A patient asks how to apply transdermal nitroglycerin. What is the nurse™s best response?
- A. Always apply the transdermal patch over the area of your chest where your heart is.
- B. Keep the previous patch on for 1 full day so you always have two patches on at a tim
- C.
- D. Apply the patch to hairless areas of the body.
Correct Answer: D
Rationale: Transdermal nitroglycerin patches should be applied to clean, dry, hairless areas of the body to ensure proper absorption of the medication. Hair can interfere with the absorption of the medication through the skin. Commonly recommended areas for application include the chest, upper arm, or abdomen. It is important to rotate application sites to prevent skin irritation and to follow the specific instructions provided by the healthcare provider or pharmacist.
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An adolescent client will receive Depo-Provera as a method of birth control. She asks the nurse how long the drug will be effective. What is the best response by the nurse?
- A. 2 months
- B. 6 months
- C. 1 year
- D. 3 months
Correct Answer: D
Rationale: Depo-Provera, a progestin injection, provides contraception by inhibiting ovulation for 3 months , requiring re-administration every 12 weeks. This duration is based on its pharmacokinetic profile, ensuring reliable hormone levels. Two months underestimates, risking unprotected gaps. Six months or 1 year overestimate, reducing efficacy mid-cycle. The nurse's accurate response (D) educates the client on timing, ensuring adherence and preventing unintended pregnancy, aligning with clinical standards for injectable contraceptives.
A client has just been prescribed with methotrexate (Trexall) for the treatment of rheumatoid arthritis who did not respond to any other treatment. An important reminder for the client is to?
- A. Clay-colored stool is a normal response to the treatment.
- B. Pregnancy is not contraindicated with the use of the medication.
- C. Strict hand washing.
- D. Get a daily source of sunlight during the day.
Correct Answer: C
Rationale: Methotrexate is an immunosuppressant, increasing the risk of infections. Strict hand washing and infection prevention measures are crucial. Clay-colored stools are not normal and may indicate liver dysfunction. Pregnancy is contraindicated due to the risk of fetal harm. Sunlight exposure should be limited to reduce the risk of photosensitivity reactions.
A patient with extremely high blood pressure (BP) is in the emergency department. The physician will order therapy with nitroglycerin to manage the patient™s BP. Which form of nitroglycerin is most appropriate?
- A. Sublingual spray
- B. Transdermal patch
- C. Oral capsule
- D. IV infusion
Correct Answer: D
Rationale: In the emergency management of a patient with extremely high blood pressure, intravenous (IV) administration of nitroglycerin is the most appropriate form of delivery. IV infusion provides rapid and precise control of blood pressure by allowing the medication to take effect quickly and be titrated to the desired blood pressure level. This route of administration is crucial in acute settings like the emergency department, where immediate blood pressure management is needed. Other forms of nitroglycerin, such as sublingual spray, transdermal patch, or oral capsule, may not provide the rapid onset of action required in this critical situation.
The pregnant patient tells the nurse that her prescribed medication is not as effective as it was before her pregnancy. What is the best response by the nurse?
- A. This is because your blood volume has increased
- B. Tell me how you have been taking your medication
- C. This is because your baby is receiving part of the medication
- D. Maybe the medication has expired; check the label
Correct Answer: A
Rationale: Pregnancy increases blood volume (50% more), diluting drugs, reducing efficacy-e.g., lower concentration per unit volume, a pharmacokinetic shift. Asking about administration checks adherence, not cause. Baby receiving drug is unlikely-placental transfer varies. Expiration is a guess, not tied to pregnancy. Blood volume explains the change, addressing her concern.
Which of the following is NOT an opioid or NSAID?
- A. Morphine
- B. Ibuprofen
- C. Hydromorpho
- D. Acetaminoph en
Correct Answer: D
Rationale: Acetaminophen is not an opioid or NSAID. It is a pain reliever and fever reducer, but it works in a different way compared to opioids and NSAIDs. Unlike opioids, acetaminophen does not have the same risk of physical dependence or addiction. And unlike NSAIDs, acetaminophen does not have anti-inflammatory properties. It is often used for mild to moderate pain relief and as a fever reducer. Be cautious when taking acetaminophen, as high doses can be harmful to the liver.
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