Question

A nurse is reinforcing teaching with a client who has angina pectoris about starting therapy with nitroglycerin sublingual tablets. Which of the following statements by the client indicates an understanding of the teaching?

Answer 1

Correct Answers:

I will dial 911 if one tablet does not relieve my pain."

Rationale :

🚨 When managing angina pectoris with sublingual nitroglycerin, it's essential for the client to understand the correct steps for administration and follow-up actions. 🚨 The goal is to relieve chest pain quickly. The client should take one sublingual tablet at the onset of pain. 🚨 If there is no relief after 5 minutes, a second tablet can be taken, but if the pain continues or worsens after a total of 10 minutes, the client should call 911. 🚨This step is critical because persistent chest pain may indicate a myocardial infarction (heart attack), and prompt emergency intervention can be life-saving. 🚨Delaying or neglecting to seek medical help may lead to serious complications, including heart damage or death.

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Answer 2

Correct Answers:

Prothrombin time (PT))

Rationale :

✔️Warfarin is an oral anticoagulant that works by inhibiting vitamin K-dependent clotting factors. ✔️The therapeutic effect of warfarin is monitored by measuring the prothrombin time (PT), which assesses the blood’s ability to clot. ✔️The International Normalized Ratio (INR) is often calculated from PT to standardize the results across different laboratories. ✔️PT/INR helps ensure the client is within a therapeutic range, reducing the risk of clot formation while avoiding excessive bleeding. ✔️The other tests, such as aPTT, platelet count, and WBC count, are not appropriate for monitoring warfarin therapy.

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Answer 3

Correct Answers:

Potassium level of 3.0 mEq/L

Rationale :

✔️Digoxin is a cardiac glycoside used to treat heart failure and atrial arrhythmias. ✔️ It has a narrow therapeutic range, meaning that even slight changes in electrolyte levels can lead to toxicity. ✔️A potassium level of 3.0 mEq/L is dangerously low and can predispose the client to digoxin toxicity, which manifests as arrhythmias and other serious symptoms. ✔️The normal potassium range is 3.5 to 5.0 mEq/L, and low potassium (hypokalemia) increases the risk of digoxin binding to the sodium-potassium pump, leading to toxicity.

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Answer 4

Correct Answers:

It's okay to crush a tablet as long as I make sure it dissolves completely in water before swallowing it."

Rationale :

✨Enteric-coated medications, like naproxen, are designed to pass through the stomach and dissolve in the intestine, preventing gastric irritation. ✨Crushing or breaking these tablets can destroy the coating, causing the medication to dissolve too early, which may lead to stomach irritation or reduce its effectiveness. ✨ The statement about crushing the tablet to dissolve it in water indicates a misunderstanding of the purpose of the enteric coating. ✨The client requires further teaching to emphasize that these tablets should not be crushed.

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Answer 5

Correct Answers:

Heparin will be continued until the warfarin reaches a therapeutic level!"

Rationale :

🔥Warfarin therapy takes time to achieve a therapeutic effect, typically 3-5 days, so heparin is initially administered alongside warfarin. 🔥Heparin provides immediate anticoagulation while warfarin builds up to a therapeutic level, as it takes several days for the INR to stabilize. 🔥Once warfarin has reached the desired therapeutic range, heparin can be discontinued. 🔥This dual therapy is necessary to prevent thrombus formation during the transition period.

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Answer 6

Correct Answers:

I take my alendronate at the same day every week with an 8-ounce glass of milk.'

Rationale :

🔥 Alendronate is a bisphosphonate used for osteoporosis and should be taken on an empty stomach with plain water, not with milk or any other food or beverage. 🔥Taking it with milk or other food can decrease absorption. 🔥The client should also remain upright for at least 30 minutes after taking the medication to prevent esophageal irritation. 🔥The client's statement about taking it with milk indicates a need for further teaching.

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Answer 7

Correct Answers:

Apply the ointment in a thin line into the conjunctival sac."

Rationale :

💎When administering antibiotic ophthalmic ointment for bacterial conjunctivitis, it is important to apply a thin line of ointment into the lower conjunctival sac, not directly onto the eye's surface. 💎 This method ensures proper distribution of the medication. Keeping the eye open after application helps the medication spread effectively. 💎 Using sterile gloves prevents contamination, and wiping from the outer to inner canthus helps avoid transferring bacteria from the outer eye to the inner eye.

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Answer 8

Correct Answers:

Metformin

Rationale :

💎Metformin, a common medication for managing type 2 diabetes, should be withheld before any radiological studies involving contrast dye. 💎The use of contrast dye can lead to kidney stress, and combining it with metformin increases the risk of lactic acidosis, a rare but serious complication. 💎The nurse should withhold metformin 48 hours before and after the administration of contrast dye to prevent this risk. 💎Other medications listed, such as pantoprazole, simvastatin, and valsartan, do not have this specific contraindication.

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Answer 9

Correct Answers:

This medication adheres to the ulcer and protects it from gastric acid."

Rationale :

🎨Sucralfate is a medication used to treat duodenal ulcers by forming a protective barrier over the ulcer site. This barrier helps prevent further damage by gastric acid and promotes healing. 🎨 It does not neutralize or inhibit gastric acid production, nor does it kill bacteria, making the statement about protecting the ulcer correct. 🎨The nurse should clarify this mechanism of action to the client.

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Answer 10

Correct Answers:

Ask the client to rate her pain on a scale from 0 to 10.

Rationale :

✅The first step in assessing postoperative pain is to determine its intensity using a pain scale, such as a 0-10 scale. ✅This helps guide the nurse in providing appropriate pain relief. ✅ It is essential to assess the severity of pain before offering interventions like repositioning or giving pain medication. ✅Assessing vital signs and asking about recent pain medication use are also important, but pain intensity should be evaluated first to guide appropriate treatment.

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RN Medsurg Pharmacology

No.

1 : A nurse is reinforcing teaching with a client who has angina pectoris about starting therapy with nitroglycerin sublingual tablets. Which of the following statements by the client indicates an understanding of the teaching?

2 : A nurse is caring for a client who has a new prescription for warfarin. The nurse should use the results of which of the following diagnostic tests to monitor the effect of this therapy?

3 : A nurse is collecting data from a client prior to the administration of digoxin. Which of the following findings should the nurse report to the provider?

4 : A nurse is reinforcing teaching with a client who is to start taking enteric-coated naproxen for rheumatoid arthritis. Which of the following client statements by the client indicates a need for further teaching?

6 : A nurse is reinforcing teaching with a client who has osteoporosis and is prescribed alendronate 70 mg PO weekly. Which of the following statements by the client indicates a need for further instruction?

7 : A nurse is reinforcing teaching with a client with bacterial conjunctivitis of the right eye and a prescription for an antibiotic ophthalmic ointment. Which of the following statements should the nurse make?

8 : A nurse is reviewing the chart of a client who is scheduled to have radiological studies of the kidneys performed with the use of IV contrast dye. Which of the following client medications should the nurse withhold prior to the examination?

9 : A nurse is reinforcing teaching for a client who has a duodenal ulcer and a new prescription for sucralfate. The client asks the nurse how sucralfate works. Which of the following statements should the nurse make?

10 : A nurse is caring for a client who is 1 day postoperative following gynecologic surgery and reports incisional pain. Which of the following actions should the nurse take first?

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