A nurse is teaching a client who has angina about a new prescription for sublingual nitroglycerin tablets.
Which of the following instructions should the nurse include in the teaching?

Take one tablet each morning 30 minutes prior to eating.

Discard any tablets you do not use every 6 months.

Keep the tablets at room temperature in their original glass bottle.

Place the tablet between your cheek and gum to dissolve.

Answer and Explanation

The Correct Answer is C

The correct answer is choice C. Keep the tablets at room temperature in their original glass bottle. Rationales: Choice A rationale: Taking one tablet each morning 30 minutes prior to eating is incorrect. Sublingual nitroglycerin is used to relieve acute angina attacks and is taken as needed rather than on a fixed schedule. Choice B rationale: Discarding any tablets not used every 6 months is incorrect. Sublingual nitroglycerin tablets should be replaced every 6 months to ensure potency, but this is not the main teaching point for safe storage. Choice C rationale: Keeping the tablets at room temperature in their original glass bottle is correct. Nitroglycerin tablets are sensitive to light and moisture, and the original glass bottle protects them from these elements, ensuring their effectiveness. Choice D rationale: Placing the tablet between the cheek and gum to dissolve is incorrect. Sublingual nitroglycerin tablets should be placed under the tongue where they dissolve and are absorbed quickly into the bloodstream for rapid relief of angina symptoms

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Correct Answer is B

Explanation

Lisinopril is an angiotensin converting enzyme (ACE) inhibitor that is used to treat high blood pressure and heart failure. It works by relaxing the blood vessels and increasing the supply of blood and oxygen to the heart. However, one of the common side effects of lisinopril is hypotension, which means low blood pressure. Hypotension can cause dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position. Therefore, the nurse should monitor the client’s blood pressure when administering lisinopril and report any signs of hypotension to the doctor.

Choice A is wrong because tinnitus, which means ringing or buzzing in the ears, is not a common or serious side effect of lisinopril.

Tinnitus can be caused by other factors such as ear infections, loud noises, or medications such as aspirin or antibiotics.

Choice C is wrong because hypokalemia, which means low potassium levels in the blood, is not a common or serious side effect of lisinopril. In fact, lisinopril can cause hyperkalemia, which means high potassium levels in the blood, especially in patients with kidney problems or diabetes. Hyperkalemia can cause irregular heartbeats, muscle weakness, or numbness. Therefore, the nurse should monitor the client’s potassium levels when administering lisinopril and avoid giving potassium supplements or salt substitutes that contain potassium.

Choice D is wrong because bradycardia, which means slow heart rate, is not a common or serious side effect of lisinopril.

Lisinopril does not affect the heart rate directly, but it can lower the blood pressure and improve the heart function.

Bradycardia can be caused by other factors such as heart block, sinus node dysfunction, or medications such as beta blockers or calcium channel blockers.

A. Taking an HMG CoA reductase inhibitor. B. Having a 10-year history of COPD. C. Taking a high-ceiling diuretic. D. Having a prolapsed mitral valve.

Correct Answer is C

Explanation

Taking a high-ceiling diuretic predisposes this client to developing digoxin toxicity because it can cause hypokalemia (low blood potassium level), which increases the sensitivity of the heart to digoxin. Digoxin is a medicine that is used to treat heart failure or arrhythmias (abnormal heart rhythms) by increasing cardiac contractility and controlling the heart rate. Digoxin toxicity happens when there is too much digoxin in the body and it becomes harmful, causing symptoms such as nausea, vomiting, headache, confusion, vision disturbance, and irregular heartbeat.

Choice A is wrong because taking an HMG CoA reductase inhibitor (also called a statin) does not increase the risk of digoxin toxicity.

Statins are lipid-lowering medications used to prevent coronary heart disease by blocking an enzyme involved in cholesterol synthesis.

Statins do not affect the blood potassium level or the sensitivity of the heart to digoxin.

Choice B is wrong because having a 10-year history of COPD (chronic obstructive pulmonary disease) does not increase the risk of digoxin toxicity. COPD is a lung condition that causes breathing difficulties and chronic inflammation.

COPD does not affect the blood potassium level or the sensitivity of the heart to digoxin.

Choice D is wrong because having a prolapsed mitral valve does not increase the risk of digoxin toxicity.

A prolapsed mitral valve is a condition where the valve between the left atrium and left ventricle of the heart does not close properly, allowing some blood to leak back into the atrium.

A prolapsed mitral valve does not affect the blood potassium level or the sensitivity of the heart to digoxin.

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A nurse is teaching a client who has angina about a new prescription for sublingual nitroglycerin tablets. Which of the following instructions should the nurse include in the teaching?

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Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who has heart failure and a new prescription for lisinopril. For which of the following adverse effects should the nurse monitor when administering lisinopril?

Correct Answer is B

Explanation

A nurse is caring for a client who is taking digoxin to treat heart failure. Which of the following factors predisposes this client to developing digoxin toxicity?

Correct Answer is C

Explanation

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A nurse is teaching a client who has angina about a new prescription for sublingual nitroglycerin tablets.
Which of the following instructions should the nurse include in the teaching?