Nursing Chapter 46 Answers 1

After teaching a group of students about angina, the instructor determines that the teaching was successful when the students describe stable angina as:  Chest pain that is relieved by rest A client arrives at the urgent care center complaining of chest pain. After diagnosis, the health care provider prescribes amlodipine for the client’s condition. The nurse understands that this drug is indicated for which condition?  Prinzmetal angina What should a client be told in regards to the pain relief anti-anginal drugs provide? (Select all that apply.)   Pain may be less intense. Pain may be less frequent. A patient receiving amlodipine for angina reports dizziness. Which intervention should the nurse implement to help alleviate the condition?  Instruct the patient to lie down. The nurse is caring for a client whose chest pain has not been relieved with sublingual organic nitrate. What medication does the nurse suspect willmostlikely be prescribed by the health care provider?  Intravenous nitroglycerine A male client has sustained a head injury in a motor vehicle accident. He has nitroglycerine tablets for chest pain and asks the nurse for one due to chest pain. What effect will the nitroglycerine have on the client's current status?  Nitroglycerine will increase intracranial pressure. A client is experiencing chest pain and self-administers nitroglycerine sublingually. When should the client expect to notice relief of the chest pain?  1 to 3 minutes A nurse is caring for a patient with chronic angina. The patient is receiving ranolazine (Ranexa) 500 mg PO bid. Which sign or symptom would the nurse attribute to being a common adverse effect of this medication?  Dizziness Mr. Martin, a 52-year-old man, is prescribed amlodipine (Norvasc) for stable angina. What is the reason the physician prescribed this medication?  Amlodipine is a calcium channel blocker that decreases the oxygen needs of the heart by a negative inotropic effect. A patient has been prescribed a beta-adrenergic blocker to help control angina. What effect might the patient experience as a result of the drug therapy?  Decreased cardiac output While teaching a patient about sublingual nitroglycerin, the nurse explains proper use and storage. When the patient asks whether the medication ever expires, the nurse should respond that it:  should be replaced every six months. The client is started on a transdermal nitroglycerin patch system. The nurse teaches the client that the system relieves pain by which action?  Dilates arteries and veins A client is diagnosed with atherosclerosis. What would the nurse say is themostlikely cause of his angina?  Decreased oxygenation to the myocardium A male client does not respond to traditional treatment for his chronic angina. The health care provider orders ranolazine (Ranexa) and orders a baseline ECG prior to medication administration. Three months later, the health care provider orders a repeat ECG. For what reason is the provider monitoring the client?  Dose-dependent QT prolongation A male client presents to the health care provider’s ofÏce for the results of his exercise-tolerance test and for modification of his medication regimen. The provider informs the client that he experiences tachycardia that, based on his history, may precipitate anginal episodes. Based on this information, what would the nurse expect the provider to order?  Propranolol Which would a nurse identify as a nitrate?  Isosorbide What indicates that a client understands how to use sublingual nitroglycerin?  “I should feel a fizzing or burning sensation.” When describing the action of ranolazine, which would bemostappropriate?  Decreases myocardial workload The nurse provides client teaching for a client diagnosed with angina about the prescribed nitroglycerin transdermal patch. Which client statement establishes the need for further teaching?  “I will apply the patch for 24 hours and then remove it, and place another transdermal patch.” The nurse is providing education to a client who has been prescribed bisoprolol. During teaching, the nurse explains that the drug achieves a therapeutic effect in what way?  Decreasing heart rate After teaching a client who is using isosorbide dinitrate for treatment of angina, the client demonstrates understanding of the information when he identifies what needs to be avoided? (Select all that apply.)    Sildenafil Tadalafil Vardenafil After teaching a patient who is receiving nadolol for long-term treatment of angina, the nurse determines that the patient has understood the teaching when the patient identifies what possible adverse effects? (Select all that apply.)     Dyspnea Cough Malaise Sleep disturbance A client arrives at the urgent care center complaining of chest pain. After diagnosis, the health care provider prescribes amlodipine for the client’s condition. The nurse understands that this drug is indicated for which condition?  Prinzmetal angina The nurse is caring for a client whose chest pain has not been relieved with sublingual organic nitrate. What medication does the nurse suspect willmostlikely be prescribed by the health care provider?  Intravenous nitroglycerine A male client has sustained a head injury in a motor vehicle accident. He has nitroglycerine tablets for chest pain and asks the nurse for one due to chest pain. What effect will the nitroglycerine have on the client's current status?  Nitroglycerine will increase intracranial pressure. Which electrocardiogram change should prompt the nurse to question the use of ranolazine for the treatment of a client diagnosed with chronic angina?  QT prolongation Mr. Penny, age 67, was diagnosed with chronic angina several months ago and has been unable to experience adequate relief of his symptoms. As a result, his physician has prescribed ranolazine (Ranexa). Which statement is true regarding the use of ranolazine for the treatment of this patient's angina?  Mr. Penny requires concurrent treatment with a beta blocker, nitrate, or a calcium channel blocker. The client is started on a transdermal nitroglycerin patch system. The nurse teaches the client that the system relieves pain by which action?  Dilates arteries and veins The client has been started on nitroglycerin ointment for angina. The nurse identifies that the nitroglycerin ointment has been effective if the client reports:  no episodes of angina since ointment was initiated. A male client asks the nurse why the health care provider has added combined aspirin, antilipemics, and antihypertensives to his medication regimen when he feels fine and hasn’t experienced an anginal episode in a year. The nurse explains that this combination of drugs is given for what reason?  Prevents progression of myocardial ischemia to MI The health care provider prescribes calcium channel blockers for a client who is diagnosed with angina pectoris. What is the action of calcium channel blockers?  Improve blood supply to the myocardium A client experiences pain in the chest that radiates to the jaw, occurring when the client is at rest. The nurse would interpret this as:  Unstable angina Which would a nurse identify as a nitrate?  Isosorbide A client is using nitroglycerin in translingual spray form. The nurse would inform the client that the drug would begin working within which time frame?  1- 3 minutes What indicates that a client understands how to use sublingual nitroglycerin?  “I should feel a fizzing or burning sensation.” A client is using transdermal nitroglycerin. The nurse would instruct the client to apply a new patch at which frequency?  Every day The nurse provides client teaching for a client diagnosed with angina about the prescribed nitroglycerin transdermal patch. Which client statement establishes the need for further teaching?  “I will apply the patch for 24 hours and then remove it, and place another transdermal patch.” The nurse is teaching a client diagnosed with angina how to properly store and use nitroglycerin sublingual tablets. Which statement made by the client establishes a need for additional teaching by the nurse?  “I will keep the bottle of nitroglycerin in my pants pocket.” A client with angina is prescribed atenolol. Following absorption of the drug, the nurse should monitor the client for what desired effect?  Decreased heart rate When teaching the client to safely administer nitroglycerin ointment, the nurse should convey which instruction?  “Make sure you squeeze the ointment on to a paper measuring scale before applying it.” A client arrives at the urgent care center complaining of chest pain. After diagnosis, the health care provider prescribes amlodipine for the client’s condition. The nurse understands that this drug is indicated for which condition?  Prinzmetal angina What does the nurse need to include as part of the physical assessment of a client with anginal pain? (Select all that apply.)     Blood pressure Apical pulse Radial pulse Respiratory rate Which anti-anginal medications are indicated for the prevention of angina pectoris? (Select all that apply.)      Isosorbide dinitrate (Isordil) Isosorbide mononitrate (Monoket) Topical nitroglycerin Oral nitroglycerin Transdermal nitroglycerin The nurse is caring for a client whose chest pain has not been relieved with sublingual organic nitrate. What medication does the nurse suspect willmostlikely be prescribed by the health care provider?  Intravenous nitroglycerine A male client has sustained a head injury in a motor vehicle accident. He has nitroglycerine tablets for chest pain and asks the nurse for one due to chest pain. What effect will the nitroglycerine have on the client's current status?  Nitroglycerine will increase intracranial pressure. A client with a long-standing diagnosis of asthma is prescribed a beta-blocker for the treatment of angina. The nurse should consequentlyprioritizeassessment for what health problem?  Bronchospasm Which electrocardiogram change should prompt the nurse to question the use of ranolazine for the treatment of a client diagnosed with chronic angina?  QT prolongation A nurse is caring for a patient with chronic angina. The patient is receiving ranolazine (Ranexa) 500 mg PO bid. Which sign or symptom would the nurse attribute to being a common adverse effect of this medication?  Dizziness Frequent episodes of exercise-related chest pain have caused a 79-year-old woman to use her prescribed nitroglycerin spray several times in recent weeks. This patient's age will have what effect on her use of nitroglycerin?  The woman will be more susceptible to hypotension than a younger patient. The client is started on a transdermal nitroglycerin patch system. The nurse teaches the client that the system relieves pain by which action?  Dilates arteries and veins The client has been started on nitroglycerin ointment for angina. The nurse identifies that the nitroglycerin ointment has been effective if the client reports:  no episodes of angina since ointment was initiated. A male client asks the nurse why the health care provider has added combined aspirin, antilipemics, and antihypertensives to his medication regimen when he feels fine and hasn’t experienced an anginal episode in a year. The nurse explains that this combination of drugs is given for what reason?  Prevents progression of myocardial ischemia to MI The nurse is aware that the use of ranolazine is contraindicated in clients who have what condition?  QT-interval prolongation A male client does not respond to traditional treatment for his chronic angina. The health care provider orders ranolazine (Ranexa) and orders a baseline ECG prior to medication administration. Three months later, the health care provider orders a repeat ECG. For what reason is the provider monitoring the client?  Dose-dependent QT prolongation A client is using nitroglycerin in translingual spray form. The nurse would inform the client that the drug would begin working within which time frame?  1- 3 minutes What indicates that a client understands how to use sublingual nitroglycerin?  “I should feel a fizzing or burning sensation.” When describing the action of ranolazine, which would bemostappropriate?  Decreases myocardial workload The nurse provides client teaching for a client diagnosed with angina about the prescribed nitroglycerin transdermal patch. Which client statement establishes the need for further teaching?  “I will apply the patch for 24 hours and then remove it, and place another transdermal patch.” The nurse is teaching a client diagnosed with angina how to properly store and use nitroglycerin sublingual tablets. Which statement made by the client establishes a need for additional teaching by the nurse?  “I will keep the bottle of nitroglycerin in my pants pocket.” When teaching the client to safely administer nitroglycerin ointment, the nurse should convey which instruction?  “Make sure you squeeze the ointment on to a paper measuring scale before applying it.”