Question 1

The nurse places highest priority on assessing which vital sign before administering a scheduled dose of nitroglycerin paste to an assigned client?&#10;A) Temperature&#10;B) Pulse&#10;C) Blood pressure&#10;D) Respirations with oxygen saturation&#10;

Accepted Answer

Nitroglycerin paste is a medication used to treat angina by dilating the blood vessels, which can cause a decrease in blood pressure. Therefore, the nurse should assess the client's blood pressure prior to administering the medication to ensure it is not too low, as this could lead to hypotension and potentially result in harm to the client.

Question 2

Client education about the use of sublingual nitroglycerin should include which of the following statements?&#10;A) &#34;Swallow the tablet 1 minute after it has been in your mouth for maximal effect.&#34;&#10;B) &#34;You can take up to 5 doses for an anginal attack at 3-minute intervals.&#34;&#10;C) &#34;Remember that sublingual nitroglycerin is only stable for approximately 9 to 10 months.&#34;&#10;D) &#34;You might want to sit down for a few minutes after taking the sublingual nitroglycerin so that you don't faint.&#34;&#10;

Accepted Answer

Sublingual nitroglycerin can cause a rapid drop in blood pressure, leading to dizziness or fainting, so sitting down can help prevent falls.

Question 3

The nurse working in a cardiac telemetry nursing unit understands that Transderm-Nitro patches are&#10;A) filled with nitroglycerin and digoxin.&#10;B) applied three to four times daily.&#10;C) used when a 24-hour effect is desired.&#10;D) indicated for aborting a heart attack.&#10;

Accepted Answer

Transderm-Nitro patches are used when a 24-hour effect is desired. They contain nitroglycerin and are used to treat angina and congestive heart failure. They are not used to abort a heart attack, and they are applied only once every 24 hours. They do not contain digoxin.

Question 4

Because pentoxifylline is a xanthine derivative,the nurse anticipates that it could be administered to clients who have an intolerance to which of the following?&#10;A) Xanax&#10;B) Caffeine&#10;C) Aminophylline&#10;D) Theobromine&#10;

Accepted Answer

The answer of Because pentoxifylline is a xanthine derivative,the nurse...

Question 5

The nurse determines that a client receiving pentoxifylline (Trental)is having a satisfactory response to drug therapy when the client reports which of the following?&#10;A) Fewer episodes of chest pain&#10;B) Less dizziness when climbing stairs&#10;C) Less shortness of breath while walking&#10;D) Ability to walk longer distances without leg pain&#10;

Accepted Answer

Pentoxifylline (Trental) is a medication used to increase blood flow by decreasing the viscosity of blood. It is commonly used to treat intermittent claudication, a condition in which there is pain or cramping in the legs during exercise due to poor circulation. A satisfactory response to treatment with Trental would be demonstrated by an increase in the distance the client can walk without experiencing leg pain or discomfort. The other options listed (reduction in chest pain, dizziness, or shortness of breath) are not directly related to the indication for which Trental is typically prescribed.

Question 6

A client who is taking sublingual nitroglycerin is reporting flushing of the face and headaches.The nurse explains that&#10;A) this is a sympathetic response to chest pain.&#10;B) smoking could have precipitated these symptoms.&#10;C) these symptoms are probably unrelated to the nitrates.&#10;D) these symptoms are related to the nitrates.&#10;

Accepted Answer

Flushing of the face and headaches are common side effects of nitroglycerin due to its ability to dilate blood vessels, which leads to increased blood flow to the head and neck. This is a known side effect of nitrates and is not related to sympathetic response or smoking. Therefore, the correct answer is option D.

Question 7

When instructing the client about administering nitroglycerin ointment,the nurse explains to the client to&#10;A) use the forefinger to spread the ointment.&#10;B) apply the ointment to a hairy skin area.&#10;C) massage the ointment into the skin.&#10;D) wear gloves or a finger cot when applying the ointment.&#10;

Accepted Answer

The client should wear gloves or a finger cot when applying the ointment to prevent the medication from being absorbed into the nurse's skin. The forefinger should be used to spread the ointment, and it should be applied to a hairless skin area, such as the upper arm or chest. The ointment should not be massaged into the skin.

Question 8

The nurse would implement what standard and prescribed practice to prevent tolerance to nitrates?&#10;A) Do not remove patches or paste&#10;B) Have a 12-hour &#34;no nitrate&#34; time&#10;C) Have a 24-hour &#34;no nitrate&#34; time&#10;D) Keep nitrates on for 24 hours,then leave them off for 24 hours&#10;

Accepted Answer

To prevent tolerance to nitrates, it is standard practice to have a nitrate-free period, commonly a 12-hour "no nitrate" time each day. This allows the body's nitrate receptors to reset and reduces the risk of developing tolerance to the medication.

Question 9

The nurse is teaching a client about proper use of nitroglycerin sublingual tablets for chest pain.The nurse would include which of the following pieces of information about maximal number of doses and timing before calling for emergency cardiac care?

A) Take up to three doses if needed 2 minutes apart
B) Take up to five doses if needed 3 minutes apart
C) Take up to three doses if needed 5 minutes apart
D) Take up to five doses if needed 5 minutes apart

Accepted Answer

The client should take up to three doses of nitroglycerin sublingual tablets if needed, 5 minutes apart before calling for emergency cardiac care. This is the standard recommendation by the American Heart Association. Taking more than three doses can lead to adverse effects such as severe hypotension and headache. It is important to call for emergency care if the chest pain persists or worsens after taking three doses of nitroglycerin.

Question 10

A client who is new to drug therapy with nitroglycerin reports to the health care provider that she has a headache after each dose.The nurse forms which appropriate conclusion about this client's statement?

A) The client needs a smaller dose
B) This client cannot tolerate therapy with nitrates
C) This is a known adverse effect that will decrease with use
D) This indicates a possible hypersensitivity reaction

Accepted Answer

Headache is a well-known and common side effect of nitroglycerin, and it usually decreases over time as the client becomes more tolerant to the medication. A smaller dose may not be effective in managing the client's condition and hypersensitivity reaction is not a likely explanation for this particular side effect.

Question 11

The nurse is working with a client who has just been diagnosed with intermittent claudication.The nurse anticipates that which of the following drugs will be ordered for this client?&#10;A) Pentoxifylline (Trental)&#10;B) Dipyridamole (Persantine)&#10;C) Ticlopidine (Ticlid)&#10;D) Sodium warfarin (Coumadin)&#10;

Accepted Answer

The answer of The nurse is working with a client...

Question 12

Nitrates work through which of the following mechanisms?&#10;A) They constrict blood vessels in the systemic circulation&#10;B) They dilate only the collateral circulation and thereby decrease venous return&#10;C) They relax vascular smooth muscle and lead to a decrease in ischemia&#10;D) They increase total systemic blood flow and increase venous pressure&#10;

Accepted Answer

The answer of Nitrates work through which of the following...

Question 13

When describing the purpose for the drug pentoxifylline (Trental)to a client,the nurse explains that it&#10;A) prevents red blood cell formation.&#10;B) lowers blood viscosity.&#10;C) reduces the ability of the blood to clot.&#10;D) increases the usage of oxygen in the blood.&#10;

Accepted Answer

The answer of When describing the purpose for the drug...

Question 14

Of the following statements about nitrates,which is the most appropriate to share with a client before discharge?&#10;A) &#34;Prescriptions should be filled every 6 to 9 months.&#34;&#10;B) &#34;The nitrates degrade with heat,light,and moisture.&#34;&#10;C) &#34;You may use any application paper with any form of ointment.&#34;&#10;D) &#34;Sublingual potency is assessed by flushing of the face and postural hypotension.&#34;&#10;

Accepted Answer

The answer of Of the following statements about nitrates,which is...

Question 15

The nurse assesses the client receiving pentoxifylline (Trental)for which of the following most common adverse effects?&#10;A) Gastrointestinal upset&#10;B) Transient chest pain&#10;C) Irregular heart rhythm&#10;D) Feeling of faintness&#10;

Accepted Answer

The answer of The nurse assesses the client receiving pentoxifylline...

Deck 28: Vasodilators and Blood Viscosityreducing Agents