Diltiazem (Cardizem) is prescribed for a patient with newly diagnosed Prinzmetal’s (variant) angina. Which action of diltiazem is accurate for the nurse to include in the teaching plan?

Correct Answer: C

Rationale: The correct answer is C: Decreases coronary artery spasms. Diltiazem is a calcium channel blocker that works by relaxing and dilating coronary arteries, thereby reducing spasms in Prinzmetal's angina. This action helps to improve blood flow to the heart muscle and alleviate chest pain. Choice A is incorrect because diltiazem does not directly reduce heart palpitations. Choice B is incorrect because diltiazem does not prevent coronary artery plaque buildup. Choice D is incorrect because diltiazem does not increase the contractile force of the heart; in fact, it may actually decrease contractility due to its negative inotropic effects. In summary, the accurate action of diltiazem in the context of Prinzmetal's angina is to decrease coronary artery spasms, which improves blood flow to the heart and relieves chest pain.

Correct Answer: C

Rationale: The correct action is to assess the client's medications first. Step 1: Determine potential causes of bradycardia. Step 2: Medications are common culprits in slowing heart rate. Step 3: Assessing medications can reveal drugs like beta blockers or calcium channel blockers. Step 4: Adjusting medication regimen can potentially resolve bradycardia. This approach addresses the root cause before considering immediate interventions like external pacing or atropine administration. Option A is not proactive in addressing the client's health concern. Option B is premature without identifying the cause. Option D is not indicated without understanding the underlying reason for the bradycardia.

Correct Answer: D

Rationale: The correct answer is D. Exercise to the point of discomfort should be questioned because in patients with peripheral artery disease, it is important to avoid excessive exertion that could worsen symptoms or lead to complications. Cilostazol and omeprazole are commonly used in the management of peripheral artery disease and do not have contraindications with clopidogrel. The use of treadmill for exercise is beneficial for patients with peripheral artery disease as it helps improve circulation and overall cardiovascular health.

Correct Answer: C

Rationale: The correct answer is C because the use of accessory muscles in breathing indicates severe respiratory distress in asthma patients. This finding suggests increased work of breathing and potential impending respiratory failure. Immediate action is necessary to prevent further deterioration. A, B, and D are incorrect as they are concerning but not as critical as the use of accessory muscles, which indicates a more severe condition that requires immediate intervention.

Correct Answer: D

Rationale: The correct answer is D because assisting patients with hygiene is a task that can be safely and appropriately delegated to unlicensed assistive personnel (UAP). UAP are trained to provide basic care such as bathing, grooming, and toileting under the supervision of licensed nurses. This task does not require complex critical thinking skills or clinical judgment. Choice A is incorrect because an initial assessment of a patient requires a licensed healthcare provider due to the need for comprehensive clinical knowledge and critical thinking skills. Choice B is incorrect because determining a nursing diagnosis involves analyzing assessment data and formulating a plan of care, which requires specialized nursing education and training. Choice C is incorrect because evaluating patient progress with the nursing care plan involves interpreting data, making clinical judgments, and modifying the plan of care as needed, which are responsibilities of licensed nurses.