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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Intermittent claudication is a condition where leg pain is produced upon increased activity and ischemia to tissues, but then the pain is reduced with rest.This is because the lack of oxygen to the muscles causes pain, and resting allows the blood flow to resume.
Choice B, sporadic ischemia, is wrong because it is not a specific condition, but a general term for reduced blood supply to a tissue or organ.
Choice C, angina, is wrong because it is a chest pain caused by reduced blood flow to the heart, not the legs.
Choice D, paresthesia, is wrong because it is a sensation of tingling, numbness, or prickling in the skin, not pain.
It can be caused by various conditions, such as nerve damage, diabetes, or Raynaud’s disease.
Correct Answer is B
Explanation
Furosemide is a diuretic that lowers blood pressure and increases urine output. It also causes potassium loss, which can lead to hypokalemia (low potassium levels). The patient’s blood pressure is already low when sitting, and the serum potassium is below the normal range of 3.5 to 5.0 mEq/L. Administering furosemide could worsen these conditions and cause adverse effects such as dehydration, dizziness, muscle weakness, cardiac arrhythmias, and renal impairment. Therefore, the nurse should contact the provider before giving the medication and report the vital signs and laboratory results.
Choice A. Administer medication is wrong because it could harm the patient as explained above.
Choice C. Hold medication until next dose is wrong because it does not address the underlying problem of fluid retention and hypokalemia.
The nurse should not delay notifying the provider about the patient’s condition.
Choice D. Check urine output before giving medication is wrong because it is not enough to ensure the patient’s safety.
The nurse should also check the blood pressure and serum potassium levels, which are more critical indicators of the patient’s status.
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