A nurse is providing teaching to a client who has angina and a new prescription for nitroglycerin tablets. Which of the following instructions should the nurse include in the teaching?
Repeat up to four doses until pain is relieved.
Store unused tablets at room temperature.
Take two tablets at the onset of pain.
Take the medication two hours prior to exercise.
The Correct Answer is B
Choice A rationale
Repeating up to four doses until pain is relieved is incorrect. The correct instruction is to take one tablet at the onset of pain and repeat every 5 minutes if needed, up to a maximum of three tablets in 15 minutes.
Choice B rationale
Storing unused tablets at room temperature is correct. Nitroglycerin tablets should be stored in their original container at room temperature, away from moisture and heat.
Choice C rationale
Taking two tablets at the onset of pain is incorrect. The correct instruction is to take one tablet at the onset of pain and repeat every 5 minutes if needed, up to a maximum of three tablets in 15 minutes.
Choice D rationale
Taking the medication two hours prior to exercise is incorrect. Nitroglycerin should be taken 5 to 10 minutes before an activity that may cause chest pain.
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Correct Answer is B
Explanation
Choice A rationale
Decreased excretion of urine sodium is not an expected therapeutic effect of bumetanide. Bumetanide is a loop diuretic that works by inhibiting the reabsorption of sodium and chloride in the ascending loop of Henle, leading to increased excretion of sodium and water.
Choice B rationale
Increased urinary output is the expected therapeutic effect of bumetanide. As a potent loop diuretic, bumetanide increases the excretion of water and electrolytes, which helps reduce fluid accumulation in conditions like ascites.
Choice C rationale
Decreased serum glucose is not associated with bumetanide. Bumetanide primarily affects fluid and electrolyte balance and does not have a significant impact on blood glucose levels.
Choice D rationale
Increased blood pressure is not an expected effect of bumetanide. On the contrary, bumetanide can help lower blood pressure by reducing fluid volume and decreasing the workload on the heart.
Correct Answer is ["B","C","D","E"]
Explanation
Choice A rationale:
The client’s temperature has decreased from 37.8°C (100°F) to 37.2°C (99°F). While this is a slight reduction, it indicates a move towards a more normal body temperature. Elevated temperatures can be associated with stress, anxiety, or other underlying conditions. A decrease in temperature suggests that the client’s body is stabilizing and that any potential underlying issues causing the elevated temperature are being managed effectively.
Choice B rationale:
The client’s mood has improved as she appears less anxious and more composed during the physical examination. Anxiety can significantly impact a person’s overall well-being, and a reduction in anxiety levels is a positive indicator of improvement. The client also expresses optimism about her recovery, which is a good sign of mental health improvement.
Choice C rationale:
The client has gained weight, increasing from 53 kg (117 lb) to 55 kg (121 lb). Weight gain in this context is a positive sign, indicating that the client’s body is responding well to treatment and that her nutritional status is improving. Unintentional weight loss can be a symptom of underlying health issues, so reversing this trend is a good indicator of recovery.
Choice D rationale:
The client reports better sleep, which is a significant improvement from her previous insomnia. Sleep is crucial for physical and mental health, and improved sleep patterns can lead to better overall health outcomes. Insomnia can exacerbate anxiety and other health issues, so better sleep is a positive sign.
Choice E rationale:
The client’s heart rate has decreased from 120/min to 95/min. A high heart rate can be a sign of anxiety, stress, or other health issues. A reduction in heart rate indicates that the client’s anxiety levels are decreasing and that her cardiovascular system is stabilizing. This is a positive sign of improvement in her overall health.
Choice F rationale:
The client's abdominal findings remained normal from the initial to the follow-up visit, so this does not indicate improvement. These findings were normal to begin with and have stayed unchanged.