1) A nurse is reinforcing teaching for a client who has angina pectoris and a new prescription to apply a

nitroglycerin transdermal patch daily at home. Which of the following instructions should the nurse

give the client?

ANSWERS - Multiple Choice

1) Fold used patch with medication area to the inside and discard in a closed

receptacle.

Answer Rationale:

It is important to prevent pets, children, and others in the client’s home from coming into contact with the

medication on the nitroglycerin patch. Therefore, the client should be instructed to fold the patch in half with

the medication area to the inside and to discard the patch in a closed receptacle rather than in an open trash

can.

INCORRECT

2) Put a second patch in place if angina pain occurs.

Answer Rationale:

Nitroglycerin transdermal patches are designed for prophylaxis of angina pain and are not to be used to stop an

existing angina attack. Adding a second patch is not appropriate and could cause adverse effects, such as

hypotension. The client should discuss strategies for treating an angina attack with the provider.

INCORRECT

3) Keep a nitroglycerin patch in place 24 hr per day.

Answer Rationale:

Since clients can develop tolerance to nitroglycerin, the transdermal patch should be removed after 12 to 14 hr

each day, and the client should have 10 to 12 hr of time without a patch during the evening and nighttime

hours.

INCORRECT

4) Shave excess hair from skin before applying a nitroglycerin patch.

Answer Rationale:

The client should be instructed to apply the patch to a different hairless area each day. If it is necessary to apply

the patch to an area with hair, the hair should be clipped, not shaved, to avoid irritation to the skin.