Nursing Elites

1. When teaching a client how to use nitroglycerin transdermal ointment for angina, which instruction should the nurse include?

• A. Remove the prior dose before applying a new dose.
• B. Rub the ointment directly into your skin until it is no longer visible.
• C. Cover the applied ointment with a clean gauze pad.
• D. Apply the ointment to the same skin area each time.

Correct answer: A

Rationale: The correct instruction is to remove the prior dose before applying a new dose. This helps prevent toxicity by ensuring the client does not inadvertently apply an excessive amount of nitroglycerin.

2. A healthcare professional is preparing to administer verapamil by IV bolus to a client who is experiencing cardiac dysrhythmias. For which of the following adverse effects should the healthcare professional monitor when giving this medication?

• A. Hyperthermia
• B. Hypotension
• C. Ototoxicity
• D. Muscle pain

Correct answer: B

Rationale: Verapamil is known to cause hypotension as one of its adverse effects due to its vasodilatory properties. Therefore, it is essential for the healthcare professional to monitor the client's blood pressure closely during and after administration to prevent complications such as severe hypotension. Hyperthermia, ototoxicity, and muscle pain are not commonly associated with verapamil administration, making choices A, C, and D incorrect.

3. A client has a new prescription for Captopril for hypertension. The nurse should monitor the client for which of the following adverse effects of this medication?

• A. Hypokalemia
• B. Hypernatremia
• C. Neutropenia
• D. Bradycardia

Correct answer: C

Rationale: Neutropenia is a serious adverse effect associated with ACE inhibitors like Captopril. It is characterized by a decreased level of neutrophils, which are important in fighting infections. Monitoring the client's complete blood count (CBC) is crucial to detect neutropenia early. The nurse should also educate the client on recognizing signs of infection and promptly reporting them to the healthcare provider for timely intervention. Hypokalemia is a potential adverse effect of diuretics, not ACE inhibitors. Hypernatremia is an electrolyte imbalance more commonly associated with conditions like dehydration. Bradycardia is not a typical adverse effect of Captopril.

4. A patient with hypertension is taking an ACE inhibitor to lower blood pressure. What should the nurse advise the patient to avoid in their diet?

• A. Vinegar
• B. Apples
• C. Salt substitutes
• D. Tomatoes

Correct answer: C

Rationale: Patients taking ACE inhibitors should avoid salt substitutes as they often contain potassium, which can lead to hyperkalemia. Hyperkalemia is an elevated level of potassium in the blood that can be dangerous, especially for patients on ACE inhibitors. Vinegar, apples, and tomatoes do not pose a risk for patients taking ACE inhibitors. Therefore, the nurse should advise the patient to avoid salt substitutes to prevent potential complications.

5. What is the first type of medication prescribed to prevent angina pain for a client?

• A. Beta blockers
• B. Alpha blockers
• C. Calcium channel blockers
• D. Organic nitrates

Correct answer: A

Rationale: Beta blockers are the first-line medication prescribed to prevent angina pain. They work by reducing the heart rate and blood pressure, decreasing the heart's demand for oxygen. This helps in preventing angina attacks by improving blood flow to the heart. Alpha blockers, calcium channel blockers, and organic nitrates are also used in angina treatment but are typically considered after beta blockers.

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