A patient has been diagnosed with angina and will be given a prescription for sublingual nitroglycerin tablets. When teaching the patient how to use sublingual nitroglycerin, the nurse will include which instruction?

Correct Answer: C

Rationale: When teaching a patient how to use sublingual nitroglycerin, it is essential to include the instruction that if the chest pain is not relieved after one tablet, they should call 911 immediately. This is because persistent chest pain could indicate a serious cardiac event, such as a heart attack, that requires immediate medical attention. It is not advisable to take multiple doses without consulting a healthcare provider, as this can lead to complications. The patient should seek emergency medical help if their symptoms are not relieved after taking one tablet of sublingual nitroglycerin.

Correct Answer: D

Rationale: The nurse's priority action would be to discontinue the infusion immediately and notify the prescriber. The patient developing chills and back pain during a blood transfusion may be signs of a transfusion reaction, possibly indicating an incompatibility or adverse reaction to the blood product. It is crucial to stop the transfusion to prevent further complications and to notify the prescriber immediately so that appropriate interventions can be initiated promptly. Observing for other symptoms and slowing the infusion rate are secondary actions compared to discontinuing the infusion and informing the prescriber in this situation. Telling the patient that these symptoms are a normal reaction to the blood product is incorrect as the symptoms could indicate a serious issue that needs to be addressed promptly.

Correct Answer: C

Rationale: The response, "This drug is the first medication your health care provider will use to treat your angina," is accurate because Ranexa (ranolazine) is commonly used as a first-line treatment for chronic angina. It is typically prescribed when other angina medications, such as beta-blockers or calcium channel blockers, are not sufficient or well-tolerated by the patient. Ranexa works by helping the heart muscle to relax, which can improve blood flow to the heart and reduce angina symptoms. It is important for the patient to understand that Ranexa is specifically intended to treat angina and should not be used for other conditions without consulting their healthcare provider.

Correct Answer: D

Rationale: The most concerning adverse effect for an older adult patient taking a vasodilator for hypertension is hypotension, which refers to abnormally low blood pressure levels. Older adults are more susceptible to experiencing drops in blood pressure due to age-related changes in their cardiovascular system. Vasodilators work by dilating blood vessels, which can further lower blood pressure. Excessive hypotension can lead to symptoms such as dizziness, lightheadedness, weakness, and falls, which can be particularly dangerous for older adults who are at a higher risk of injury. Close monitoring of blood pressure and gradual dosage titration are essential in older adult patients to minimize the risk of hypotension.

Correct Answer: C

Rationale: Milrinone (Primacor) is a phosphodiesterase inhibitor that acts by increasing the levels of cyclic adenosine monophosphate (cAMP) in cardiac muscle cells. This leads to an increased force of cardiac contractions, which is known as a positive inotropic effect. This effect results in the heart muscle contracting more forcefully, leading to an increased cardiac output. The other options (A. Increased heart rate, B. Increased blood vessel dilation, D. Increased conduction of electrical impulses across the heart) do not directly relate to the inotropic effect of milrinone.