When providing discharge instructions for a client who has been prescribed sublingual nitroglycerin for stable angina, the nurse should plan to include which instructions?

"Only take one nitroglycerin tablet for each episode of angina."

"Place the nitroglycerin tablet between cheek and gum."

"Call 911 if you develop a headache following nitroglycerin use."

"See if rest relieves the chest pain before using the nitroglycerin."

Answer and Explanation

The Correct Answer is A

A. "Only take one nitroglycerin tablet for each episode of angina."

This instruction is correct. Sublingual nitroglycerin is typically administered as needed for the relief of angina symptoms, with one tablet being the initial dose. If the chest pain persists after 5 minutes, the client may take a second tablet, and if needed, a third tablet after another 5 minutes. However, if the pain is not relieved after three tablets, they should seek immediate medical attention.

B. "Place the nitroglycerin tablet between cheek and gum."

This instruction is incorrect. Sublingual nitroglycerin tablets should be placed under the tongue, allowing them to dissolve and be absorbed directly into the bloodstream. Placing the tablet between the cheek and gum is not the recommended administration route for sublingual nitroglycerin.

C. "Call 911 if you develop a headache following nitroglycerin use."

This instruction is partially correct. Headache is a common side effect of nitroglycerin due to its vasodilatory effects. Clients should be informed about this potential side effect, but not every headache following nitroglycerin use requires immediate medical attention. However, if the headache is severe, persistent, or accompanied by other concerning symptoms, the client should seek medical evaluation.

D. "See if rest relieves the chest pain before using the nitroglycerin."

This instruction is incorrect. Sublingual nitroglycerin is a rapid-acting medication used to relieve angina symptoms quickly. Clients should not delay taking nitroglycerin and wait for rest to relieve chest pain, as this can lead to worsening symptoms and complications.

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Correct Answer is C

Explanation

A. 120/80 mm Hg or lower:

This blood pressure range is considered normal or optimal for most adults. However, for individuals diagnosed with hypertension, the goal is typically to reduce blood pressure to below 140/90 mm Hg, as maintaining normal blood pressure is not considered a goal for hypertension treatment unless specifically indicated based on individual circumstances.

B. Average of two BP readings of 150/80 mm Hg:

A blood pressure reading of 150/80 mm Hg is elevated and indicates hypertension, especially if consistently elevated across multiple readings. The goal of hypertension treatment is to lower blood pressure to below 140/90 mm Hg, so an average of 150/80 mm Hg would not be considered the goal of treatment.

C. 140/90 mm Hg or lower:

This blood pressure range is commonly recommended as the goal of treatment for individuals with hypertension who otherwise enjoy good health. It represents a balance between effective blood pressure control and minimizing the risk of side effects or complications associated with overly aggressive treatment.

D. 156/96 mm Hg or lower:

While a blood pressure reading of 156/96 mm Hg is elevated and indicates hypertension, the goal of treatment is typically to reduce blood pressure to below 140/90 mm Hg rather than targeting a specific numeric value below 156/96 mm Hg.

A. The blood was infused too quickly and overwhelmed the client's circulatory system. B. The donor blood was incompatible with that of the client. C. The client had a sensitivity reaction to a plasma protein in the blood. D. Antibodies to donor leukocytes remained in the blood.

Correct Answer is B

Explanation

A. The blood was infused too quickly and overwhelmed the client's circulatory system:

While infusing blood too quickly can lead to circulatory overload and related complications like heart failure or pulmonary edema, it is not the cause of an acute hemolytic transfusion reaction. Acute hemolytic reactions occur due to immune responses against incompatible donor blood.

B. The donor blood was incompatible with that of the client:

This is the correct answer. An acute hemolytic transfusion reaction happens when there is an incompatibility between the donor's blood and the recipient's blood. This can occur due to mismatched ABO blood types or Rh factor, leading to the recipient's immune system attacking and destroying the transfused red blood cells.

C. The client had a sensitivity reaction to a plasma protein in the blood:

Sensitivity reactions to plasma proteins can occur, but they typically result in different types of transfusion reactions, such as allergic reactions or febrile non-hemolytic reactions. These reactions are caused by antibodies to specific plasma proteins and are not the cause of acute hemolytic transfusion reactions.

D. Antibodies to donor leukocytes remained in the blood:

This option refers to febrile non-hemolytic transfusion reactions, which occur due to antibodies against donor leukocytes. However, this type of reaction is distinct from acute hemolytic reactions, which are primarily caused by ABO or Rh incompatibility.

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When providing discharge instructions for a client who has been prescribed sublingual nitroglycerin for stable angina, the nurse should plan to include which instructions?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is planning the care of a client who has been diagnosed with hypertension but who otherwise enjoys good health. When assessing the response to an antihypertensive drug regimen, what blood pressure would be the goal of treatment?

Correct Answer is C

Explanation

A client is being treated in the ICU after a medical error resulted in an acute hemolytic transfusion reaction. What was the etiology of this client's adverse reaction?

Correct Answer is B

Explanation

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