1. Which instruction should be included in the discharge teaching for a patient with a transdermal
nitroglycerin (Nitro-Dur) patch?
A. “If you get chest pain, apply a second patch next to the first patch.”
B. “If you
...
1. Which instruction should be included in the discharge teaching for a patient with a transdermal
nitroglycerin (Nitro-Dur) patch?
A. “If you get chest pain, apply a second patch next to the first patch.”
B. “If you get a headache, remove the patch for 4 hours and then reapply.”
C. “Make sure to rub a lotion or cream on the skin before putting on a new patch.”
D. “Apply the patch to a hairless, nonirritated area of the chest, upper arm, back or shoulder.”
2. The patient states to the nurse, “My friend said nitroglycerin relieves angina pain by reducing
preload. What is preload?” Which statement by the nurse explains preload to this patient?
A. “It is the blood return to the heart.”
B. “It is the oxygen demand of the heart.”
C. “It is the pressure against which the heart must pump.”
D. “It is dilation of arteries and veins throughout the body.”
3. Which statement by the patient demonstrates a need for further education regarding
nitroglycerin (Nitrostat) sublingual tablets?
A. “I should keep my nitroglycerin in a cool, dry place.”
B. “I can take up to four tablets at 5-minute intervals for chest pain.”
C. “If I get a headache, I should keep taking my nitroglycerin and use Tylenol to relieve my
headache.”
D. “I should change positions slowly to avoid getting dizzy from the drug’s effect on my blood
pressure.”
4. Calcium channel blockers reduce myocardial oxygen demand by decreasing afterload. How
would the nurse explain afterload to the patient?
A. It is the contractility of the heart muscle.
B. It is the total volume of blood in the heart.
C. It is the force against which the heart must pump.
D. It is the pressure within the four chambers of the heart.
5. Which dosage form of nitroglycerin has the longest duration of action?
A. Sublingual tablet
B. Transdermal patch
C. Intravenous (IV) infusion
D. Immediate-release tablet
6. To prevent the development of tolerance to nitroglycerin (Nitro-Bid) transdermal patch, the
nurse instructs the patient to perform which action?
A. Apply a new nitroglycerin patch every other day.
B. Use the nitroglycerin patch for acute episodes of angina only.
C. Apply the nitroglycerin patch in the morning and remove it at night for 8 hours.
D. Switch to sublingual nitroglycerin when the systolic blood pressure is greater than 140 mm
Hg.
7. Before administering isosorbide mononitrate (Imdur) sustained-release tablet to a patient,
what is the priority nursing intervention?
A. Obtain a blood pressure reading.
B. Remind the patient to take the tablet before meals.
C. Emphasize that the patient should swallow the tablet whole.
D. Advise the patient that Tylenol is used to treat headache.
8. The patient asks the nurse, “How should sublingual nitroglycerin be stored when I travel?”
What is the nurse’s best response?
A. “You can protect it from heat by placing the bottle in an ice chest.”
B. “It’s best to keep it in its original container away from heat and light.”
C. “You can put a few tablets in a resealable bag and carry it in your pocket.”
D. “Keep it in the glove compartment of your car to prevent exposure to heat.”
9. The nurse is teaching treatment of acute chest pain for a patient prescribed nitroglycerin
(Nitrostat) sublingual tablets. Which instructions should the nurse include?
A. Take five tablets every 3 minutes for chest pain.
B. Sit or lie down before taking medication.
C. Chew or swallow the tablet for the quickest effect.
D. Keep the tablets locked in a safe place until you need them.
10. The nurse is providing discharge teaching for a patient with a new prescription for nitroglycerin
(Nitrostat) sublingual tablets. Which statement by the patient indicates an understanding of the
nurse’s discharge instructions about this medication?
A. “My nitroglycerin tablets are not affected by cold or heat.”
B. “I can take some aspirin if I get a headache related to nitroglycerin.”
C. “I will keep my nitroglycerin tablets in their original glass container.”
D. “I will need to refill my prescription when I feel burning under my tongue.”
11. A patient who is taking nitroglycerin (Nitrostat) sublingual tablets is complaining of flushing
and headaches. What is the nurse’s best response?
A. “Put a cold wet washcloth or use an icepack on your forehead and lie down in a quiet place.”
B. “Stop taking the nitroglycerin because you are experiencing an allergic reaction to the
medication.”
C. “These are the most common adverse effects of nitroglycerin. They should subside with
continued use of nitroglycerin.”
D. “Immediately notify your health care provider because these symptoms are not related to the
sublingual nitroglycerin.”
12. When applying nitroglycerin (Nitro-Bid) ointment, the nurse should perform which action?
A. Massage and then gently rub the ointment into the skin.
B. Apply the ointment to a nonhairy part of the upper torso.
C. Apply a thick layer of ointment on the nitroglycerin paper.
D. Use the fingers to spread the ointment evenly over a 3-inch area.
13. A patient receiving IV nitroglycerin at 20 mcg/min complains of dizziness. Nursing assessment
reveals a blood pressure of 85/40 mm Hg, heart rate of 110 beats/min, and respiratory rate of 16
breaths/min. What is the nurse’s best action?
A. Assess the patient’s lung sounds.
B. Decrease the IV nitroglycerin by 10 mcg/min.
C. Increase the IV nitroglycerin by 10 mcg/min.
D. Recheck the patient’s vital signs in 1 hour.
14. It is MOST important for the nurse to instruct a patient prescribed nitroglycerin to avoid which
substance?
A. Antacids
B. Grapefruit juice
C. Erectile dysfunction drugs
D. Potassium-sparing diuretics
15. When caring for a patient with angina pectoris, the nurse would question a prescription for a
noncardioselective beta blocker in a patient with which preexisting condition?
A. Hypertension
B. Atrial fibrillation
C. Bronchial asthma
D. Myocardial infarction
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