The nurse instructs a client diagnosed with hypertension and coronary artery disease who has been given a new prescription for carvedilol 6.25 mg PO bid to:

Increase the intake of dietary fiber

Change from a lying to sitting position slowly

Expect weight gain of 6-8 pounds

Take the medication after eating breakfast

Answer and Explanation

The Correct Answer is B

Choice A reason: Increasing the intake of dietary fiber is not related to the instruction for carvedilol. Dietary fiber is beneficial for lowering cholesterol and blood sugar levels, but it does not affect the action or side effects of carvedilol. The client should follow a balanced diet that is low in sodium, fat, and cholesterol.

Choice B reason: This is the correct answer. Changing from a lying to sitting position slowly is an important instruction for carvedilol. Carvedilol is a beta-blocker that lowers the blood pressure and the heart rate. It can cause orthostatic hypotension, which is a sudden drop in blood pressure when changing positions. This can lead to dizziness, fainting, or falls. The client should change positions gradually and avoid sudden movements.

Choice C reason: Expecting weight gain of 6-8 pounds is not an instruction for carvedilol. Weight gain is not a common or expected side effect of carvedilol. It can indicate fluid retention, which can worsen the heart condition and the blood pressure. The client should monitor their weight regularly and report any significant changes to the health care provider.

Choice D reason: Taking the medication after eating breakfast is not an instruction for carvedilol. Carvedilol can be taken with or without food, depending on the client's preference and tolerance. The important thing is to take the medication at the same time every day and not to skip or double the doses.

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Correct Answer is D

Explanation

Choice A reason: Total cholesterol is not the best indicator of the effectiveness of simvastatin, a drug that lowers cholesterol levels and reduces the risk of cardiovascular disease. ¹ Total cholesterol includes both LDL and HDL (high density lipoprotein), which have opposite effects on the heart and blood vessels. ² The normal range of total cholesterol for adults is less than 200 mg/dL, but this does not reflect the balance between LDL and HDL.

Choice B reason: Blood pressure is not directly related to the effectiveness of simvastatin, although high blood pressure and high cholesterol are both risk factors for cardiovascular disease. ³ Simvastatin does not lower blood pressure, but it may prevent or slow down the development of atherosclerosis, which is the narrowing and hardening of the arteries due to plaque buildup. ¹ The normal range of blood pressure for adults is less than 120/80 mmHg.

Choice C reason: Serum triglycerides are another type of fat in the blood that can contribute to cardiovascular disease. ² Simvastatin can lower triglyceride levels, but this is not its main effect. ¹ The normal range of serum triglycerides for adults is less than 150 mg/dL.

Choice D reason: LDL is the main target of simvastatin therapy, as it is the "bad" cholesterol that can cause plaque buildup and damage the arteries. ¹ Simvastatin works by inhibiting an enzyme that produces LDL in the liver. The optimal level of LDL for adults is less than 100 mg/dL, and even lower for those with high risk of cardiovascular disease. ² A LDL level of 90 mg/dL indicates that the client's current dose of simvastatin has been effective.

A. The pain you have is because your heart valves are damaged. B. Your heart muscle is weak and is not pumping forcefully. C. The pain is caused by decreased oxygen to the heart muscle. D. The layers of your heart are weak and thin.

Correct Answer is C

Explanation

Choice A reason: The pain you have is because your heart valves are damaged is not the most appropriate response. This statement may apply to a client with valvular heart disease, but not necessarily to a client with coronary artery disease. The nurse should explain that coronary artery disease is a condition that affects the blood vessels that supply the heart, not the heart valves.

Choice B reason: Your heart muscle is weak and is not pumping forcefully is not the most appropriate response. This statement may apply to a client with heart failure, but not necessarily to a client with coronary artery disease. The nurse should explain that coronary artery disease is a condition that reduces the blood flow to the heart, not the heart's contractility.

Choice C reason: The pain is caused by decreased oxygen to the heart muscle is the most appropriate response. This statement accurately describes the cause of angina, which is the chest pain that occurs when the heart does not receive enough oxygen due to narrowed or blocked coronary arteries. The nurse should also inform the client about the factors that can trigger or relieve angina, such as physical exertion, emotional stress, cold weather, or nitroglycerin.

Choice D reason: The layers of your heart are weak and thin is not the most appropriate response. This statement may apply to a client with cardiomyopathy, but not necessarily to a client with coronary artery disease. The nurse should explain that coronary artery disease is a condition that affects the blood vessels that supply the heart, not the heart's structure.

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The nurse instructs a client diagnosed with hypertension and coronary artery disease who has been given a new prescription for carvedilol 6.25 mg PO bid to:

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Naxlex Comprehensive Predictor Exams

Which data indicates to the nurse that the client's current dose of simvastatin has been effective?

Correct Answer is D

Explanation

The client with coronary artery disease asks the nurse, "Why do I get this chest pain?" Which would be the most appropriate response?

Correct Answer is C

Explanation

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