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The nurse will suspect that the patient with stable angina is experiencing a side effect of the prescribed metoprolol (Lopressor) if
a.the patient is restless and agitated.b.the blood pressure is 190/110 mm Hg.c.the patient complains about feeling anxious.d.the cardiac monitor shows a heart rate of 45.ANS: DPatients taking -blockers should be monitored for bradycardia. Because this category of medication inhibits the sympathetic nervous system, restlessness, agitation, hypertension, and anxiety will not be side effects.DIF:Cognitive Level: ApplicationREF:776TOP:Nursing Process: EvaluationMSC: NCLEX: Physiological Integrity11.Nadolol (Corgard) is prescribed for a patient with angina. To determine whether the drug is effective, the nurse will monitor forBecause the medication is ordered to improve the patient’s angina, effectiveness is indicated if the patient is able to accomplish daily activities without chest pain. Blood pressure (BP) and apical pulse rate may decrease, but these data do not indicate that the goal of decreased angina has been met. The noncardioselective -blockers can cause peripheral vasoconstriction, so the nurse would not expect an improvement in peripheral pulse quality or skin temperature.DIF:Cognitive Level: ApplicationREF:776TOP:Nursing Process: EvaluationMSC: NCLEX: Physiological Integrity12.A patient with a non–ST-segment-elevation myocardial infarction (NSTEMI) is receiving heparin. What is the purpose of the heparin?
Heparin helps prevent the conversion of fibrinogen to fibrin and decreases coronary artery thrombosis. It does not change coronary artery plaque, dissolve already formed clots, or enhance platelet aggregation.DIF:Cognitive Level: ComprehensionREF:775TOP:Nursing Process: ImplementationMSC:NCLEX: Physiological Integrity13.When administering IV nitroglycerin (Tridil) to a patient with a myocardial infarction (MI), which action will the nurse take to evaluate the effectiveness of the medication?The goal of IV nitroglycerin administration in MI is relief of chest pain by improving the balance between myocardial oxygen supply and demand. The nurse also will monitor heart rate and BP and observe for dysrhythmias, but these parameters will not indicate whether the medication is effective.