The nurse reviews the newly written prescriptions for a client admitted with the diagnoses of coronary artery disease and hypertension. Which prescription should the nurse implement first?

Furosemide 40 mg PO daily for a client whose blood pressure is 123986.

Nitroglycerin 0.4 mg SL PRN for a client complaining of chest

Metoprolol 25 mg PO bid for a client whose heart rate is 55 beats

Diltiazem 30 mg PO tid for a client whose heart rate is 90 beats/min

Answer and Explanation

The Correct Answer is B

A) Furosemide 40 mg PO daily for a client whose blood pressure is 123/86: While furosemide is important for managing fluid status, the client's blood pressure is within a normal range, and this medication does not address any acute concerns.

B) Nitroglycerin 0.4 mg SL PRN for a client complaining of chest pain: This prescription should be implemented first because it addresses an immediate and potentially life-threatening symptom. Chest pain can indicate angina or myocardial infarction, making it critical to relieve this symptom promptly.

C) Metoprolol 25 mg PO bid for a client whose heart rate is 55 beats: While metoprolol is important for managing heart rate and hypertension, a heart rate of 55 beats/minute is on the lower end and could warrant caution. The priority would be to assess the need for medication before administering it.

D) Diltiazem 30 mg PO tid for a client whose heart rate is 90 beats/min: This medication is also important for managing heart rate and hypertension but is not the priority over addressing acute chest pain. The client’s heart rate is within a normal range, so this does not require immediate action compared to the nitroglycerin for chest pain.

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Correct Answer is B

Explanation

A. Increased platelet count: While platelet activation can occur in unstable angina, an increased platelet count alone does not indicate heart damage. It is more relevant to thrombotic events than direct myocardial injury.

B. Elevated troponins: Troponin is a protein released when the heart muscle is damaged. Elevated levels are a key indicator of myocardial injury, making this a significant finding in the context of unstable angina.

C. Decreased homocysteine levels: Homocysteine levels are related to cardiovascular risk but are not directly indicative of heart damage. Elevated levels may suggest risk but do not confirm damage.

D. Elevated CK-MB: Creatine kinase-MB is an enzyme found in heart muscle. Elevated levels are indicative of myocardial injury, making this a relevant laboratory test for assessing heart damage in unstable angina.

E. Decreased alkaline phosphatase (ALT): Alkaline phosphatase is primarily related to liver and bone health and does not indicate heart damage. Decreased levels of ALT (alanine aminotransferase) are not relevant to myocardial injury.

A. Meat and eggs mostly contain unsaturated fats B. Coconut oil has a rich flavor and is a good cooking oil C. "Olive oil is high in saturated fats so I should avoid it D. "Canola oil is a monounsaturated fat and is recommended.

Correct Answer is D

Explanation

A. Meat and eggs mostly contain unsaturated fats: This statement is incorrect. Meat and eggs are primarily sources of saturated fats, which should be limited in a diet aimed at reducing coronary artery disease risk.
B. Coconut oil has a rich flavor and is a good cooking oil: This is misleading. While coconut oil is popular, it is high in saturated fats, and many health guidelines recommend limiting its use, especially for those with coronary artery disease.

C. "Olive oil is high in saturated fats so I should avoid it": This statement is also incorrect. Olive oil is primarily composed of monounsaturated fats, which are considered heart-healthy and are recommended in moderation for individuals with coronary artery disease.

D. "Canola oil is a monounsaturated fat and is recommended": This statement is accurate. Canola oil contains a high proportion of monounsaturated fats and is often recommended as a healthier option for cooking and salad dressings for those looking to limit saturated fat intake.

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The nurse reviews the newly written prescriptions for a client admitted with the diagnoses of coronary artery disease and hypertension. Which prescription should the nurse implement first?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is reviewing the chart of a client with a diagnosis of unstable angina. Which laboratory test(s) result(s) should the nurse recognize as an Indication of heart damage? (SELECT ALL THAT APPLY)

Correct Answer is B

Explanation

The nurse is conducting dietary teaching for a client diagnosed with coronary artery disease. Which statement made by the client indicates an understanding of fat sources and the need to limit saturated fats?

Correct Answer is D

Explanation

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