Which of the following statements regarding the storage of sublingual nitroglycerin is accurate?
It can be stored in an open bottle or pill organizer at room temperature.
It should be stored in a light-resistant container.
Nitroglycerin tablets should be refrigerated to enhance their potency.
It should be discarded after one month after opening, regardless of its appearance.
The Correct Answer is B
Nitroglycerin is a nitrate vasodilator commonly used for the rapid relief and prevention of angina pectoris. Sublingual tablets act quickly by relaxing vascular smooth muscle and improving myocardial oxygen supply while reducing cardiac workload. Because nitroglycerin is highly sensitive to light, heat, air, and moisture, improper storage can reduce its effectiveness. Correct storage is essential to maintain potency and ensure therapeutic action during an acute chest pain episode.
Rationale:
A. Storing nitroglycerin in an open bottle or pill organizer is inappropriate because exposure to air, moisture, and light causes the tablets to lose potency rapidly. The original tightly sealed glass container is specifically designed to protect the medication from environmental degradation. Using pill organizers increases the risk that the client will receive ineffective medication during an angina attack.
B. Nitroglycerin should be stored in a light-resistant container because the medication is highly unstable when exposed to light and air. The original dark-colored glass bottle helps preserve potency and prevents breakdown of the active ingredient. Keeping the lid tightly closed and avoiding transfer to other containers helps ensure the medication remains effective when urgently needed.
C. Refrigeration is not recommended for routine storage of sublingual nitroglycerin tablets. Extreme temperatures and moisture from refrigeration can negatively affect the medication and compromise tablet stability. The preferred storage method is at room temperature in the original light-resistant container, away from heat, humidity, and direct sunlight.
D. Nitroglycerin is not routinely discarded after one month regardless of appearance. Most recommendations advise replacing tablets approximately every 6 months after opening, depending on manufacturer guidance and storage conditions. The key concern is loss of potency rather than visible changes, so the medication should be checked based on expiration guidance rather than an arbitrary one-month rule.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["B","C","D","F"]
Explanation
Primary cancer prevention focuses on reducing exposure to risk factors and strengthening protective behaviors before cancer develops. It targets lifestyle modification, vaccination against oncogenic viruses, and avoidance of known carcinogens. These strategies aim to decrease cellular damage and mutation risk at the earliest stage of disease development. Nurses play a key role in educating clients on evidence-based preventive measures that reduce overall cancer incidence.
Rationale:
A. Providing education on routine screenings by age is not primary prevention because screening is a form of secondary prevention. Screening aims to detect cancer early, before symptoms develop, rather than preventing its occurrence. Examples include mammograms, colonoscopies, and Pap smears, which identify disease at an early stage.
B. Providing education on tobacco cessation is a primary prevention strategy because tobacco use is a major modifiable risk factor for multiple cancers, including lung, oral, and bladder cancer. Eliminating exposure to carcinogens in tobacco significantly reduces cellular damage and mutation risk. Smoking cessation also improves overall respiratory and cardiovascular health.
C. Encouraging the client to maintain a healthy weight and stay physically active is a primary prevention measure. Obesity and sedentary lifestyle are associated with increased risk for cancers such as breast, colorectal, and endometrial cancer. Regular physical activity and weight control help regulate hormones and reduce chronic inflammation linked to cancer development.
D. Suggesting skin protection measures such as sunscreen use is a primary prevention intervention. Ultraviolet (UV) radiation exposure is a major risk factor for skin cancers, including melanoma and basal cell carcinoma. Protective behaviors such as sunscreen application, protective clothing, and limiting sun exposure reduce DNA damage in skin cells.
E. Teaching the client how and when to perform breast self-examination is not considered primary prevention but rather secondary prevention. Self-examination is intended for early detection of existing abnormalities, not prevention of cancer development. It helps identify lumps or changes that may require further diagnostic evaluation.
F. Encouraging hepatitis B and HPV vaccinations is a primary prevention strategy because these infections are linked to cancers such as hepatocellular carcinoma and cervical cancer. Vaccination prevents viral infections that can lead to long-term cellular changes and malignant transformation. Immunization significantly reduces the incidence of virus-associated cancers.
Correct Answer is A
Explanation
Bone marrow suppression leads to decreased production of blood cells, especially white blood cells, red blood cells, or platelets depending on the cause. This condition increases the risk of infection, anemia, and bleeding. Filgrastim is a hematopoietic growth factor used to stimulate neutrophil production and improve immune function in clients with neutropenia. Monitoring improvement focuses primarily on rising white blood cell (WBC) counts, especially neutrophils.
Rationale:
A. A WBC count of 4,800 mm³ indicates improvement because it falls within the lower end of the normal range (approximately 4,000–11,000 mm³). This reflects effective stimulation of bone marrow production by filgrastim and a reduced risk of infection. It shows recovery from neutropenia and improved immune function.
B. A WBC count of 500 mm³ indicates severe neutropenia and a high risk of life-threatening infections. This level reflects significant bone marrow suppression and lack of response to therapy. It is far below normal and represents worsening or unresolved immunosuppression.
C. A hemoglobin level of 11.5 g/dL indicates mild anemia but does not reflect the therapeutic effect of filgrastim. Filgrastim primarily stimulates white blood cell production rather than red blood cell production. Therefore, hemoglobin is not the best indicator of improvement in this case.
D. A platelet count of 150,000 mm³ is within normal limits but does not directly reflect the action of filgrastim. Platelet production is primarily influenced by different growth factors such as thrombopoietin or drugs like oprelvekin. Thus, this value is not the most specific indicator of response to filgrastim therapy.
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