A nurse is teaching a group of nurses about the administration of nitroglycerin. Which of the following routes of administration has the most rapid onset for the client?
Topical ointment
Sublingual
Transdermal patch
Sustained-release
The Correct Answer is B
A. Topical ointment has a slower onset as it must be absorbed through the skin before it can exert its effects.
B. Sublingual nitroglycerin provides rapid relief of angina symptoms because it is absorbed quickly into the bloodstream through the mucous membranes in the mouth, allowing for an immediate effect.
C. Transdermal patches release nitroglycerin slowly over time, leading to a delayed onset of action.
D. Sustained-release formulations are designed for prolonged effects rather than rapid onset, making them slower to take effect compared to sublingual administration.
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Correct Answer is B
Explanation
A. Bradycardia is not a common side effect of atorvastatin and would not necessarily require immediate reporting unless it is significantly low and symptomatic.
B. Dark-red urine could indicate the presence of myoglobinuria, which can occur due to rhabdomyolysis, a serious side effect of statins like atorvastatin that necessitates immediate medical attention.
C. Elevated HDL cholesterol is generally a positive finding and does not require reporting unless it is part of a larger adverse effect context.
D. A migraine headache, while concerning, is not a known side effect specifically associated with atorvastatin and may not require immediate intervention unless severe or persistent.
Correct Answer is D
Explanation
A. A shuffling gait is more commonly associated with parkinsonism, a side effect of antipsychotic medications, rather than tardive dyskinesia.
B. A sudden onset of high fever could indicate neuroleptic malignant syndrome (NMS), which is a serious reaction to antipsychotic medications, not tardive dyskinesia.
C. Constant tapping of feet when sitting can indicate restlessness or akathisia, but it does not specifically represent tardive dyskinesia.
D. Twisting tongue movements are a classic manifestation of tardive dyskinesia, characterized by involuntary, repetitive movements of the face, tongue, and extremities, which may develop after long-term use of antipsychotic medications like fluphenazine.