A nurse is reinforcing discharge teaching with client who has stable angina pectoris. Which of the following statements by the client indicates an understanding of what to do when chest pain occurs?

I will stop what I am doing and lie down."

I will take two 325 milligram aspirin tablets at the same time

I will hold my breath and bear down."

I will call the provider after taking one dose of nitroglycerin."

Answer and Explanation

The Correct Answer is A

A) "I will stop what I am doing and lie down.": This is the correct response. When a client with stable angina experiences chest pain, they should stop any physical activity and rest in a comfortable position, preferably lying down. This helps reduce the heart’s workload and decrease the demand for oxygen, which can relieve the pain. Rest is important before taking any further action.

B) "I will take two 325 milligram aspirin tablets at the same time.": While aspirin can help reduce blood clot formation in some cases of chest pain, the recommended dosage is typically one 81-325 mg aspirin, not two 325 mg tablets. Taking two large doses may lead to an overdose or unwanted side effects. Additionally, this is not the immediate intervention for stable angina pain, which typically responds to rest and nitroglycerin.

C) "I will hold my breath and bear down.": This technique, known as the Valsalva maneuver, can increase intrathoracic pressure and slow the heart rate, but it is not recommended to relieve chest pain in stable angina. In fact, it could increase stress on the heart and worsen the symptoms. This maneuver is used in specific situations, such as slowing a rapid heart rate, not for chest pain relief.

D) "I will call the provider after taking one dose of nitroglycerin.": The client should first try nitroglycerin for chest pain as prescribed, and if the pain doesn’t resolve after one dose (or if it worsens), they should seek medical attention. However, in the case of stable angina, it's more appropriate to call the provider if the chest pain persists despite rest and nitroglycerin, not immediately after the first dose.

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Correct Answer is ["A","B","C","D","G"]

Explanation

A. Respiratory complaint: A 4-day productive cough with fatigue and night sweats raises concern for a respiratory infection, including tuberculosis (TB) or pneumonia. Further evaluation, including chest imaging and sputum studies, is warranted.
B. Temperature: A low-grade fever (38.1°C/100.5°F) for several days, along with night sweats, suggests a possible infectious process, requiring further investigation.
C. Sputum characteristics: Blood-tinged sputum raises concern for TB, bronchitis, pneumonia, or malignancy, necessitating a sputum culture and acid-fast bacillus (AFB) testing.
D. Weight: Unintentional weight loss (5 lb in 1 week) and decreased appetite can indicate chronic infection, malignancy, or another systemic illness, necessitating further evaluation.
G. Travel history: Recent travel to South Africa, a country with a high TB prevalence, increases the risk of tuberculosis exposure and justifies further screening.
Incorrect Choices:
E. Blood pressure: 112/88 mm Hg is within the normal range and does not require further evaluation.
F. Oxygen saturation: 98% on room air is normal and does not indicate respiratory compromise.
H. Heart rate: 98/min is slightly elevated but could be due to fever or mild dehydration. It is not a primary concern.

A. "You should expect to have blood work every 6 months while taking this medication." B. *You can safely take this medication if you become pregnant." C. "You might experience swollen gums while taking this medication." D. "You can skip a dose of this medication if you are nauseated."

Correct Answer is C

Explanation

A) "You should expect to have blood work every 6 months while taking this medication.": While it is important for clients on phenytoin to have regular blood work, especially to monitor drug levels and assess for potential side effects (e.g., liver function, complete blood count), the frequency of blood work is typically more frequent than every 6 months. Blood work is often performed at least every 3-6 months, or more frequently if there are concerns about phenytoin levels or side effects. Therefore, this statement is not accurate.

B) "You can safely take this medication if you become pregnant.": Phenytoin is classified as a Category D medication in pregnancy, meaning it has been shown to cause potential harm to the fetus. It is not considered safe during pregnancy, and women who are pregnant or planning to become pregnant should discuss alternative medications with their healthcare provider.

C) "You might experience swollen gums while taking this medication.": Gingival hyperplasia (swelling of the gums) is a common side effect of phenytoin. Clients taking this medication should be aware of this potential side effect and should be instructed on proper oral hygiene and regular dental checkups to help minimize this risk. This statement is accurate and should be included in the teaching.

D) "You can skip a dose of this medication if you are nauseated.": It is important not to skip doses of phenytoin, as maintaining therapeutic levels of the drug is crucial for its effectiveness in preventing seizures. If a client experiences nausea or difficulty taking the medication, they should contact their healthcare provider for guidance rather than skipping doses. Skipping doses could lead to breakthrough seizures.

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A nurse is reinforcing discharge teaching with client who has stable angina pectoris. Which of the following statements by the client indicates an understanding of what to do when chest pain occurs?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is ["A","B","C","D","G"]

Explanation

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Correct Answer is C

Explanation

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