DVT Exam Rated A+ Brand New!!

DVT Exam Rated A+ Brand New!! Nitroglycerin via the sublingual route is ordered for a client diagnosed with angina. Which of the following would the nurse include when teaching a client how to administer this drug? a) "Apply the medication to your upper chest area." b) "Place the medication under your tongue." c) "Swallow the medication with a sip of water." d) "Tuck the medication into the inside of your cheek." - Answer- "Place the medication under your tongue." Correct Explanation: The nurse should tell the client to keep the medication below the tongue to ensure the sublingual route of administration. The buccal route of administration requires the medication to be kept in the side of the mouth. Oral medications are swallowed; patients should not swallow sublingual tablets. Topical medications are applied to the skin Which of the following terms refers to chest pain brought on by physical or emotional stress and relieved by rest or medication? a) Angina pectoris b) Ischemia c) Atheroma d) Atherosclerosis - Answer- Angina pectoris Correct Explanation: Angina pectoris is a symptom of myocardial ischemia. Atherosclerosis is an abnormal accumulation of lipid deposits and fibrous tissue within arterial walls and lumens. Atheromas are fibrous caps composed of smooth muscle cells that form over lipid deposits within arterial vessels. Ischemia is insufficient tissue oxygenation and may occur in any part of the body A nurse is providing education about hypertension to a community group. One client reports that his doctor has diagnosed him with hypertension, but that he feels just fine. He asks, "What would happen if I did not treat my hypertension?" Which of the following are possible consequences of untreated hypertension? Choose all that apply. a) Tension pneumothorax b) Pancreatitis c) Coronary artery disease d) Stroke e) Myocardial infarction - Answer- Stroke • Myocardial infarction • Coronary artery disease Correct Explanation: People with hypertension may remain asymptomatic for many years. When specific signs and symptoms appear, however, they usually indicate vascular damage. Coronary artery disease with angina and myocardial infarction are common consequences of hypertension. Cerebrovascular involvement may lead to a stroke. Tension pneumothorax and pancreatitis are not directly related to hypertension Which symptom should the nurse teach the client with unstable angina to report immediately to the health care provider (HCP)? a) pain during an argument b) a change in the pattern of the chest pain c) pain during sexual activity d) pain during or after a physical activity - Answer- a change in the pattern of the chest pain Correct Explanation: The client should report a change in the pattern of chest pain. It may indicate increasing severity of coronary artery disease. Pain occurring during stress or sexual activity would not be unexpected, and the client may be instructed to take nitroglycerin to prevent this pain. Pain during or after an activity such as lawn mowing also would not be unexpected; the client may be instructed to take nitroglycerin to prevent this pain or may be restricted from doing such activities As an initial step in treating a client with angina, the health care provider (HCP) prescribes nitroglycerin tablets, 0.3 mg given sublingually. This drug's principal effects are produced by: a) improved conductivity in the myocardium. b) antispasmodic effects on the pericardium. c) causing an increased myocardial oxygen demand. d) vasodilation of peripheral vasculature. - Answer- vasodilation of peripheral vasculature. Correct Explanation: Nitroglycerin produces peripheral vasodilation, which reduces myocardial oxygen consumption and demand. Vasodilation in coronary arteries and collateral vessels may also increase blood flow to the ischemic areas of the heart. Nitroglycerin decreases myocardial oxygen demand. Nitroglycerin does not have an effect on pericardial spasticity or conductivity in the myocardium Patients who are taking beta-adrenergic blocking agents should be cautioned not to stop taking their medications abruptly because which of the following may occur? a) Worsening angina b) Formation of blood clots c) Internal bleeding d) Thrombocytopenia - Answer- Worsening angina Correct Explanation: Patients taking beta blockers are cautioned not to stop taking them abruptly because angina may worsen and myocardial infarction may develop. Beta blockers do not cause the formation of blood clots, internal bleeding, or thrombocytopenia Which of the following signs and symptoms would the nurse expect in a client with angina? Select all that apply. a) General muscle aching b) Slowed respiratory rate c) Jaw pain d) Bradycardia e) Chest pressure f) Chest tightness - Answer- Chest pressure • Jaw pain • Chest tightness Correct Explanation: Chest tightness, chest pressure, and jaw pain are all symptoms of angina. General muscle aching is not associated with angina. Respirations and heart rate typically increase, not decrease, with anginal attacks How should the nurse instruct the client with unstable angina to use sublingual nitroglycerin tablets when chest pain occurs? "Sit down and then: a) take one tablet. If pain persists after 5 minutes call 911." b) take one tablet every 2 to 5 minutes until the pain stops." c) take one tablet and rest for 15 minutes. Call the physician if pain persists after 15 minutes." d) take one tablet, then if the pain persists take 2 additional tablets in 5 minutes. Call the physician if pain persists after 15 minutes." - Answer- take one tablet. If pain persists after 5 minutes call 911." Correct Explanation: The nurse should instruct the client that correct protocol for using sublingual nitroglycerin involves immediate administration when chest pain occurs. Sublingual nitroglycerin appears in the bloodstream within 2 to 3 minutes and is metabolized within about 10 minutes. The client should sit down and place the tablet under the tongue. If the chest pain is not relieved within 5 minutes, then the client should call 911. Although some physicians may recommend taking a second or third tablet spaced 5 minutes apart and then calling for emergency assistance, it is not appropriate to take 2 tablets at once. Nitroglycerin acts within 2 to 3 minutes and the client should not wait 15 minutes to take further action. The client should call 911 to obtain emergency help rather than calling the physician Following a total joint replacement, which complication has the greatest likelihood of occurring? a) displacement of the new joint b) deep vein thrombosis (DVT) c) wound evisceration d) polyuria - Answer- deep vein thrombosis (DVT) Correct Explanation: DVT is a complication of total joint replacement and may occur during hospitalization or develop later when the client is home. Clients who are obese or have previous history of a deep vein thrombosis or pulmonary embolism are at high risk. Immobility produces venous stasis, increasing the client's chance to develop a venous thromboembolism. Signs of a DVT include unilateral calf tenderness, warmth, redness, and edema (increased calf circumference). Findings should be reported promptly to the health care provider (HCP) for definitive evaluation and therapy. Polyuria may be indicative of diabetes mellitus. Displacement of the new joint is unlikely. Wound evisceration is more likely to occur after abdominal surgeries. Knee-high sequential compression devices have been prescribed for a newly admitted client. The client reports new pain localized in the right calf area that is noted to be slightly reddened and warm to touch upon initial assessment. What should the nurse do first? a) Massage the area of discomfort before applying the compression devices. b) Leave the compression devices off, and contact the health care provider (HCP) to report the assessment findings. c) Leave the compression devices off, and report the assessment findings to the oncoming shift. d) Offer analgesics as ordered, and apply the compression devices. - Answer- Leave the compression devices off, and contact the health care provider (HCP) to report the assessment findings. Correct Explanation: Localized pain, tenderness, redness, and warmth may be symptoms of deep vein thrombosis (DVT), information the nurse should report to the HCP; the compression devices should not be applied until further evaluation is completed as intermittent compression may dislodge a thrombus. Massaging the area may dislodge a thrombus and is not recommended. The nurse may offer PRN analgesics if the client requires pain management, but the compression devices should not be applied until further evaluation is completed. Diagnosis and treatment of DVT should be discussed with the HCP as soon as possible; the nurse should not wait until the next shift to report findings as a DVT can become life threatening if a thrombus travels to the lung and becomes a pulmonary embolus