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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
According to the International Society of Hypertension, lifestyle interventions are recommended for three to six months before medication in patients with grade 1 hypertension (BP < 160/100 mm Hg) and no comorbidities.Diet and exercise can lower BP by reducing weight, sodium intake, alcohol consumption, and stress levels.
Choice A is wrong because angiotensin-converting enzyme (ACE) inhibitors are not the first-line medication for hypertension in the general population.They are preferred in patients with diabetes, chronic kidney disease, or heart failure.
Choice B is wrong because combination diuretics are not the initial recommendation for hypertension.They are used when monotherapy is not sufficient to achieve the target BP or when there is fluid retention.
Choice C is wrong because beta-adrenergic blocking agents are not the first-line medication for hypertension in the general population.They are preferred in patients with ischemic heart disease, heart failure, or arrhythmias.
Correct Answer is C
Explanation
Antidigoxin is an antidote for digoxin toxicity that binds and inactivates digoxin, a cardiac glycoside that can cause life-threatening arrhythmias, hyperkalemia, and other symptoms when overdosed.Antidigoxin is also known as digoxin immune Fab or DIGIFab.
Choice A, protamine sulfate, is wrong because it is an antidote for heparin, an anticoagulant that can cause bleeding when overdosed.
Choice B, acetylcysteine, is wrong because it is an antidote for acetaminophen, a painkiller that can cause liver damage when overdosed.
Choice D, activated charcoal, is wrong because it is a nonspecific adsorbent that can reduce the absorption of some drugs or poisons from the gastrointestinal tract, but it is not effective for digoxin toxicity.
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