A nurse is collecting data from a client who has a history of angina and reports having a dull chest pressure that radiates to the left side of his neck. Which of the following is the priority medication the nurse should anticipate the provider prescribing?
Nifedipine
Nitroglycerin
Atenolol
Clopidogrel
The Correct Answer is B
Rationale:
A. Nifedipine: Nifedipine is a calcium channel blocker that helps reduce myocardial oxygen demand by decreasing afterload and dilating coronary arteries. However, it is not the priority in acute chest pain management because it has a slower onset compared to nitroglycerin.
B. Nitroglycerin: Nitroglycerin is the priority medication for acute angina. It works rapidly by dilating coronary arteries and reducing myocardial oxygen demand, which helps relieve chest pressure and prevent progression to myocardial infarction.
C. Atenolol: Atenolol, a beta-blocker, decreases heart rate and contractility to reduce myocardial oxygen consumption. While useful for long-term angina management, it is not the first-line agent for immediate chest pain relief in acute settings.
D. Clopidogrel: Clopidogrel is an antiplatelet agent that prevents clot formation, often used in long-term management or following stent placement. It does not provide immediate relief from angina and is therefore not the priority medication in this scenario.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Rationale:
A. Encourage the client to increase fluid intake: Clients receiving continuous peritoneal dialysis may need to restrict fluids to prevent volume overload, depending on residual kidney function and dialysis efficiency. Encouraging increased intake without provider orders can be harmful.
B. Obtain the client's weight: Daily weight is a critical indicator of fluid balance and dialysis effectiveness. Monitoring weight helps determine if the dialysis is removing the appropriate amount of fluid and supports adjustments to the treatment plan.
C. Palpate the access site for a thrill: A thrill is a vibration felt over an arteriovenous fistula, which is used in hemodialysis, not peritoneal dialysis. Peritoneal dialysis uses a soft catheter in the abdomen and does not produce a thrill.
D. Auscultate the access site for a bruit: A bruit, a whooshing sound heard over a vascular access, is associated with AV fistulas used in hemodialysis. It is not relevant for peritoneal dialysis, which uses a catheter and does not involve high-pressure blood flow.
Correct Answer is C
Explanation
Rationale:
A. “I will wait 15 minutes before taking a second tablet.": Waiting 15 minutes delays relief and increases the risk of complications. The client should take a second tablet if chest pain is unrelieved after 5 minutes, up to three doses within 15 minutes, then seek emergency help if symptoms persist.
B. "I should stop taking the medication if I get a headache.": Stopping the medication due to a headache overlooks the therapeutic benefit. Headaches are a common side effect caused by vasodilation and can be managed with mild analgesics while continuing the medication as prescribed.
C. "I should expect pain relief in 1 to 3 minutes.": Sublingual nitroglycerin is rapidly absorbed through the oral mucosa, leading to relief typically within 1 to 3 minutes. This fast onset is essential for treating acute angina episodes effectively.
D. "I will swallow the tablet for faster absorption.": Swallowing the tablet bypasses the sublingual route, delaying its effect due to first-pass metabolism in the liver. The tablet must be placed under the tongue to ensure rapid absorption and therapeutic effectiveness.
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