A nurse is caring for a client who has acute angina. Which of the following actions should the nurse take first?
Administer aspirin.
Measure blood pressure.
Administer nitroglycerin.
Initiate IV access.
The Correct Answer is C
Choice A reason: Administering aspirin is one of the first interventions for a client experiencing acute angina because aspirin has antiplatelet properties that help prevent blood clots, which can reduce the risk of a heart attack.
Choice B reason: Measuring blood pressure is important but not the first action to take. It provides valuable information about the cardiovascular status of the client and can influence further treatment decisions.
Choice C reason: Administering nitroglycerin is a priority action for acute angina as it helps to dilate the coronary arteries and relieve chest pain. However, it is typically administered after aspirin unless contraindicated.
Choice D reason: Initiating IV access is an important step in the management of acute angina, as it allows for the administration of medications and fluids if needed. However, it is not the first action to take during an acute angina episode.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A reason: Hypotension, or low blood pressure, is not typically associated with thyroid storm. Thyroid storm is a life-threatening condition that often presents with hypertensive crisis due to the excessive amount of thyroid hormones accelerating the body's metabolism.
Choice B reason: Increased temperature is a hallmark sign of thyroid storm. Patients experiencing a thyroid storm can have a high fever, with temperatures ranging from 104°F to 106°F. This is due to the hypermetabolic state induced by excessive thyroid hormones, which increases the body's heat production.
Choice C reason: Lethargy is not a common symptom of thyroid storm. Instead, patients may experience agitation, irritability, and anxiety due to the overstimulation of the nervous system by excessive thyroid hormones. Lethargy might be observed in hypothyroidism, which is the opposite condition.
Choice D reason: A decreased heart rate is not characteristic of thyroid storm. On the contrary, tachycardia, or a rapid heart rate, is a common symptom. The heart rate can exceed 140 beats per minute as the body's demand for oxygen increases due to the hypermetabolic state.
Correct Answer is B
Explanation
Choice A reason : Desmopressin is a medication used to treat conditions like diabetes insipidus and certain cases of hemophilia, not allergic reactions such as hives and urticaria.
Choice B reason: Diphenhydramine is an antihistamine that is commonly used to treat allergic reactions, including hives and urticaria. It works by blocking the action of histamine, a substance in the body that causes allergic symptoms.
Choice C reason: Spironolactone is a diuretic and is not used to treat allergic reactions. It is typically prescribed for conditions like heart failure, hypertension, and certain hormonal disorders.
Choice D reason: Metoclopramide is a medication used to treat nausea and gastroparesis, not allergic reactions.
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