When administering sublingual nitroglycerin for emergency treatment of angina or chest pain, the nurse monitors for which common adverse effect?
Nausea.
Bradycardia.
Hypertension.
Headache.
The Correct Answer is D
The correct answer is Choice D: Headache.
Choice A rationale: Nausea is not a common adverse effect of sublingual nitroglycerin. Nausea may occur in some patients, but it is usually mild and transient. Nausea may be related to the vasodilatory effects of nitroglycerin, which can cause hypotension and reflex tachycardia1. Nausea may also be caused by other factors, such as anxiety, stress, or food intolerance. Nausea is not a specific indicator of nitroglycerin toxicity or overdose2.
Choice B rationale: Bradycardia is not a common adverse effect of sublingual nitroglycerin. Bradycardia is a slow heart rate, usually defined as less than 60 beats per minute. Bradycardia may occur in some patients who take nitroglycerin, especially in combination with other drugs that affect the heart rate, such as beta-blockers, calcium channel blockers, or digoxin3. Bradycardia may also be caused by other factors, such as vagal stimulation, hypothyroidism, or electrolyte imbalance. Bradycardia is not a specific indicator of nitroglycerin toxicity or overdose2.
Choice C rationale: Hypertension is not a common adverse effect of sublingual nitroglycerin. Hypertension is a high blood pressure, usually defined as more than 140/90 mmHg. Hypertension may occur in some patients who take nitroglycerin, especially in those who have a history of hypertension, renal impairment, or volume overload4. Hypertension may also be caused by other factors, such as stress, pain, or caffeine intake. Hypertension is not a specific indicator of nitroglycerin toxicity or overdose2.
Choice D rationale: Headache is a common adverse effect of sublingual nitroglycerin. Headache may occur in up to 80% of patients who take nitroglycerin, especially during the first few days of therapy or after an increase in dose5. Headache may be related to the vasodilatory effects of nitroglycerin, which can cause cerebral vasodilation and increased intracranial pressure. Headache may also be caused by other factors, such as dehydration, sinusitis, or migraine. Headache is usually mild to moderate in intensity and can be relieved by analgesics, such as acetaminophen or aspirin. Headache is not a specific indicator of nitroglycerin toxicity or overdose
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Atorvastatin is a type of statin, which are the most potent antilipidemic agents and have proven to lower the risk of myocardial infarction. Statins work by inhibiting an enzyme called HMG-CoA reductase, which is involved in the synthesis of cholesterol in the liver.By reducing the production of cholesterol, statins lower the levels of low-density lipoprotein (LDL) and triglycerides, and slightly increase the levels of high-density lipoprotein (HDL) in the blood.
Choice B, niacin, is wrong because niacin is not as effective as statins in lowering LDL and preventing cardiovascular events.Niacin is a water-soluble vitamin that can lower LDL and triglycerides, and increase HDL, but it can also cause flushing, itching, and liver toxicity.
Choice C, gemfibrozil, is wrong because gemfibrozil is a type of fibric acid derivative, which are mainly used to lower triglycerides and increase HDL, but have little effect on LDL.
Fibric acid derivatives work by activating a receptor called PPAR-alpha, which regulates the metabolism of lipids in the liver and muscle.Fibric acid derivatives can also increase the risk of gallstones and muscle damage.
Choice D, ezetimibe, is wrong because ezetimibe is a selective cholesterol absorption inhibitor, which blocks the absorption of dietary and biliary cholesterol in the intestine.Ezetimibe can lower LDL by about 15-20%, but it has not been shown to reduce the risk of myocardial infarction on its own.Ezetimibe is usually combined with a statin for better efficacy and safety.
Normal ranges for lipid levels are:
• Total cholesterol: less than 200 mg/dL
• LDL cholesterol: less than 100 mg/dL
• HDL cholesterol: more than 40 mg/dL for men and more than 50 mg/dL for women
• Triglycerides: less than 150 mg/dL
Correct Answer is A
Explanation
Food high in potassium should be avoided for clients taking ACE inhibitors. ACE inhibitors are drugs that block the conversion of angiotensin I to angiotensin II, which is a potent vasoconstrictor and also stimulates the secretion of aldosterone. Aldosterone is a hormone that increases the reabsorption of sodium and water and the excretion of potassium in the kidneys. By inhibiting angiotensin II, ACE inhibitors lower blood pressure and reduce the loss of potassium. However, this can also lead to hyperkalemia, which is a high level of potassium in the blood that can cause cardiac arrhythmias and muscle weakness.Therefore, clients taking ACE inhibitors should limit their intake of foods that are rich in potassium, such as bananas, oranges, tomatoes, potatoes, spinach, beans, nuts, and salt substitutes.
Choice B is wrong because a low sodium diet is recommended for clients taking ACE inhibitors.
A low sodium diet can help lower blood pressure and reduce fluid retention, which are beneficial effects for clients with hypertension, heart failure, or chronic kidney disease.A low-potassium diet should aim for potassium intake of less than 50 or 75 mmol/day and sodium intake of less than 60 mmol/day for hypertensive patients with chronic kidney disease.
Choice C is wrong because adequate fluid intake is not contraindicated for clients taking ACE inhibitors.
Adequate fluid intake can help prevent dehydration and maintain kidney function, especially in patients with diabetes or nephropathy.However, excessive fluid intake may worsen heart failure or edema in some patients, so fluid intake should be individualized and monitored according to the patient’s condition and response to therapy.
Choice D is wrong because foods low in potassium are not harmful for clients taking ACE inhibitors.
Foods low in potassium do not affect the serum potassium level or the risk of hyperkalemia in clients taking ACE inhibitors.However, foods low in potassium may not provide enough dietary potassium for normal cellular functions, so a balanced diet that includes moderate amounts of potassium-rich foods is advisable.
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