessary for the administration of this medication.

Question 6

Which statements by the client are specifically associated with unstable angina? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.&#10;A) &#34;My chest has started hurting even if I am just watching television.&#34;&#10;B) &#34;My chest starts hurting if I climb one set of stairs.&#34;&#10;C) &#34;My attacks of chest pain are coming more frequently now.&#34;&#10;D) &#34;The pain occurs most often after I eat a meal.&#34;&#10;E) &#34;The pain is worse than it used to be.&#34;

Accepted Answer

Unstable angina is characterized by chest pain that occurs even at rest or with minimal activity (A). The pain can also increase in frequency and severity over time (C, E). Chest pain after eating a meal is associated with stable angina, not unstable angina (D). Chest pain with exertion, such as climbing stairs, is also associated with stable angina (B).

Question 7

Which prescriptions reduce the heart's demand for oxygen by lowering heart rate?&#10;A) Anticoagulants and beta-adrenergic blockers&#10;B) Calcium channel blockers and anticoagulants&#10;C) Organic nitrates and calcium channel blockers&#10;D) Beta-adrenergic blockers and calcium channel blockers

Accepted Answer

Beta-adrenergic blockers and calcium channel blockers can both decrease heart rate, which in turn reduces the heart's demand for oxygen. Anticoagulants do not directly affect heart rate, and organic nitrates increase blood flow to the heart instead of reducing demand for oxygen.

Question 8

A client asks the nurse if angina is the same thing as having a heart attack. Which response should the nurse provide?&#10;A) &#34;They have some things in common, for example, severe emotional distress and panic can accompany both angina and myocardial infarction.&#34;&#10;B) &#34;Angina means the heart muscle is not getting enough oxygen, while heart attack, or myocardial infarction, means part of your heart has died.&#34;&#10;C) &#34;Actually, it depends on what type of angina you mean; there are several types.&#34;&#10;D) &#34;They are basically the same.&#34;

Accepted Answer

Angina means that the heart muscle is not getting enough oxygen, while a heart attack or myocardial infarction means that part of the heart muscle has died. This is a clear and concise explanation that helps to differentiate between the two conditions. Option A may be confusing as it suggests that the two conditions are similar in more ways than just the presence of emotional distress, and Option C is vague without providing further information as to which type of angina may be more similar to a heart attack. Option D is incorrect as it does not provide any explanatory information.

Question 9

Which statement by the client receiving nitroglycerine (Nitrostat) should the nurse be concerned about?&#10;A) &#34;I'm getting married tomorrow; I hope my erectile dysfunction isn't a problem.&#34;&#10;B) &#34;I'm going water skiing tomorrow; I hope my angina isn't a problem.&#34;&#10;C) &#34;I really don't like taking those little pills, I would like to use a patch.&#34;&#10;D) &#34;My angina has been a little more frequent I would like something to take for the pain.&#34;

Accepted Answer

Nitroglycerine and erectile dysfunction medications (such as sildenafil, tadalafil, and vardenafil) can both lower blood pressure significantly. When used together, they can cause a dangerous drop in blood pressure. The nurse should be concerned about the client's statement regarding erectile dysfunction and the potential use of medications for it, given the risk of severe hypotension.

Question 10

Which is a priority assessment for the client receiving reteplase (Retavase) intravenously?&#10;A) Fluid balance&#10;B) Abnormal bleeding&#10;C) Blood glucose&#10;D) Respiratory rate

Accepted Answer

Reteplase is a thrombolytic medication that can increase the risk of abnormal bleeding, such as internal bleeding or hemorrhage. Therefore, monitoring for signs of bleeding and assessing for any increase in bleeding is a priority assessment. While the other options may still be important to assess, they are not directly related to the administration of reteplase.

Question 11

Which lifestyle behaviors should the nurse discuss with a client to help reduce their risk of coronary artery disease? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A) Abstinence from smoking
B) Decrease stress
C) Limit alcohol consumption
D) Maintain optimal weight
E) Limit sodium intake

Accepted Answer

The answer of Which lifestyle behaviors should the nurse discuss...

Question 12

Which should the nurse assess a client for prior to administering atenolol (Tenormin)?&#10;A) Temperature&#10;B) Pulse&#10;C) Respirations&#10;D) Blood pressure&#10;E) Oxygen saturation

Accepted Answer

The answer of Which should the nurse assess a client...

Question 13

A client post-acute myocardial infarction asks the nurse why they are prescribed reteplase (Retavase) intravenously (IV). Which response should the nurse provide the client?&#10;A) &#34;The prescription dilates the arteries in the heart so it can get more oxygen.&#34;&#10;B) &#34;The prescription is dissolving the clot that has caused your heart attack.&#34;&#10;C) &#34;The prescription thins your blood so more clots will not develop.&#34;&#10;D) &#34;The prescription will increase the strength of the muscles in the heart during each beat.&#34;

Accepted Answer

The answer of A client post-acute myocardial infarction asks the...

Question 14

Which mechanism of action does beta-adrenergic agonists have on the cardiovascular system?&#10;A) Increase cardiac output&#10;B) Dilate arterial smooth muscle&#10;C) Decrease the contractility of the heart&#10;D) Dilate venous system

Accepted Answer

The answer of Which mechanism of action does beta-adrenergic agonists...

Question 15

Which information should the nurse include in the education for a client prescribed a transdermal nitroglycerin patch? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A) Place the patch on the upper arm or leg.
B) Rotate sites of application.
C) Remove the patch for an hour each day.
D) Cleanse the skin under the patch after removal.
E) Triple wrap the patch in plastic wrap for disposal.

Rotate sites of application.
Cleanse the skin under the patch after removal.

Accepted Answer

The answer of Which information should the nurse include when...

Question 16

Which is the primary pharmacologic goal in the treatment of a client experiencing stable angina?&#10;A) Increase venous blood flow to the right atrium.&#10;B) Eliminate blockages by using thrombolytics.&#10;C) Establish a regular exercise program and diet plan.&#10;D) Increase cardiac oxygen supply and reduce cardiac oxygen demand.

Accepted Answer

The answer of Which is the primary pharmacologic goal in...

Question 17

The nurse has completed the education for a client with angina prescribed nitroglycerine (Nitrostat). Which statement made by the client indicates further teaching is required?&#10;A) &#34;I can take up to 5 tablets to resolve the chest pain.&#34;&#10;B) &#34;If my pain is not reduced 5 minutes after taking one tablet I should call EMS.&#34;&#10;C) &#34;I should take a tablet as soon as chest pain occurs.&#34;&#10;D) &#34;I can take three tablets, one every 5 minutes.&#34;

Accepted Answer

The answer of The nurse has completed the education for...

Question 18

The nurse is reviewing the myocardial blood supply for a client with coronary artery disease (CAD). Which statements made by the client indicate an understanding of the information? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A) "The heart has right and left arteries that arise from the aorta."
B) "The coronary arteries carry blood away from the heart to the right atrium."
C) "The heart receives its oxygen through the blood that fills it."
D) "Coronary arteries primarily carry blood to the left ventricle."
E) "The right and left arteries have smaller branches that go around the heart."

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Accepted Answer

The answer of The nurse is reviewing the myocardial blood...

Question 19

Which is the primary desired outcome for a client that has experienced several episodes of angina?&#10;A) The client will experience relief of chest pain with anticoagulant therapy.&#10;B) The client will experience relief of chest pain with nitrate therapy.&#10;C) The client will experience relief of chest pain with aspirin therapy.&#10;D) The client will experience relief of chest pain with therapeutic lifestyle changes.

Accepted Answer

The answer of Which is the primary desired outcome for...

Question 20

Which information about the primary therapeutic action of an antianginal prescription should the nurse include in client teaching?&#10;A) &#34;The prescription decreases how much oxygen your heart needs.&#34;&#10;B) &#34;This prescription will thin your blood so your heart receives more oxygen.&#34;&#10;C) &#34;This prescription increases the amount of oxygen your heart receives.&#34;&#10;D) &#34;This prescription increases the oxygen to your heart by increasing nitric oxide production.&#34;

Accepted Answer

The answer of Which information about the primary therapeutic action...

Question 21

Which is the most sensitive and effective biomarker of a myocardial infarction?&#10;A) White blood cells&#10;B) Troponin&#10;C) Myoglobin&#10;D) Creatine kinase

Accepted Answer

The answer of Which is the most sensitive and effective...

Question 22

Which prescription is indicated for the prevention of blood clots?&#10;A) Captopril (Capoten)&#10;B) Reteplase (Retavase)&#10;C) Morphine&#10;D) Abciximab (ReoPro)

Accepted Answer

The answer of Which prescription is indicated for the prevention...

Question 23

For which conditions should the nurse instruct a client to hold the application of nitroglycerin ointment and contact the healthcare provider? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A) Dyspnea
B) Productive cough
C) Headache
D) Fever
E) Confusion

Accepted Answer

The answer of For which conditions should the nurse instruct...

Question 24

Which information should the nurse include in the education for a client prescribed a transdermal nitroglycerin patch? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A) Place the patch on the upper arm or leg.
B) Rotate sites of application.
C) Remove the patch for an hour each day.
D) Cleanse the skin under the patch after removal.
E) Triple wrap the patch in plastic wrap for disposal.

Rotate sites of application.
Cleanse the skin under the patch after removal.

Accepted Answer

The answer of Which information should the nurse include in...

Question 25

A client experiencing bradycardia is suspected of overdosing on diltiazem (Cardizem). Which treatment should the nurse anticipate prescribed?&#10;A) Dopamine&#10;B) Atropine&#10;C) Calcium chloride&#10;D) Narcan

Accepted Answer

The answer of A client experiencing bradycardia is suspected of...

Question 26

Which client should the nurse anticipate a prescription for reteplase (Retavase) therapy post myocardial infarction?&#10;A) A 54-year-old female with type 2 diabetes&#10;B) A 45-year-old female with a 2-week-old cranial artery repair&#10;C) A 62-year-old with a recent hemorrhagic stroke&#10;D) A 70-year-old male with active GI bleed

Accepted Answer

The answer of Which client should the nurse anticipate a...

Question 27

Which conditions is the use of thrombolytic therapy contraindicated in? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.&#10;A) Venous emboli&#10;B) History of intracranial hemorrhage&#10;C) Hemophilia&#10;D) Liver disease&#10;E) Peptic ulcer disease

Accepted Answer

The answer of Which conditions is the use of thrombolytic...

Question 28

Which prescriptions does the nurse anticipate to be included in the goal to reduce the post-MI mortality of a client? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A) Aspirin
B) Beta blockers
C) Narcotic analgesics
D) ACE inhibitors
E) Antidysrhythmics

Accepted Answer

The answer of Which prescriptions does the nurse anticipate to...

Question 29

A client asks which conditions will cause the heart to need more oxygen. Which information should the nurse be prepared to discuss?&#10;A) Sleep apnea&#10;B) Hyperthyroidism&#10;C) Asthma&#10;D) Hepatitis B

Accepted Answer

The answer of A client asks which conditions will cause...

Question 30

Which are the goals of antianginal therapy? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.&#10;A) Decreased oxygen consumption of the brain&#10;B) Increased myocardial contractility&#10;C) Increased blood flow to the peripheral blood vessels&#10;D) Increased blood flow to the myocardium&#10;E) Decreased myocardial oxygen demand

Accepted Answer

The answer of Which are the goals of antianginal therapy?...

Deck 28: Drugs for Angina Pectoris and Myocardial Infarction