a nurse is providing teaching to a client who has a new prescription for nitroglycerin transdermal patch which of the following instructions should th

ATI RN

ATI Pharmacology

1. A client has a new prescription for a Nitroglycerin transdermal patch. Which of the following instructions should the nurse include?

A. Apply the patch to a different site each day.
B. Remove the patch at bedtime each day.
C. Apply the patch over an area with little or no hair.
D. Keep the patch on for 24 hours at a time.

Correct answer: B

Rationale: The correct instruction for a client using a Nitroglycerin transdermal patch is to remove the patch each day, usually at bedtime, to prevent tolerance. This practice allows for a nitrate-free interval, reducing the risk of developing tolerance to the medication. Applying the patch to a different site each day (choice A) is not necessary as long as the skin is clean and rotated to avoid skin irritation. Applying the patch over an area with little or no hair (choice C) does not impact the effectiveness of the medication. Keeping the patch on for 24 hours at a time (choice D) can lead to tolerance, which is why the patch should be removed daily.

2. A client with a history of migraine headaches is starting prophylaxis therapy with Propranolol. Which of the following findings in the client history should be reported to the provider by the nurse?

A. The client had a prior myocardial infarction.
B. The client takes warfarin for atrial fibrillation.
C. The client takes an SSRI for depression.
D. An ECG indicates a first-degree heart block.

Correct answer: D

Rationale: Propranolol is contraindicated in clients with a first-degree heart block due to its negative chronotropic properties that can further slow the heart rate. This can worsen conduction through the atrioventricular node, potentially leading to heart block progression. Therefore, the nurse should report the finding of a first-degree heart block to the provider before initiating Propranolol therapy. Choices A, B, and C are not contraindications for Propranolol therapy. A prior myocardial infarction, taking warfarin for atrial fibrillation, or using an SSRI for depression do not directly impact the initiation of Propranolol therapy in a client with a history of migraine headaches.

3. Which of the following conditions is not treated with Nifedipine?

A. Angina
B. Arrhythmias
C. Hypertension
D. Fluid retention

Correct answer: D

Rationale: Nifedipine is a calcium channel blocker primarily used in the management of angina and hypertension. It is not typically used to treat arrhythmias or fluid retention. Angina is chest pain caused by reduced blood flow to the heart, and hypertension is high blood pressure. Therefore, fluid retention is the condition that is not treated with Nifedipine.

4. A client has a new prescription for Spironolactone. Which of the following adverse effects should the nurse instruct the client to monitor?

A. Hyperkalemia
B. Hypoglycemia
C. Hypocalcemia
D. Hyponatremia

Correct answer: A

Rationale: Spironolactone is a potassium-sparing diuretic that can lead to hyperkalemia due to its mechanism of action. Hyperkalemia can cause muscle weakness and cardiac dysrhythmias. Therefore, the nurse should educate the client to monitor for signs and symptoms of hyperkalemia while taking Spironolactone.

5. What is the classification for the drug valproate?

A. Anti-diabetic
B. Anti-convulsant
C. Anti-ulcer agent
D. Anti-hypertensive

Correct answer: B

Rationale: Valproate is classified as an anticonvulsant. It is commonly used to treat epilepsy and bipolar disorder by stabilizing electrical activity in the brain. Therefore, the correct classification for valproate is as an anticonvulsant. Options A, C, and D are incorrect because valproate is not used to treat diabetes, ulcers, or hypertension.