a client with a history of myocardial infarction mi is prescribed nitroglycerin what instruction should the nurse provide about this medication
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ATI Medical Surgical Proctored Exam 2019 Quizlet

1. What instruction should be provided to a client with a history of myocardial infarction (MI) who is prescribed nitroglycerin?

Correct answer: B

Rationale: Nitroglycerin is a medication that should be stored in a dark, glass container to protect it from light and moisture. Exposure to light and moisture can reduce its effectiveness. Storing it in a dark, glass container helps maintain the medication's stability and potency, ensuring that it remains safe and effective for use in emergencies, such as angina attacks.

2. A 28-year-old woman at 34 weeks of gestation presents with elevated liver enzymes and pruritus. Labs reveal total bilirubin to be 4.2 mg/dL, AST 480 U/L, ALT 640 U/L, and alkaline phosphatase 232 U/L. Viral hepatitis serologies and ANA are negative. On physical examination, she is jaundiced, but has a normal blood pressure, no edema, and a soft abdomen. The fetus is in no distress. Which of the following is true?

Correct answer: B

Rationale: The patient's presentation is consistent with intrahepatic cholestasis of pregnancy (ICP), a condition characterized by elevated liver enzymes, pruritus, and jaundice in the absence of other liver disease causes. ICP typically resolves promptly after delivery. Immediate delivery is indicated only for fetal distress, not maternal symptoms. ICP does have a significant risk of recurrence in subsequent pregnancies. Treatment options for ICP include cholestyramine and ursodeoxycholic acid. Screening for long-chain 3-hydroxyacyl-CoA dehydrogenase (LCHAD) deficiency is not indicated in this context as it is associated with acute fatty liver of pregnancy and HELLP syndrome, not ICP.

3. The patient described in the preceding questions has a positive H. pylori antibody blood test. She is compliant with the medical regimen you prescribe. Although her symptoms initially respond, she returns to see you six months later with the same symptoms. Which of the following statements is correct?

Correct answer: C

Rationale: Reinfection with H. pylori is rare, and the persistence of infection usually indicates poor compliance with the medical regimen or antibiotic resistance. A positive serum IgG may persist indefinitely and cannot alone determine the failure of eradication. However, a decrease in quantitative IgG levels has been used to confirm treatment success. The urease breath test is recommended to assess the failure of eradication as it can detect the presence of H. pylori in the stomach, indicating treatment failure if positive.

4. A client with hyperthyroidism is prescribed propylthiouracil (PTU). Which instruction should the nurse include in the client's discharge teaching?

Correct answer: A

Rationale: Propylthiouracil (PTU) can suppress bone marrow function, increasing the risk of infection, so it is important to report signs of infection promptly.

5. The nurse is caring for a client with a spinal cord injury. Which intervention should the nurse implement to prevent autonomic dysreflexia?

Correct answer: C

Rationale: To prevent autonomic dysreflexia in clients with spinal cord injuries, it is crucial to ensure the client's bladder is emptied regularly. Bladder distention is a common trigger for autonomic dysreflexia in these clients. Keeping the bladder empty helps prevent the complications associated with autonomic dysreflexia, such as dangerously high blood pressure. Choices A, B, and D are incorrect. Restricting fluid intake can lead to dehydration, keeping the room warm is not directly related to preventing autonomic dysreflexia, and limiting high-fiber foods is not a primary intervention for this condition.

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