A nurse is teaching a client who has a new prescription for transdermal nitroglycerin to treat angina pectoris. Which of the following instructions should the nurse include in the teaching?
Apply a new transdermal patch when chest pain is experienced.
Apply the transdermal patch in the morning.
Apply the transdermal patch in the same location as the previous patch.
Apply a new transdermal patch once a week.
The Correct Answer is B
Choice A reason: Applying a new transdermal patch when chest pain is experienced is not a correct instruction, as it may delay the relief of the pain and increase the risk of adverse effects. Transdermal nitroglycerin is a long-acting form of nitrate that is used for the prevention of angina attacks, not for the treatment of acute episodes. The client should use a short-acting form of nitrate, such as sublingual or spray, for the immediate relief of chest pain.
Choice B reason: Applying the transdermal patch in the morning is a correct instruction, as it helps to maintain a steady level of nitrate in the blood throughout the day and prevent angina attacks. Transdermal nitroglycerin has a duration of action of about 12 to 24 hours, depending on the dose and the individual response. The client should apply the patch in the morning and remove it at night, to allow a nitrate-free interval of at least 8 hours and prevent the development of tolerance.
Choice C reason: Applying the transdermal patch in the same location as the previous patch is not a correct instruction, as it may cause skin irritation and reduce the absorption of the medication. Transdermal nitroglycerin should be applied to a clean, dry, and hairless area of the skin, preferably on the chest, upper arm, or back. The client should rotate the application sites and avoid areas that are exposed to heat, moisture, or friction.
Choice D reason: Applying a new transdermal patch once a week is not a correct instruction, as it may not provide adequate protection against angina attacks and increase the risk of rebound angina. Transdermal nitroglycerin should be applied daily, with a nitrate-free interval of at least 8 hours, to maintain a therapeutic level of nitrate in the blood and prevent the loss of efficacy. The client should follow the prescribed dosing schedule and consult the provider before making any changes.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A reason: Injecting the medication into the abdomen above the level of the iliac crest is the correct action. This is the preferred site for heparin administration, as it has fewer blood vessels and nerves, and allows for better absorption of the medication. The nurse should avoid the area around the umbilicus, as it may have increased bleeding and bruising.
Choice B reason: Massaging the injection site after administration of the medication is not the correct action. This may cause hematoma formation, tissue irritation, and reduced effectiveness of the medication. The nurse should apply gentle pressure to the injection site for 1 to 2 minutes after administration.
Choice C reason: Using a 1-inch needle to inject the medication is not the correct action. This may cause pain, tissue damage, and bleeding. The nurse should use a 25- to 28-gauge needle that is 3/8 to 5/8 inch long to inject the medication.
Choice D reason: Using a 22-gauge needle to inject the medication is not the correct action. This may cause pain, tissue damage, and bleeding. The nurse should use a 25- to 28-gauge needle that is 3/8 to 5/8 inch long to inject the medication.
Correct Answer is C
Explanation
Choice A reason: Platelets 190,000/mm3 is within the normal range of 150,000 to 450,000/mm3. This result does not indicate a bleeding risk or a need to adjust the warfarin dose.
Choice B reason: Hct 44% is within the normal range of 37% to 47% for females and 42% to 52% for males. This result does not indicate anemia or polycythemia, which could affect the warfarin therapy.
Choice C reason: PT 45 seconds is above the normal range of 11 to 13.5 seconds. This result indicates that the blood is taking too long to clot, which increases the risk of bleeding. The nurse should notify the provider and expect a decrease in the warfarin dose.
Choice D reason: Hgb 16 g/dL is within the normal range of 12 to 16 g/dL for females and 14 to 18 g/dL for males. This result does not indicate anemia or polycythemia, which could affect the warfarin therapy.
Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.
Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today
Report Wrong Answer on the Current Question
Do you disagree with the answer? If yes, what is your expected answer? Explain.
Kindly be descriptive with the issue you are facing.