Nursing Elites

1. A client has a new prescription for nitroglycerin. Which of the following instructions should the nurse include in the discharge teaching?

• A. Store the medication in a cool, dark place.
• B. Take the medication at bedtime.
• C. Take the medication on an empty stomach.
• D. Take the medication at the first sign of chest pain.

Correct answer: D

Rationale: The correct instruction to include in the discharge teaching for a client with a new prescription for nitroglycerin is to take the medication at the first sign of chest pain. Nitroglycerin is a vasodilator that helps relax blood vessels, increasing blood flow to the heart muscle and reducing the workload of the heart. Taking it at the onset of chest pain helps alleviate angina symptoms quickly and effectively. Storing the medication in a cool, dark place (Choice A) is not a critical instruction for this medication. Taking the medication at bedtime (Choice B) or on an empty stomach (Choice C) is not relevant to the administration of nitroglycerin for angina relief.

2. A healthcare professional is assessing a client who has a new prescription for warfarin. Which of the following findings should the healthcare professional report to the provider?

• A. Weight gain
• B. Frequent urination
• C. Hypokalemia
• D. Bleeding gums

Correct answer: D

Rationale: Bleeding gums are a sign of excessive anticoagulation with warfarin, indicating a potential risk of bleeding complications. It is crucial to report this finding promptly to the provider for further assessment and adjustment of the medication regimen to prevent serious bleeding events. Weight gain, frequent urination, and hypokalemia are not typically associated with warfarin use and are not immediate concerns that require urgent reporting to the provider.

3. A client with chronic stable angina is prescribed nitroglycerin (Nitrostat) for chest pain. The nurse should include which instruction when teaching the client about this medication?

• A. Take nitroglycerin at the first sign of chest pain.
• B. Swallow the tablet whole with water.
• C. Take nitroglycerin with meals to prevent stomach upset.
• D. Store nitroglycerin in a cool, dry place.

Correct answer: A

Rationale: The correct instruction when teaching a client about nitroglycerin (Nitrostat) is to take it at the first sign of chest pain. Nitroglycerin works rapidly to dilate blood vessels, improving blood flow to the heart muscle. Taking it promptly can help alleviate symptoms quickly and prevent the condition from worsening. Choice B is incorrect because nitroglycerin is usually taken sublingually (under the tongue) and not swallowed. Choice C is incorrect because nitroglycerin is not typically taken with meals. Choice D is incorrect because nitroglycerin should be stored in its original container away from heat and light.

4. What should be the nurse's priority action when a client diagnosed with angina pectoris complains of chest pain while taking a brisk walk?

• A. Administer nitroglycerin
• B. Have the client sit down
• C. Obtain an electrocardiogram
• D. Apply oxygen

Correct answer: B

Rationale: The nurse's priority action when a client diagnosed with angina pectoris complains of chest pain while taking a brisk walk is to have the client sit down. Sitting down reduces the workload on the heart and may alleviate pain by improving oxygen supply. This action aims to reduce the strain on the heart and improve oxygen delivery to the myocardium, which can help relieve the symptoms of angina pectoris. Administering nitroglycerin could be the next step after having the client sit down if the pain persists. Obtaining an electrocardiogram and applying oxygen are not the immediate priority actions when dealing with angina pectoris symptoms.

5. When assisting a hospitalized client newly diagnosed with coronary artery disease (CAD) to make appropriate selections from the dietary menu, which meal should the nurse encourage the client to select?

• A. Sausage, pancakes, and toast
• B. Broccoli, buttered rice, and grilled chicken
• C. Hamburger, baked apples, and avocado salad
• D. Fresh strawberries, steamed vegetables, and baked fish

Correct answer: D

Rationale: The correct choice is D: Fresh strawberries, steamed vegetables, and baked fish. This meal is low in saturated fats and cholesterol, which is suitable for a client with CAD. It aligns with dietary recommendations to support heart health and manage CAD. Choices A, B, and C are less appropriate as they contain higher levels of saturated fats and cholesterol, which are not ideal for individuals with CAD.

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