Nursing Elites

1. The healthcare provider is reviewing the medication orders for a client with angina pectoris. Which medication is typically prescribed to prevent angina attacks?

• A. Aspirin
• B. Nitroglycerin
• C. Atenolol
• D. Simvastatin

Correct answer: B

Rationale: Nitroglycerin is the medication typically prescribed to prevent angina attacks. It works by dilating blood vessels, increasing blood flow, and reducing the heart's workload, hence relieving angina symptoms. Aspirin is often used to prevent blood clots, not specifically to prevent angina attacks. Atenolol is a beta-blocker used to manage high blood pressure and chest pain but is not typically prescribed to prevent angina attacks. Simvastatin is a statin medication primarily used to lower cholesterol levels and is not indicated for preventing angina attacks.

2. A client with a diagnosis of angina pectoris is prescribed nitroglycerin. The nurse should teach the client to take the medication in which way?

• A. Take one tablet daily with breakfast
• B. Take one tablet every 5 minutes as needed, up to three times
• C. Take one tablet every hour until pain subsides
• D. Take one tablet only if pain does not subside after 30 minutes

Correct answer: B

Rationale: Nitroglycerin is a rapid-acting medication used to relieve angina pain by dilating blood vessels. The correct administration is to take one tablet every 5 minutes as needed, up to three doses. This dosing regimen helps in managing acute angina episodes effectively. Choice A is incorrect because nitroglycerin is not taken once daily. Choice C is incorrect because waiting for an hour between doses may not provide timely relief during angina attacks. Choice D is incorrect as it suggests waiting for 30 minutes before taking another dose, which could delay symptom relief in acute situations.

3. A client with chronic heart failure is being discharged with a prescription for digoxin (Lanoxin). Which instruction should the nurse reinforce?

• A. Take the medication at the same time each day.
• B. Avoid foods high in potassium.
• C. Skip a dose if you feel well.
• D. Take the medication on an empty stomach.

Correct answer: A

Rationale: Taking digoxin at the same time each day is essential to maintain a consistent blood level of the medication. This consistency helps optimize the therapeutic effects of digoxin in managing chronic heart failure. Deviating from the scheduled time could lead to fluctuations in drug levels, affecting its effectiveness and potentially causing harm. Choices B, C, and D are incorrect because avoiding potassium-rich foods, skipping doses when feeling well, and taking the medication on an empty stomach are not relevant or appropriate instructions for a client prescribed digoxin.

4. A client has a new prescription for amlodipine. Which of the following instructions should the nurse include?

• A. Take the medication with food.
• B. Monitor blood pressure daily.
• C. Increase intake of potassium-rich foods.
• D. Avoid consuming grapefruit juice.

Correct answer: B

Rationale: The correct answer is B: 'Monitor blood pressure daily.' When a client is prescribed amlodipine, it is essential to monitor their blood pressure regularly. Amlodipine is known to cause hypotension, so monitoring blood pressure helps ensure it stays within the desired range to prevent complications associated with low blood pressure. Choice A is incorrect because amlodipine can be taken with or without food. Choice C is incorrect as increasing potassium intake is not a specific instruction related to amlodipine. Choice D is incorrect as grapefruit juice interactions are not typically a concern with amlodipine.

5. A client with known coronary artery disease (CAD) begins to experience chest pain while getting out of bed. What action should the nurse take?

• A. Obtain a prescription for pain medication.
• B. Have the client stop and lie back down in bed.
• C. Report the complaint to the healthcare provider.
• D. Instruct the client to continue getting out of bed and into a chair.

Correct answer: B

Rationale: When a client with CAD experiences chest pain, it indicates myocardial ischemia. The nurse should have the client stop the activity and lie back down in bed to reduce the heart's oxygen demand, decrease myocardial workload, and prevent further ischemia. This action helps in improving blood flow to the heart and can potentially alleviate the chest pain. Option A is incorrect as pain medication should not be the initial action for chest pain in CAD. Option C is incorrect because the nurse should first intervene directly to address the chest pain. Option D is incorrect as continuing the activity can worsen the myocardial ischemia and chest pain.

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