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 D
Explanation
HDL stands for high-density lipoprotein, which is a type of cholesterol that carries excess cholesterol from other parts of the body to the liver, where it can be removed.
HDL is sometimes called “good” cholesterol because it helps protect against heart disease.Having high HDL levels is not a characteristic of metabolic syndrome, but rather a protective factor.
Metabolic syndrome is a group of conditions that increase the risk of heart disease, stroke, and type 2 diabetes.These conditions include:
• Low HDLs (choice A): Having low levels of HDL cholesterol is a risk factor for metabolic syndrome, as it means there is less “good” cholesterol to remove excess cholesterol from the blood vessels.
• Type II diabetes mellitus (choice B): This is a condition where the body does not use insulin properly, leading to high blood sugar levels.
Insulin is a hormone that helps the cells take up glucose from the blood.
Insulin resistance is a key feature of metabolic syndrome.
• Hypertension (choice C): This means having high blood pressure, which can damage the heart and blood vessels over time.
High blood pressure is often associated with obesity and insulin resistance, which are common in metabolic syndrome.
• Abdominal obesity (choice E): This means having excess fat around the waist and trunk, also known as central or visceral obesity.
This type of fat is more harmful than fat in other parts of the body, as it can release inflammatory substances that affect the metabolism and increase the risk of cardiovascular disease.
• Hyperglycemia (choice F): This means having high blood sugar levels, which can damage the blood vessels and organs over time.
Hyperglycemia can result from insulin resistance or type 2 diabetes, which are both components of metabolic syndrome.
The normal ranges for some of these conditions are:
• HDL cholesterol: more than 40 mg/dL for men and more than 50 mg/dL for women
• Blood pressure: less than 120/80 mmHg
• Blood sugar: less than 100 mg/dL after fasting or less than 140 mg/dL two hours after eating
• Waist circumference: less than 40 inches for men and less than 35 inches for women
Correct Answer is B
Explanation
According to the World Health Organization (WHO), noncommunicable diseases (NCDs) are the leading cause of death globally, accounting for 74% of all deaths. NCDs are chronic diseases that are not transmitted from person to person, such as cardiovascular diseases, cancers, chronic respiratory diseases and diabetes.The main risk factors for NCDs are modifiable behaviours, such as tobacco use, physical inactivity, unhealthy diet and the harmful use of alcohol.These behaviours can lead to metabolic risk factors, such as raised blood pressure, increased blood glucose, elevated blood lipids and obesity, which in turn increase the risk of developing NCDs. Therefore, lifestyle changes that reduce these risk factors can prevent or delay many NCDs and improve health outcomes.
Choice A is wrong because trauma is not a major contributing factor to many diseases.Trauma is an injury or damage to living tissue caused by an external force, such as accidents, violence or natural disasters.Trauma can result in acute or chronic conditions, such as infections, fractures, burns, bleeding or organ failure.
However, trauma is not a common cause of NCDs, which are the main burden of disease globally.
Choice C is wrong because congenital factors are not the greatest contributing factor to many diseases.Congenital factors are those that are present at birth, such as genetic disorders, birth defects or inherited diseases.Congenital factors can affect the development and function of various organs and systems in the body, leading to various health problems.
However, congenital factors are not the main cause of NCDs, which are largely influenced by environmental and behavioural factors.
Choice D is wrong because genetics is not the greatest contributing factor to many diseases.
Genetics is the study of how traits are inherited and expressed in living organisms.
Genetics can influence the susceptibility and resistance to various diseases, as well as the response to treatment and prevention strategies.
However, genetics is not the sole determinant of health and disease, as environmental and behavioural factors also play a significant role in modulating gene expression and function.
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