A nurse is teaching a client who has a new prescription for a transdermal nitroglycerin patch. Which of the following instructions should the nurse include?
Apply the patch to the same site each day
Remove the patch at night
Cut the patch in half if dizziness occurs
Apply the patch to the upper arm only
The Correct Answer is B
Choice A reason: Applying the patch to the same site daily risks skin irritation and reduced absorption. Rotating sites (e.g., chest, arms) ensures efficacy, making this an incorrect instruction.
Choice B reason: Removing the nitroglycerin patch at night provides a nitrate-free period, reducing tolerance and maintaining efficacy. This is standard practice, making it the correct instruction for the client.
Choice C reason: Cutting the patch disrupts the controlled-release mechanism, causing unpredictable dosing and risks. Dizziness requires medical evaluation, not patch modification, making this incorrect and unsafe.
Choice D reason: Limiting application to the upper arm restricts options. Patches can be applied to hairless areas like the chest or back, making this unnecessarily restrictive and incorrect.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A reason: Decreased skin elasticity is an expected finding in an 84-year-old, as aging reduces collagen and elastin, causing thinner, less resilient skin. This physiological change increases wrinkling and fragility, making it a common and anticipated sign in elderly patients.
Choice B reason: Increased muscle strength is not expected in an 84-year-old, as aging leads to sarcopenia, reducing muscle mass and strength. This causes weakness and mobility issues, making this an incorrect finding for an elderly patient’s typical presentation.
Choice C reason: Enhanced night vision is not typical in aging; older adults often experience reduced night vision due to retinal changes and slower pupil adaptation. This makes night vision an incorrect expected finding for an 84-year-old patient.
Choice D reason: Improved short-term memory is not expected, as aging often impairs short-term memory due to neuronal loss and slower cognitive processing. Memory decline is common in the elderly, making this an incorrect finding for an 84-year-old.
Correct Answer is B
Explanation
Choice A reason: Oranges have minimal vitamin K, which does not significantly affect warfarin’s anticoagulant effect. They are safe for consumption, making this an incorrect food to avoid.
Choice B reason: Spinach is high in vitamin K, which counteracts warfarin by promoting clotting factor synthesis. Clients should limit such foods to maintain stable anticoagulation, making this the correct choice.
Choice C reason: Chicken breast is low in vitamin K and does not interfere with warfarin. It is a safe protein source, making it incorrect to include in foods to avoid.
Choice D reason: White bread contains negligible vitamin K, having no significant impact on warfarin efficacy. It is safe for consumption, making it incorrect for the teaching.
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