A nurse at a provider's office receives a telephone call from a client who reports nausea and has unrelieved chest pain after taking a nitroglycerin tablet 5 min ago. Which of the following is an appropriate response by the nurse?
Advise the client to come into the office.
Advise the client to take an antacid.
Instruct the client to call 911.
Tell the client to take another nitroglycerin tablet in 15 min.
The Correct Answer is C
A. Advise the client to come into the office. The client needs immediate emergency intervention, not a routine office visit.
B. Advise the client to take an antacid. Chest pain unrelieved by nitroglycerin may indicate myocardial infarction; an antacid would not help.
C. Instruct the client to call 911. Persistent chest pain unrelieved by nitroglycerin warrants emergency attention due to potential heart attack.
D. Tell the client to take another nitroglycerin tablet in 15 min. The protocol allows taking an additional dose in 5 minutes, but emergency services should be called for unrelieved chest pain.
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Correct Answer is ["A","C","E"]
Explanation
A. "This medication can make me have mood swings." Beta blockers can cause mood changes, such as depression or mood swings, as a side effect.
B. "I may have urinary incontinence while taking this medication." Urinary incontinence is not a common side effect of beta blockers.
C. "I should not drive while taking this new medication." Beta blockers can cause dizziness or fatigue, so clients should avoid driving until they know how the medication affects them.
D. "I may have frequent hiccups while taking this medication." Hiccups are not a common side effect of beta blockers.
E. "This new medication may decrease my sex drive." Beta blockers can sometimes cause decreased libido as a side effect.
Correct Answer is D
Explanation
A. Schedule deep tissue massage with physical therapy. Massaging the area is contraindicated in cases of suspected deep vein thrombosis (DVT), as it can dislodge the clot, leading to a pulmonary embolism.
B. Monitor Homan's sign. Homan’s sign (pain in the calf upon dorsiflexion) is no longer considered a reliable or safe assessment for DVT due to the risk of dislodging a clot.
C. Obtain platelet aggregation studies. Platelet aggregation studies are not specific to diagnosing a DVT; instead, imaging is preferred.
D. Arrange for a venous duplex ultrasound. A venous duplex ultrasound is a non-invasive test that can confirm the presence of a DVT in the affected extremity.