A nurse is providing teaching to a client who has angina pectoris and a new prescription for nitroglycerin sublingual tablets. Which of the following statements by the client indicates an understanding of the teaching?
"I'll dial 911 if I still have pain after taking 4 nitroglycerin tablets over a 20-minute period."
"I'll dial 911 if 1 nitroglycerin tablet does not relieve my pain, and then take up to 2 more tablets 5 minutes apart while waiting."
“I’ll dial 911 when I have pain and then take the nitroglycerin tablets."
"I'll dial 911 if I still have pain after taking 3 nitroglycerin tablets 5 minutes apart."
The Correct Answer is D
A. Taking 4 nitroglycerin tablets is incorrect. The maximum dose is 3 tablets, taken 5 minutes apart. If chest pain persists after the third dose, the client should seek emergency help.
B. Calling 911 after only one dose is incorrect. The correct protocol is to take up to three doses before seeking emergency assistance unless symptoms worsen rapidly.
C. Calling 911 immediately before taking nitroglycerin is incorrect. The client should attempt to relieve the chest pain with nitroglycerin before calling for emergency help.
D. Calling 911 if pain persists after taking 3 nitroglycerin tablets 5 minutes apart is correct. Persistent chest pain despite nitroglycerin use suggests a possible myocardial infarction (MI), requiring immediate medical intervention.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. Obtaining an ECG is important but not the first action. The priority is to stop activity, as exertion can worsen myocardial oxygen demand.
B. Having the client sit down immediately is correct. Stopping activity reduces cardiac workload and oxygen demand, preventing further ischemia or infarction.
C. Assessing vital signs is important but should follow stopping activity. Chest pain requires immediate action to reduce cardiac strain.
D. Administering sublingual nitroglycerin is appropriate but should be done after ensuring the client is seated. This prevents hypotension and syncope from occurring while standing.
Correct Answer is C
Explanation
A. Brain Natriuretic Peptide (BNP) is a marker for heart failure, not the primary diagnostic test for myocardial infarction (MI).
B. Total Lactate Dehydrogenase (LDH) was historically used but is not specific for MI and has been replaced by troponin testing.
C. Troponin is correct. Cardiac-specific troponins (Troponin I and Troponin T) are the gold standard for detecting myocardial injury. Elevated levels indicate myocardial damage and are crucial for diagnosing MI.
D. Creatinine is important for assessing kidney function but is not a marker for myocardial infarction.
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