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NurseDive Free Nursing Practice Question
A client who has chronic stable angina is being discharged. Which statement by the client indicates an understanding of the discharge teaching?
A. I should not experience chest pain since I am on aspirin therapy.
I should not experience chest pain since I am on aspirin therapy is not a statement that indicates an understanding of the discharge teaching. This statement is false and misleading, as aspirin therapy does not prevent or relieve angina, but only reduces the risk of blood clots and heart attacks. The client should be instructed to take nitroglycerin as prescribed for chest pain and to seek medical attention if the pain persists or worsens.
B. The chest pain is caused by a spasm in my heart.
The chest pain is caused by a spasm in my heart is not a statement that indicates an understanding of the discharge teaching. This statement is inaccurate and incomplete, as chest pain can have different causes and mechanisms. The client should be educated about the types and triggers of angina, such as stable, unstable, or variant angina, and how they are related to the reduced blood flow and oxygen supply to the heart muscle.
C. Each time I have chest pain, my heart is damaged more.
Each time I have chest pain, my heart is damaged more is not a statement that indicates an understanding of the discharge teaching. This statement is exaggerated and pessimistic, as chest pain does not necessarily imply permanent or irreversible damage to the heart. The client should be encouraged to adopt a positive and proactive attitude and to follow the recommended lifestyle modifications and medications to prevent or minimize angina episodes and complications.
D. I should hire someone to shovel snow in the winter.
I should hire someone to shovel snow in the winter is a statement that indicates an understanding of the discharge teaching. This statement is sensible and realistic, as shoveling snow is a strenuous and cold activity that can trigger or exacerbate angina. The client should be advised to avoid or limit physical exertion, especially in extreme temperatures, and to pace themselves and rest as needed.
This question is an excerpt from Nurse Dive's nursing test bank - Ati Med Surg Nursing 200 Proctored Exam. Take the full exam now
Similar Questions
The nurse has provided discharge teaching to a client prescribed nitroglycerin SL. Which statement, made by the client, indicates that the teaching has been effective? I will:
A. throw away any tablets that fizzle under my tongue, it means they are ineffective.
B. keep my bottle of nitroglycerin at home in the medicine cabinet.
C. call 911 if I get chest pain that doesn't go away after one tablet and I will take another tablet.
D. remove the tablets from the bottle and keep them in a plastic bag in my handbag.
Full Explanation
Choice A reason: Throwing away any tablets that fizzle under my tongue, it means they are ineffective is not a statement that indicates an understanding of the discharge teaching. This statement is incorrect and dangerous, as fizzling or tingling is a normal sensation that indicates that the tablet is working. The client should not discard or waste the medication, but keep it in a dark, dry, and cool place.
Choice B reason: Keeping my bottle of nitroglycerin at home in the medicine cabinet is not a statement that indicates an understanding of the discharge teaching. This statement is impractical and risky, as the client may need the medication when they are away from home. The client should always carry the medication with them and have it readily available in case of chest pain.
Choice C reason: Calling 911 if I get chest pain that doesn't go away after one tablet and I will take another tablet is a statement that indicates an understanding of the discharge teaching. This statement is correct and safe, as it follows the standard protocol for using nitroglycerin SL for angina. The client should take one tablet under the tongue at the onset of chest pain, wait five minutes, and repeat if the pain persists. If the pain is not relieved after three tablets, the client should seek emergency medical attention.
Choice D reason: Removing the tablets from the bottle and keeping them in a plastic bag in my handbag is not a statement that indicates an understanding of the discharge teaching. This statement is inappropriate and harmful, as it exposes the medication to light, moisture, and heat, which can reduce its potency and effectiveness. The client should keep the tablets in their original container and close it tightly after each use.
A patient has recently started ferrous sulfate 500 mg by mouth two times per day for anemia. Which of the following data would indicate to the nurse that the therapy is successful?
A. International normalized ratio 1.3 seconds
The international normalized ratio (INR) is a measure of the blood's ability to clot. It is not affected by ferrous sulfate therapy, which is used to treat iron deficiency anemia. The normal range of INR is 0.8 to 1.2 seconds.
B. Hemoglobin 14 g/dL
Hemoglobin is the protein in red blood cells that carries oxygen. It is the main indicator of anemia and the response to iron therapy. The normal range of hemoglobin for adults is 12 to 18 g/dL. A hemoglobin level of 14 g/dL suggests that the patient's anemia has improved with ferrous sulfate therapy.
C. Serum iron 150 mcg/dL
Serum iron is the amount of iron in the blood. It is not a reliable indicator of anemia or iron therapy, as it can fluctuate with dietary intake, infection, inflammation, and other factors. The normal range of serum iron for adults is 50 to 170 mcg/dL.
D. Platelet count 250,000/mm3
Platelet count is the number of platelets in the blood. Platelets are involved in blood clotting and wound healing. They are not affected by ferrous sulfate therapy, which is used to treat iron deficiency anemia. The normal range of platelet count for adults is 150,000 to 450,000/mm3.
Full Explanation
Choice A reason: The international normalized ratio (INR) is a measure of the blood's ability to clot. It is not affected by ferrous sulfate therapy, which is used to treat iron deficiency anemia. The normal range of INR is 0.8 to 1.2 seconds.
Choice B reason: Hemoglobin is the protein in red blood cells that carries oxygen. It is the main indicator of anemia and the response to iron therapy. The normal range of hemoglobin for adults is 12 to 18 g/dL. A hemoglobin level of 14 g/dL suggests that the patient's anemia has improved with ferrous sulfate therapy.
Choice C reason: Serum iron is the amount of iron in the blood. It is not a reliable indicator of anemia or iron therapy, as it can fluctuate with dietary intake, infection, inflammation, and other factors. The normal range of serum iron for adults is 50 to 170 mcg/dL.
Choice D reason: Platelet count is the number of platelets in the blood. Platelets are involved in blood clotting and wound healing. They are not affected by ferrous sulfate therapy, which is used to treat iron deficiency anemia. The normal range of platelet count for adults is 150,000 to 450,000/mm3.
In preparation for a patient having a Schilling test, the nurse should explain that the test:
A. will confirm a diagnosis of G6PD anemia.
The Schilling test is not used to diagnose G6PD anemia, which is a genetic disorder that causes red blood cells to break down when exposed to certain substances. The Schilling test is used to measure how well the body absorbs vitamin B12 from the intestine. ¹²
B. requires the patient to be NPO for 12 hours prior to the test.
The Schilling test does not require the patient to be NPO (nothing by mouth) for 12 hours prior to the test. The patient can drink water, but should avoid food for 8 hours before the test. ²
C. is a 24-hour urine specimen collection test.
The Schilling test is a 24-hour urine specimen collection test. The patient is given a dose of radioactive vitamin B12 by mouth and another dose of nonradioactive vitamin B12 by injection. The urine is collected for 24 hours to measure how much of the radioactive vitamin B12 is excreted. This indicates how well the body absorbs vitamin B12 from the intestine. ¹²
D. entails administration of methylcellulose prior to the test.
The Schilling test does not entail administration of methylcellulose prior to the test. Methylcellulose is a type of laxative that can interfere with the absorption of vitamin B12. The patient should avoid taking any laxatives, antacids, or antibiotics before the test. ²³
Full Explanation
Choice A reason: The Schilling test is not used to diagnose G6PD anemia, which is a genetic disorder that causes red blood cells to break down when exposed to certain substances. The Schilling test is used to measure how well the body absorbs vitamin B12 from the intestine. ¹²
Choice B reason: The Schilling test does not require the patient to be NPO (nothing by mouth) for 12 hours prior to the test. The patient can drink water, but should avoid food for 8 hours before the test. ²
Choice C reason: The Schilling test is a 24-hour urine specimen collection test. The patient is given a dose of radioactive vitamin B12 by mouth and another dose of nonradioactive vitamin B12 by injection. The urine is collected for 24 hours to measure how much of the radioactive vitamin B12 is excreted. This indicates how well the body absorbs vitamin B12 from the intestine. ¹²
Choice D reason: The Schilling test does not entail administration of methylcellulose prior to the test. Methylcellulose is a type of laxative that can interfere with the absorption of vitamin B12. The patient should avoid taking any laxatives, antacids, or antibiotics before the test. ²³