Chapter 17-agents that dilate blood vessels

Question 1

The nurse teaching the client with angina about how to treat an acute anginal attack instructs the client to:

Answer 1

take 1 nitroglycerin tablet sublingual up to 3 tablets 5 minutes apart; call 911 after the third tablet, if pain does not subside.

Question 2

When teaching clients about acute myocardial infarctions (MI), the nurse should include:

Answer 2

“Acute myocardial infarction, or heart attack, occurs when an area of heart muscle dies as a result of insufficient oxygen.”

Question 3

The nurse understands that anginal pain usually is associated with:

Answer 3

stress and exercise.

Question 4

The nurse should teach a client with peripheral vascular disease on vasodilator therapy about the effects of smoking, including:

Answer 4

the use of tobacco products should be avoided because of its vasoconstricting effects.

Question 5

When evaluating this client’s headaches when using nitroglycerin products, which statement by the client indicates further teaching is needed?

Answer 5

“I think my headaches are an indication of excessive dosage of nitroglycerin.”

Question 6

The nurse is preparing to administer a transdermal nitroglycerin patch to a client with CAD. The nurse should first:

Answer 6

wash his or her hands

Question 7

When teaching a client about how to use a transdermal nitroglycerin system, the nurse includes:

Answer 7

“The application site should be changed daily.”

Question 8

A nursing student asks the staff nurse which of the following medications would be LEAST effective as a monotherapy in treating acute anginal pain. The nurse responds appropriately by saying:

Answer 8

propranolol. Propranolol is more effective when used with a nitrate.

Question 9

The nurse understands that which of the following agents is contraindicated in persons with obstructive pulmonary disorders?

Answer 9

metoprolol- Beta-adrenergic blocking agents are contraindicated.

Question 10

When administering nitrate antianginal agent, the nurse’s priority concern for the client

Answer 10

postural hypotension. Risk of injury from falls secondary to postural hypotension is the nurse’s priority concern.

Question 11

Coronary vasodilators are most often used to treat:

Answer 11

angina pectoris

Treating angina is the most common use for coronary vasodilators.

Question 12

When evaluating the effectiveness of client teaching about home use of sublingual nitroglycerin, which of the following comments would demonstrate client understanding?

Answer 12

“I should discard unused tablets 6 months after opening the original bottle.”

Question 13

Which of the following statements by the nurse recruit indicates an understanding of the use of nitroglycerin sublingual tablets in hospitalized persons?

Answer 13

“The client is instructed to inform the nurse whenever it is taken.”

Question 14

The nurse is preparing to administer this coronary vasodilator by inhalation:

Answer 14

amyl nitrite- Amyl nitrate is administered by inhalation.

Question 15

The client who is using a vasodilator would be instructed to avoid which of the following?

Answer 15

nicotine-This causes vasoconstriction

Question 16

The nurse teaching clients using vasodilators should include:

Answer 16

“You should rise and change position slowly.”

The client should rise and change positions slowly, because of the risk of postural hypotension.

Question 17

When teaching clients about applying nitroglycerin ointment, the nurse should include:

Answer 17

the measured ointment side of the paper is placed against the client’s skin.

Question 18

The nurse should instruct clients using nitroglycerin translingual spray to:

Answer 18

hold the spray orifice as close to the mouth as possible.

Question 19

The nurse is attempting to assess client learning about use of sublingual nitroglycerin at home. Which of the following comments by the client indicates that further education is required?

Answer 19

“The medication remains effective for up to 1 year.”

The medication should be replaced every 6 months.

Question 20

The nurse expects to teach the client about the use of transdermal nitroglycerin patches prior to discharge. Which of the following comments by the client indicates a need for further education

Answer 20

“I can carry an extra patch in my pocket in case I have chest pain away from home.”

Question 21

The client in a critical care unit is to receive an IV infusion of nitroglycerin. The nurse prepares to:

Answer 21

mix and administer the solution in a glass bottle.

IV nitroglycerin is mixed and administered in a glass bottle.

Question 22

The nurse is preparing to apply nitroglycerin ointment to a client with hypertension. The nurse first should:

Answer 22

remove the previous ointment dose and wipe the ointment off the skin.

The first of these steps is to remove the previous dose and clean any remaining ointment off to prevent the client from receiving more than the prescribed dose when that next dose is applied.

Question 23

When caring for a client who has experienced an acute myocardial infarction, the nurse would question which of the following prescriptions?

Answer 23

325 mg enteric-coated aspirin stat

Nonenteric-coated aspirin should be used for more rapid absorption.

Question 24

For the client receiving coronary vasodilators for angina pectoris, the nurse would identify which of the following in making a nursing diagnosis?

Answer 24

ineffective cardiac tissue perfusion related to decreased oxygen to tissues
This is the reason for the angina and the need for coronary vasodilators.

Question 25

The client is prescribed both a beta-adrenergic blocking agent and a vasodilator. The nurse:

Answer 25

administers the beta-adrenergic blocker first.

Question 26

When preparing to administer a nitroglycerin ointment dose to the client, the nurse does which action to prevent self-administration of the ointment?

Answer 26

administer the nitroglycerin ointment.
Because ointment can remain on the tube especially around the cap, gloves should be donned before any contact with the ointment occurs.

Question 27

The client is prescribed 0.4 mg nitroglycerin translingual spray 10 to 15 minutes prior to exercise. The pharmacy supplies the spray with 400 mcg/metered dose. The client should:

Answer 27

use 1 metered dose/dose.

0.4 mg = 400 mcg, so client should use 1 metered dose/dose.

Question 28

The health care provider relates to the nurse that she will be prescribing an angiotensin-converting enzyme (ACE) inhibitor for the client who has experienced an acute MI. The nurse recognizes which of the following as ACE inhibitors?

Answer 28

a. captopril
b. ramipril
c. lisinopril
e. trandolapril

Question 29

The client who is receiving ISMO would be monitored for which of the following adverse effects?

Answer 29

a. headache
d. nausea and vomiting
e. vertigo
f. hypersensitivity response

Question 30

The client would receive which of the following instructions concerning ranolazine?

Answer 30

a. The medication can be taken without regard to food.
c. Do not take with grapefruit juice or any grapefruit-containing product.
d. Saint John’s wort may decrease serum levels of ranolazine.
f. Rise slowly from sitting or reclining position.