Nursing practice questions with comprehensive rationales
NurseDive Free Nursing Practice Question
A nurse is teaching a client who has a new prescription for a nitroglycerin transdermal patch.
Which of the following instructions should the nurse include?
A. Apply a new patch if you have chest pain.
Choice A is wrong because nitroglycerin transdermal patches cannot be used to treat an attack of angina once it has begun. They can only be used to prevent attacks of angina. If you have chest pain, you should use another form of nitroglycerin, such as sublingual tablets or spray.
B. Discontinue the patch if you experience a headache.
Choice B is wrong because headache is a common side effect of nitroglycerin transdermal patches and does not mean that you should stop using them. However, you should tell your doctor if the headaches are severe or do not go away. You may also take acetaminophen to relieve the headache.
C. Remove the patch prior to going to bed.
Nitroglycerin transdermal patches are used to prevent episodes of angina (chest pain) in people who have coronary artery disease (narrowing of the blood vessels that supply blood to the heart). They work by relaxing the blood vessels so that the heart does not need to work as hard and therefore does not need as much oxygen.
D. Cover the patch with dry gauze when taking a shower.
Choice D is wrong because you do not need to cover the patch with dry gauze when taking a shower. You may shower while you are wearing a nitroglycerin skin patch. If a patch loosens or falls off, replace it with a fresh one.
This question is an excerpt from Nurse Dive's nursing test bank - ATI RN Pharmacology 2019 Proctored Exam. Take the full exam now
Full Explanation
Nitroglycerin transdermal patches are used to prevent episodes of angina (chest pain) in people who have coronary artery disease (narrowing of the blood vessels that supply blood to the heart). They work by relaxing the blood vessels so that the heart does not need to work as hard and therefore does not need as much oxygen.
Choice A is wrong because nitroglycerin transdermal patches cannot be used to treat an attack of angina once it has begun. They can only be used to prevent attacks of angina. If you have chest pain, you should use another form of nitroglycerin, such as sublingual tablets or spray.
Choice B is wrong because headache is a common side effect of nitroglycerin transdermal patches and does not mean that you should stop using them. However, you should tell your doctor if the headaches are severe or do not go away. You may also take acetaminophen to relieve the headache.
Choice D is wrong because you do not need to cover the patch with dry gauze when taking a shower. You may shower while you are wearing a nitroglycerin skin patch. If a patch loosens or falls off, replace it with a fresh one.
Similar Questions
A nurse is caring for a client who has heart failure.
The nurse administered furosemide 60 mg IV bolus 30 min earlier. For which of the following findings should the nurse notify the provider?
A. BUN 15 mg/dL.
Choice A is wrong because BUN (blood urea nitrogen) is a measure of kidney function and a normal range is 7 to 20 mg/dL. A BUN of 15 mg/dL is not a cause for concern and does not indicate any adverse effect of furosemide.
B. The client reports difficulty hearing.
Furosemide is a diuretic that is used to treat heart failure by reducing fluid retention and lowering blood pressure. It can cause some side effects, such as increased urination, thirst, dry mouth, headache, dizziness, nausea, and electrolyte imbalance.
C. Potassium 3.8 mEq/L.
Choice C is wrong because potassium is an electrolyte that is important for nerve and muscle function and a normal range is 3.5 to 5.0 mEq/L. Potassium of 3.8 mEq/L is within the normal range and does not indicate any adverse effect of furosemide. However, furosemide can cause low potassium levels (hypokalemia) in some cases, so the nurse should monitor the client’s potassium levels regularly and advise the client to eat foods rich in potassium, such as bananas, oranges, and potatoes.
D. The client reports dizziness upon standing.
Choice D is wrong because dizziness upon standing is a common side effect of furosemide and does not require immediate notification from the provider. However, the nurse should instruct the client to rise slowly from a sitting or lying position to prevent falls and to drink enough fluids to prevent dehydration.
Full Explanation
Furosemide is a diuretic that is used to treat heart failure by reducing fluid retention and lowering blood pressure. It can cause some side effects, such as increased urination, thirst, dry mouth, headache, dizziness, nausea, and electrolyte imbalance.
Choice A is wrong because BUN (blood urea nitrogen) is a measure of kidney function and a normal range is 7 to 20 mg/dL.
A BUN of 15 mg/dL is not a cause for concern and does not indicate any adverse effect of furosemide.
Choice C is wrong because potassium is an electrolyte that is important for nerve and muscle function and a normal range is 3.5 to 5.0 mEq/L.
Potassium of 3.8 mEq/L is within the normal range and does not indicate any adverse effect of furosemide. However, furosemide can cause low potassium levels (hypokalemia) in some cases, so the nurse should monitor the client’s potassium levels regularly and advise the client to eat foods rich in potassium, such as bananas, oranges, and potatoes.
Choice D is wrong because dizziness upon standing is a common side effect of furosemide and does not require immediate notification of the provider. However, the nurse should instruct the client to rise slowly from a sitting or lying position to prevent falls and to drink enough fluids to prevent dehydration.
Choice B is correct because difficulty hearing or hearing loss is a rare but serious side effect of furosemide that may indicate ototoxicity (damage to the inner ear). This can be irreversible if not treated promptly and may affect the client’s quality of life and safety. The nurse should notify the provider immediately if the client reports difficulty hearing or any other signs of ototoxicity, such as ringing in the ears (tinnitus) or vertigo (a sensation of spinning). The provider may need to adjust the dose of furosemide or switch to another diuretic that is less ototoxic.
A nurse is providing teaching to a client who has a new prescription for clozapine. Which of the following statements should the nurse include in the teaching?
A. You might experience weight loss while taking this medication.
Choice A is wrong because clozapine can cause weight gain, not weight loss, in some people. This can increase the risk of diabetes, high cholesterol, and heart problems. The nurse should advise the client to monitor their weight regularly and to follow a healthy diet and exercise plan.
B. Ringing in the ears is an expected adverse effect of this medication.
Choice B is wrong because ringing in the ears (tinnitus) is not an expected adverse effect of clozapine. However, clozapine can cause other ear problems, such as otitis media (middle ear infection) or otitis externa (outer ear infection). The nurse should instruct the client to report any ear pain, discharge, or hearing loss to their provider.
C. Notify your provider if you develop a fever while taking this medication.
Clozapine is an antipsychotic medication that is used to treat schizophrenia and other psychotic disorders. It works by affecting the balance of certain chemicals in the brain.
D. Diarrhea is a common adverse effect of this medication.
Choice D is wrong because diarrhoea is not a common adverse effect of clozapine. However, clozapine can cause constipation, which can be severe and lead to bowel obstruction or perforation. The nurse should advise the client to drink plenty of fluids, eat high-fibre foods, and use laxatives as prescribed by their provider.
Full Explanation
Clozapine is an antipsychotic medication that is used to treat schizophrenia and other psychotic disorders. It works by affecting the balance of certain chemicals in the brain.
Choice A is wrong because clozapine can cause weight gain, not weight loss, in some people. This can increase the risk of diabetes, high cholesterol, and heart problems. The nurse should advise the client to monitor their weight regularly and to follow a healthy diet and exercise plan.
Choice B is wrong because ringing in the ears (tinnitus) is not an expected adverse effect of clozapine. However, clozapine can cause other ear problems, such as otitis media (middle ear infection) or otitis externa (outer ear infection). The nurse should instruct the client to report any ear pain, discharge, or hearing loss to their provider.
Choice D is wrong because diarrhoea is not a common adverse effect of clozapine. However, clozapine can cause constipation, which can be severe and lead to bowel obstruction or perforation. The nurse should advise the client to drink plenty of fluids, eat high-fibre foods, and use laxatives as prescribed by their provider.
Choice C is correct because fever is a serious adverse effect of clozapine that may indicate a life-threatening condition called
agranulocytosis. Agranulocytosis is a severe reduction in white blood cells that can impair the immune system and increase the risk of infections. The nurse should instruct the client to notify their provider immediately if they develop a fever or any signs of infection, such as sore throat, cough, or flu-like symptoms. The client should also have regular blood tests to monitor their white blood cell count while taking clozapine.
A nurse is reviewing the list of current medications for a client who is to start a new prescription for carbamazepine.
The nurse should identify which of the following medications interacts with carbamazepine?
A. Beclomethasone.
Choice A is wrong because beclomethasone is a corticosteroid that is used to treat asthma and allergic rhinitis. It does not interact with carbamazepine.
B. Estrogen-progestin combination.
Carbamazepine is an anticonvulsant medication that is used to treat seizures and nerve pain. It works by reducing the activity of certain nerve cells in the brain.
C. Diphenhydramine.
Choice C is wrong because diphenhydramine is an antihistamine that is used to treat allergies, motion sickness, and insomnia. It does not interact with carbamazepine.
D. Nicotine transdermal system.
Choice D is wrong because nicotine transdermal system is a nicotine replacement therapy that is used to help people quit smoking. It does not interact with carbamazepine.
Full Explanation
Carbamazepine is an anticonvulsant medication that is used to treat seizures and nerve pain. It works by reducing the activity of certain nerve cells in the brain.
Choice A is wrong because beclomethasone is a corticosteroid that is used to treat asthma and allergic rhinitis. It does not interact with carbamazepine.
Choice B is correct because the estrogen-progestin combination is a hormonal contraceptive that is used to prevent pregnancy and regulate menstrual cycles. It interacts with carbamazepine because carbamazepine can increase the breakdown of estrogen and progestin in the body, making them less effective. The nurse should instruct the client to use an alternative or additional method of birth control while taking carbamazepine.
Choice C is wrong because diphenhydramine is an antihistamine that is used to treat allergies, motion sickness, and insomnia. It does not interact with carbamazepine.
Choice D is wrong because the nicotine transdermal system is a nicotine replacement therapy that is used to help people quit smoking. It does not interact with carbamazepine.