Why is a patient who is using a transdermal nitroglycerin patch instructed to remove the patch at bedtime and apply a new one in the morning?
To avoid allergic response.
To prevent tolerance.
To prevent overdosage.
To prevent the patient from forgetting to remove the patch in the morning.
The Correct Answer is B
Nitroglycerin is a medication that dilates the blood vessels and improves blood flow to the heart. It is used to treat angina, a condition that causes chest pain due to reduced oxygen supply to the heart. However, nitroglycerin can lose its effectiveness over time if it is used continuously. This is called tolerance, and it means that the patient will need higher doses of the medication to achieve the same relief. To avoid tolerance, patients who use transdermal nitroglycerin patches are instructed to remove the patch at bedtime and apply a new one in the morning. This creates a nitrate-free interval of about 8 to 12 hours, which allows the body to restore its sensitivity to nitroglycerin.
Choice A is wrong because an allergic response is not a common side effect of nitroglycerin. Some patients may experience skin irritation or rash at the site of application, but this is usually mild and does not require discontinuation of the medication.
Choice C is wrong because overdosage is unlikely with transdermal nitroglycerin patches. The patches deliver a controlled amount of nitroglycerin through the skin over a period of time. The risk of overdosage is higher with other forms of nitroglycerin, such as tablets or sprays, which are taken as needed for acute angina attacks.
Choice D is wrong because forgetting to remove the patch in the morning is not a serious problem. The patch will continue to deliver nitroglycerin until it is removed, but it will not cause harm to the patient. However, it may reduce the effectiveness of the next patch if there is no nitrate-free interval between them.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Propranolol is a beta-blocker that can cause bronchoconstriction and worsen asthma symptoms.
Asthma is a reversible airway disease that is a contraindication for taking propranolol.
Choice A, tachycardia, is not a contraindication for taking propranolol.In fact, propranolol can be used to treat some types of tachycardia, such as atrial fibrillation or supraventricular tachycardia, by slowing down the heart rate.
Choice C, hypertension, is not a contraindication for taking propranolol.Propranolol can be used to treat hypertension by reducing the cardiac output and peripheral resistance.
Choice D, glaucoma, is not a contraindication for taking propranolol.Propranolol does not affect the intraocular pressure or the aqueous humor production.However, some other beta-blockers, such as timolol, can be used to treat glaucoma by lowering the intraocular pressure.
Correct Answer is B
Explanation
Class IV antidysrhythmics or calcium channel blockers decrease the flow of calcium ions into cardiac and vascular smooth muscle cells, thus decreasing heart rate and contractions.By reducing the calcium influx, they also decrease the slope of phase 0 and 4 and prolong phase 2 of the cardiac action potential.This results in vasodilation, reduced myocardial oxygen demand, and decreased conduction through the AV node.
Choice A is wrong because calcium channel blockers do not increase blood vessel spasm, but rather cause vasodilation.
Choice C is wrong because calcium channel blockers do not decrease refractory period, but rather prolong it by extending phase 2 of the cardiac action potential.
Choice D is wrong because calcium channel blockers do not increase heart rate, but rather decrease it by slowing down the pacemaker activity and AV nodal conduction.
Normal ranges for heart rate are 60 to 100 beats per minute, and for blood pressure are 120/80 mmHg or lower.
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