a nurse is teaching a client who has a new prescription for nitroglycerin sublingual tablets which of the following instructions should the nurse incl

ATI RN

ATI Pharmacology Proctored Exam

1. A client has a new prescription for nitroglycerin sublingual tablets. Which of the following instructions should the nurse include?

A. Take one tablet at the first sign of chest pain.
B. If pain is not relieved, take another tablet in 10 minutes.
C. You can take up to five tablets in 15 minutes.
D. Swallow the tablet with water.

Correct answer: A

Rationale: The correct instruction for a client with a new prescription for nitroglycerin sublingual tablets is to take one tablet at the first sign of chest pain. If the pain persists after 5 minutes, the client should call 911 and take a second tablet. Choice A is correct because taking one tablet at the onset of chest pain helps to relieve symptoms by dilating blood vessels and improving blood flow to the heart. Choices B and C are incorrect as they suggest taking multiple tablets without waiting for the initial dose to take effect, which can lead to hypotension and other adverse effects. Choice D is incorrect as nitroglycerin sublingual tablets should not be swallowed but instead placed under the tongue for rapid absorption.

2. A client is being taught about a new prescription for Escitalopram to treat generalized anxiety disorder. Which statement by the client indicates understanding of the teaching?

A. I should take the medication with food.
B. I will monitor my blood sugar levels while taking this medication.
C. I need to discontinue this medication slowly.
D. I can crush this medication before swallowing.

Correct answer: C

Rationale: The correct answer is C. When discontinuing Escitalopram, the client should taper the medication slowly according to a prescribed dosing schedule to reduce the risk of withdrawal syndrome. Abruptly stopping the medication can lead to withdrawal symptoms, so it is important to follow the healthcare provider's instructions for gradual discontinuation. Choices A, B, and D are incorrect because Escitalopram should not necessarily be taken with food, there is no direct correlation with blood sugar levels, and the medication should not be crushed before swallowing.

3. Which of the following is considered a class IA Sodium Channel blocker?

A. Mexiletine
B. Amiodarone
C. Quinidine
D. Procainamide

Correct answer: D

Rationale: Procainamide is a class IA antiarrhythmic drug that acts as a sodium channel blocker by blocking fast sodium channels. Mexiletine is a class IB antiarrhythmic drug, not class IA. Amiodarone is a class III antiarrhythmic, and Quinidine is a class IA antiarrhythmic but not a sodium channel blocker.

4. A client has a new prescription for nitroglycerin. Which of the following adverse effects should the nurse instruct the client to report that can indicate the medication is effective?

A. Headache
B. Nausea
C. Dizziness
D. Dry mouth

Correct answer: A

Rationale: Headache is a common side effect of nitroglycerin due to its vasodilatory effects. It can indicate that the medication is working effectively by dilating blood vessels, improving blood flow, and reducing cardiac workload. Therefore, the client should report experiencing headaches as it may suggest the therapeutic action of nitroglycerin. Nausea, dizziness, and dry mouth are not typically associated with the therapeutic effects of nitroglycerin and should be reported as adverse effects that may necessitate medical attention.

5. What should you monitor when administering Clopidogrel to a patient?

A. Signs of thrombotic thrombocytopenic purpura
B. Bleeding during therapy
C. CBC with differential and platelet count
D. All of the above

Correct answer: D

Rationale: When administering Clopidogrel, it is crucial to monitor for signs of thrombotic thrombocytopenic purpura, bleeding during therapy, and changes in CBC with differential and platelet count. Thrombotic thrombocytopenic purpura is a rare but serious condition associated with Clopidogrel use, characterized by microangiopathic hemolytic anemia, thrombocytopenia, neurological symptoms, fever, and renal dysfunction. Monitoring for signs of thrombotic thrombocytopenic purpura is essential to detect this potentially life-threatening condition early. Monitoring for bleeding helps to assess the risk of hemorrhagic events, a known side effect of Clopidogrel. Additionally, regular monitoring of CBC with differential and platelet count is necessary to evaluate the drug's impact on blood cell counts and detect any abnormalities that may require intervention. Therefore, monitoring all these parameters is vital to ensure patient safety and appropriate management during Clopidogrel therapy.