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 B
Explanation
Diuretics are drugs that increase the amount of urine and salt (sodium) excreted by the kidneys. They are used to treat high blood pressure, heart failure, and edema (fluid retention). However, some diuretics can cause low levels of potassium in the blood (hypokalemia), which can lead to muscle weakness, cramps, and arrhythmias. To prevent this, a combination of diuretics acting on different parts of the kidney (such as a loop diuretic and a thiazide diuretic) may be prescribed.This way, the potassium-sparing effect of one diuretic can balance the potassium-wasting effect of the other, while still achieving a net sodium loss.
Choice A is wrong because they are not a part of the initial diuretic therapy.Combination diuretic therapy is usually reserved for patients who are resistant to or intolerant of monotherapy.
Choice C is wrong because little follow up is not needed after the initial treatment.Patients on combination diuretic therapy require close monitoring of their blood pressure, electrolytes, renal function, and weight to avoid adverse effects such as dehydration, hyponatremia, hypotension, and worsening renal function.
Choice D is wrong because they do not increase the risk of hypokalemia.As explained above, combination diuretic therapy aims to reduce the risk of hypokalemia by using a potassium-sparing diuretic along with a potassium-wasting diuretic.
Correct Answer is D
Explanation
Taking niacin with an NSAID such as ibuprofen can reduce flushing, the most common adverse effect of niacin therapy. Flushing is a side effect of taking large doses of niacin (vitamin B3) supplements.It happens when the niacin causes the small blood vessels in your skin to dilate so more blood can rush through.Flushing can cause skin redness, warmth, itching, tingling, or burning sensations.
Choice A is wrong because taking niacin before starting daily activities can increase the risk of flushing and interfere with your routine.Flushing usually occurs within 15 to 30 minutes of taking niacin and lasts for about an hour.
Choice B is wrong because taking niacin with a sedative can increase the risk of liver damage, especially if the sedative is acetaminophen (Tylenol).Niacin can also cause liver problems at high doses, so combining it with another liver-toxic drug is not advisable.
Choice C is wrong because taking niacin with grapefruit juice can increase the risk of side effects, such as low blood pressure, dizziness, or fainting.Grapefruit juice can interfere with the metabolism of some drugs, including niacin, and make them more potent or toxic.
Normal ranges for niacin intake vary depending on age and gender.The recommended dietary allowance (RDA) for adult males is 16 mg per day and for adult females is 14 mg per day.Higher doses of niacin may be prescribed by a doctor to treat high cholesterol or other conditions, but they should be taken under medical supervision and with caution.
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