A nurse is evaluating a patient's understanding of nitroglycerin use for angina relief.
Which patient statement indicates the need for further teaching?

This question evaluates the patient's knowledge of the appropriate sublingual administration protocol for managing acute angina. The nurse must identify incorrect administration practices to prevent potential side effects like severe hypotension and to ensure the medication is used safely and effectively for pain relief.

Choice A rationale

Taking two tablets simultaneously is incorrect and unsafe because it significantly increases the risk of sudden, profound hypotension, headache, and reflex tachycardia. Patients are instructed to take only one tablet every 5 minutes, up to a maximum of three total doses.

Choice B rationale

Nitroglycerin patches provide continuous systemic drug delivery. Removing the previous patch is a critical safety step to prevent cumulative drug exposure and the development of tolerance, as well as to minimize the risk of severe localized irritation or systemic toxicity.

Choice C rationale

Prophylactic use of short-acting nitroglycerin is a standard, evidence-based strategy to prevent exercise-induced angina. By using the medication prior to activities known to trigger chest pain, the patient can effectively improve their functional capacity and prevent an acute coronary event.

Choice D rationale

This is the correct sublingual protocol for angina. Taking one tablet and waiting 5 minutes allows time for the vasodilator effect to occur. If the pain persists, the patient must contact emergency services while taking a second dose, up to three.