NCLEX Practice Test

Which medication reported by the client during a follow-up appointment requires further investigation?

1. 0.3 mg of nitroglycerin sublingual PRN

2. 10 mg of ezetimibe PO once daily

3. 20 mg of lisinopril PO once daily

4. 200 mg of celecoxib PO once daily

The correct answer is: 0.3 mg of nitroglycerin sublingual PRN

The correct response highlights the need for further investigation regarding the use of 0.3 mg of nitroglycerin sublingual PRN. Nitroglycerin is commonly prescribed for managing angina, but its usage requires careful monitoring due to potential side effects and interactions with other medications. When a client reports using nitroglycerin, several factors must be evaluated, such as the frequency of angina episodes, the appropriateness of the dosage, any recent changes in heart conditions, and the effectiveness of the medication. Continuous reliance on nitroglycerin can indicate poorly managed angina or heart conditions that may require a different therapeutic approach or additional medications. In contrast, the other medications listed—ezetimibe, lisinopril, and celecoxib—are well-established for their respective indications (cholesterol management, hypertension management, and pain or inflammation control). They generally involve established dosing guidelines and monitoring protocols that do not raise immediate flags for further investigation in the same way that nitroglycerin usage might. Thus, nitroglycerin's specific clinical concerns warrant additional assessment to ensure the client's cardiovascular health is appropriately managed.