How will the nurse administer a nitroglycerin sublingual tablet to the patient?
Have the patient swallow the tablet with a sip of water.
Crush the tablet and dissolve it in a teaspoon of water.
Place the tablet in the patient’s mouth next to the cheek.
Place the tablet under the patient’s tongue.
The Correct Answer is D
Choice A rationale:
Incorrect because swallowing the tablet with water would lead to slower absorption and a delayed onset of action. Nitroglycerin is rapidly absorbed through the oral mucosa, and swallowing it would route it through the digestive system, where it would be absorbed more slowly and less effectively.
Swallowing the tablet could also increase the risk of side effects, such as headache and flushing, due to the larger amount of the drug that would be absorbed systemically.
Choice B rationale:
Incorrect because crushing the tablet and dissolving it in water would also delay its absorption. This method would require the tablet to dissolve in the water before it could be absorbed through the oral mucosa, which would slow down the onset of action.
Crushing the tablet could also damage the medication and make it less effective.
Choice C rationale:
Incorrect because placing the tablet in the patient's mouth next to the cheek would not allow for optimal absorption. The oral mucosa under the tongue is more permeable than the cheek, so placing the tablet under the tongue allows for faster and more efficient absorption.
Placing the tablet in the cheek could also increase the risk of the patient accidentally swallowing it.
Choice D rationale:
Correct because placing the tablet under the patient's tongue allows for rapid absorption and a quick onset of action. The sublingual route is the preferred method of administration for nitroglycerin because it allows the medication to bypass the digestive system and be absorbed directly into the bloodstream.
This method also allows for the patient to easily remove the tablet if they experience any side effects.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Rationale for Choice A:
While maintaining normal body temperature is important for overall health, it's not the most immediate priority in a patient with fluid volume deficit due to ongoing bleeding. Fluid volume status takes precedence over temperature regulation in this context.
Hypovolemia can lead to hypothermia, but addressing the fluid deficit directly will also help stabilize temperature.
Focusing solely on temperature could delay crucial interventions to address the fluid loss and potentially worsen the patient's condition.
Rationale for Choice B:
An intact surgical incision is essential for proper wound healing and prevention of infection. However, in the context of active bleeding, it's not the priority outcome.
Maintaining adequate fluid volume is crucial to ensure perfusion of tissues, delivery of oxygen and nutrients, and proper organ function—all of which take precedence over incision integrity in this acute situation.
Addressing the fluid deficit will indirectly support wound healing by promoting tissue perfusion and reducing the risk of complications.
Rationale for Choice C:
Patient education is important, but it's not the most immediate priority in a patient with active bleeding and fluid volume deficit.
The patient's ability to comprehend and implement measures to reduce fluid loss may be compromised due to the hypovolemic state and potential cognitive effects.
Focusing on patient education at this stage could delay essential interventions to address the fluid loss and potentially worsen the patient's condition.
Rationale for Choice D:
Urine output is a sensitive and reliable indicator of renal perfusion and overall fluid status. In a patient with fluid volume deficit, maintaining a urine output of at least 30 mL/hour is a key indicator that the kidneys are receiving adequate blood flow and that fluid volume is being restored.
This outcome directly addresses the fluid deficit and serves as a measurable goal for fluid replacement therapy.
It takes priority over other choices because it directly reflects the patient's fluid status and the effectiveness of interventions to address the bleeding and fluid loss.
Correct Answer is A
Explanation
Step 1: Convert the prescribed dose to milligrams. 400 mcg = 0.4 mg (since 1 mg = 1000 mcg)
Step 2: Compare the prescribed dose to the pill strength. The prescribed dose is 0.4 mg.
The pill strength is 0.4 mg.
Step 3: Determine the number of pills needed.
Since the prescribed dose and pill strength are equal, only one pill is needed to administer the correct dose.
Rationale for Choice A:
Correct: One pill of 0.4 mg will provide the exact dose of 400 mcg that has been prescribed.
Direct match: The pill strength matches the prescribed dose, eliminating the need for any calculations or adjustments.
Therapeutic equivalence: Administering one pill ensures that the patient receives the intended amount of medication to achieve the desired therapeutic effect.
Adherence to prescription: Conforms to the healthcare provider's instructions, promoting accurate and safe medication administration.
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