N7 Pharmacology Antianiginal Agents

Found at the EVOLVE website

Lilley: Pharmacology and the Nursing Process, 4th Edition

Multiple Choice Review Questions Chapter 23

1.           

Which of the following instructions should be included in the discharge teaching for a patient discharged with a transdermal nitroglycerin patch?

A.            “Apply the patch to a nonhairy, nonfatty area of the upper torso or arms.”

B.            “Apply the patch to the same site each day to maintain consistent drug absorption.”

C.            “If you get a headache, remove the patch for 4 hours and then reapply.”

D.            “If you get chest pain, apply a second patch right next to the first patch.”

2.           

Nitrates relieve angina pain by reducing preload, which is:

A.            Blood volume within the heart

B.            Pressure within the heart

C.            Pressure against which the heart must pump

D.            Oxygen demand of the heart

3.           

Which is a NOT a common side effect of nitroglycerin?

A.            Blurred vision

B.            Flushing

C.            Headache

D.            Hypotension

4.           

Which of the following statements by the patient demonstrates a need for further education regarding nitroglycerin?

A.            “If I get a headache, I should keep taking my nitroglycerin and use Tylenol for pain relief.”

B.            “I should keep my nitroglycerin in a cool, dry place.”

C.            “I should change positions slowly to avoid getting dizzy from the nitroglycerin’s effect on my blood pressure.”

D.            “I can take up to five tablets at 3-minute intervals for chest pain.”

5.           

Calcium channel blockers reduce myocardial oxygen demand by reducing afterload, which is:

A.            Blood volume within the heart

B.            Pressure within the heart

C.            Pressure against which the heart must pump

D.            Contractility of the heart muscle

6.           

Which of the following nitrate preparations or dosage forms has the longest duration of action?

A.            Sublingual nitroglycerin

B.            Sublingual isosorbide dinitrate

C.            Oral isosorbide dinitrate

D.            Transdermal nitroglycerin patch

7.           

In order to prevent the development of tolerance, the nurse instructs the patient to:

A.            Apply the nitroglycerin patch every other day

B.            Switch to sublingual nitroglycerin when the patient’s systolic blood pressure elevates to >140 mm Hg

C.            Apply the nitroglycerin patch for 14 hours each and remove for 10 hours at night

D.            Use the nitroglycerin patch for acute episodes of angina only

8.           

Before administering isosorbide mononitrate (Imdur), a priority assessment would include:

A.            Serum electrolytes

B.            Blood urea nitrogen (BUN) and creatinine

C.            Blood pressure

D.            Level of consciousness

9.           

The patient asks how nitroglycerin should be stored while traveling. The nurse’s best response would be:

A.            “You can protect it from heat by placing the bottle in an ice chest.”

B.            “It’s best to keep it in its original container away from heat and light.”

C.            ‘You can put a few tablets in a resealable bag and carry in your pant’s pocket.”

D.            “It’s best to lock them in the glove compartment of your car to keep them away from heat and light.”

10.           

Patient teaching regarding sublingual nitroglycerin should include which of the following statements:

A.            “You can take up to five doses every 3 minutes for chest pain.”

B.            “Chew the tablet for the quickest effect.”

C.            “Keep the tablets locked in a safe place until you need them.”

D.            “Sit or lie down after you take a nitroglycerin tablet to prevent dizziness.”

11.           

What is the best way to prevent tolerance to nitrates when using the transdermal patches?

A.            Leave the old patch on for 2 hours when applying a new patch

B.            Apply a new patch off for 24 hours once a week

C.            Leave the patch off for 24 hours once a week

D.            Remove the patch at night for 8 hours, and then apply a new patch in the morning

12.           

Which of the following statements indicates that the patient understands discharge teaching about nitroglycerin?

A.            “I will need to refill my prescription once a year in order to maintain potency.”

B.            “I will need to keep the nitroglycerin stored in the bottle it comes in.”

C.            “I will take a nitroglycerin tablet every 15 minutes until my chest pain is gone.”

D.            “I should take a nitroglycerin tablet 2 hours before I want to engage in activity that will cause chest pain.”

13.           

A patient who is taking sublingual nitroglycerin is complaining of flushing and headaches. The nurse’s best response would be:

A.            “This is a normal response to your chest pain.”

B.            “Stop taking the nitroglycerin because you are probably allergic to it.”

C.            “These are the most common side effects of nitroglycerin. They should subside with continued use of nitroglycerin.”

D.            “These symptoms are not related to your sublingual nitroglycerin. You should notify your doctor for diagnostic testing.”

14.           

When applying nitroglycerin ointment, the nurse should:

A.            Use the fingers to spread the ointment evenly over a 3-inch area

B.            Apply the ointment to a nonfat, nonhairy part of the upper torso

C.            Massage the ointment into the skin

D.            Apply two thick lines of ointment over the prescribed measured area on the nitroglycerin paper

15.           

When titrating intravenous nitroglycerin, the nurse monitors:

A.            Blood pressure

B.            Heart rate

C.            Chest pain

D.            All of the above

16.           

A patient receiving intravenous nitroglycerin at 20 mcg/min complains of dizziness. Nursing assessment reveals a blood pressure of 85/40 mm Hg, heart rate of 110 beats/min, and respiratory rate of 16 breaths/min. The nurse’s best response would be to:

A.            Assess the patient’s lung sounds

B.            Decrease the intravenous nitroglycerin by 10 mcg/min

C.            Increase the intravenous nitroglycerin by 10 mcg/min

D.            Recheck the patient’s vital signs in 1 hour

17.           

Nitrates relieve angina pain by reducing afterload, which is:

A.            Blood volume within the heart

B.            Pressure within the heart

C.            Pressure against which the heart must pump

D.            Oxygen demand of the heart

18.           

During patient teaching, the nurse explains that nitroglycerin relieves chest pain primarily by:

A.            Decreasing the workload of the heart

B.            Vasoconstriction of the coronary arteries

C.            Increasing oxygen demand of the heart

D.            Reducing anxiety related to pain