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 A
Explanation
Terazosin is a medication that belongs to the class of alpha-adrenergic blockers, which relax the muscles in the prostate and bladder neck, making it easier to urinate.It also lowers blood pressure by relaxing the veins and arteries, allowing blood to flow more easily.Therefore, terazosin can cause dizziness or fainting, especially when getting up from a sitting or lying position.To prevent this, the patient should rise slowly and avoid standing for long periods or becoming overheated.
Choice B is wrong because terazosin is not a cure for benign prostatic hyperplasia (BPH), but a symptom reliever.Stopping the medication may cause the urinary problems to return or worsen.
The patient should continue taking terazosin as prescribed by the doctor, unless advised otherwise.
Choice C is wrong because decreasing fluid intake may increase the risk of dehydration, urinary tract infections, bladder stones, and kidney problems.
The patient should drink enough fluids to stay hydrated and flush out the urinary system.
Choice D is wrong because grapefruit juice may interact with terazosin and increase its blood levels, leading to more side effects such as low blood pressure, drowsiness, or headache.
The patient should avoid drinking grapefruit juice while taking terazosin, or consult the doctor before doing so.
Correct Answer is D
Explanation
Diuretics are medicines that help the kidneys get rid of excess water and salt, which can ease the symptoms of heart failure, such as breathlessness and swelling.However, diuretics may have some side effects, such as loss of potassium, which can affect the heart and require regular blood tests and dietary changes.Diuretics can also cause other electrolyte abnormalities, such as hyponatremia, hypomagnesemia, hypocalcemia, and metabolic alkalosis. Electrolyte disturbances can have serious consequences for the heart function and rhythm, as well as other organs.
Choice A is wrong because fluid retention is the opposite of what diuretics do.
Diuretics reduce fluid retention by increasing urine output and decreasing blood volume.
Choice B is wrong because hypotension is not a direct effect of diuretics on the heart, but rather a consequence of reduced blood volume and vasodilation.
Hypotension can occur with diuretic use, especially if the dose is too high or the patient is dehydrated, but it is not a specific condition caused by diuretics.
Choice C is wrong because hyperglycemia is not related to diuretics or heart failure.
Hyperglycemia is a condition of high blood sugar, which can be caused by diabetes or other factors.
Diuretics do not affect blood sugar levels directly, although some diuretics may interact with diabetes medications and affect their efficacy.
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