NCLEX Practice Test

Which medication requires further investigation during medication reconciliation?

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 choice of nitroglycerin sublingual PRN warrants further investigation during medication reconciliation due to its specific usage and potential for side effects or interactions. Nitroglycerin is typically used for the management of chest pain or angina, and its administration requires careful consideration of the patient's cardiovascular status, other concurrent medications, and their overall health condition. For example, if the patient is taking medications that lower blood pressure or other nitrates, this could lead to complications like hypotension. Furthermore, the PRN schedule indicates that its use is based on symptomatic needs, which necessitates thorough assessment of the frequency of its use, how well the patient responds, and whether additional treatment adjustments are needed. In contrast, the other medications listed—ezetimibe, lisinopril, and celecoxib—are more stable choices typically used for ongoing management of chronic conditions (like hyperlipidemia, hypertension, and arthritis, respectively). These medications are used with less immediate risk concerning acute management and are generally easier to incorporate into a medication regimen without urgent monitoring unless there are other complicating factors. Thus, nitroglycerin’s unique characteristics and implications for patient safety make it essential for further scrutiny during medication reconciliation.