NURS 347: exam1evolvequestions

1. Which instruction should be included in the discharge teaching for a patient with a transdermal nitroglycerin (Nitro-Dur) patch? A. “If you get chest pain, apply a second patch next to the first patch.” B. “If you get a headache, remove the patch for 4 hours and then reapply.” C. “Make sure to rub a lotion or cream on the skin before putting on a new patch.” D. “Apply the patch to a hairless, nonirritated area of the chest, upper arm, back or shoulder.” 2. The patient states to the nurse, “My friend said nitroglycerin relieves angina pain by reducing preload. What is preload?” Which statement by the nurse explains preload to this patient? A. “It is the blood return to the heart.” B. “It is the oxygen demand of the heart.” C. “It is the pressure against which the heart must pump.” D. “It is dilation of arteries and veins throughout the body.” 3. Which statement by the patient demonstrates a need for further education regarding nitroglycerin (Nitrostat) sublingual tablets? A. “I should keep my nitroglycerin in a cool, dry place.” B. “I can take up to four tablets at 5-minute intervals for chest pain.” C. “If I get a headache, I should keep taking my nitroglycerin and use Tylenol to relieve my headache.” D. “I should change positions slowly to avoid getting dizzy from the drug’s effect on my blood pressure.” 4. Calcium channel blockers reduce myocardial oxygen demand by decreasing afterload. How would the nurse explain afterload to the patient? A. It is the contractility of the heart muscle. B. It is the total volume of blood in the heart. C. It is the force against which the heart must pump. D. It is the pressure within the four chambers of the heart. 5. Which dosage form of nitroglycerin has the longest duration of action? A. Sublingual tablet B. Transdermal patch C. Intravenous (IV) infusion D. Immediate-release tablet 6. To prevent the development of tolerance to nitroglycerin (Nitro-Bid) transdermal patch, the nurse instructs the patient to perform which action? A. Apply a new nitroglycerin patch every other day. B. Use the nitroglycerin patch for acute episodes of angina only. C. Apply the nitroglycerin patch in the morning and remove it at night for 8 hours. D. Switch to sublingual nitroglycerin when the systolic blood pressure is greater than 140 mm Hg. 7. Before administering isosorbide mononitrate (Imdur) sustained-release tablet to a patient, what is the priority nursing intervention? A. Obtain a blood pressure reading. B. Remind the patient to take the tablet before meals. C. Emphasize that the patient should swallow the tablet whole. D. Advise the patient that Tylenol is used to treat headache. 8. The patient asks the nurse, “How should sublingual nitroglycerin be stored when I travel?” What is the nurse’s best response? A. “You can protect it from heat by placing the bottle in an ice chest.” B. “It’s best to keep it in its original container away from heat and light.” C. “You can put a few tablets in a resealable bag and carry it in your pocket.” D. “Keep it in the glove compartment of your car to prevent exposure to heat.” 9. The nurse is teaching treatment of acute chest pain for a patient prescribed nitroglycerin (Nitrostat) sublingual tablets. Which instructions should the nurse include? A. Take five tablets every 3 minutes for chest pain. B. Sit or lie down before taking medication. C. Chew or swallow the tablet for the quickest effect. D. Keep the tablets locked in a safe place until you need them.