What will the nurse instruct the client to do to prevent the development of tolerance to nitroglycerin?

• A. Apply the nitroglycerin patch every other day.
• B. Switch to sublingual nitroglycerin when the client's systolic blood pressure elevates to more than 140 mm Hg.
• C. Apply the nitroglycerin patch for 14 hours and remove it for 10 hours at night.
• D. Use the nitroglycerin patch for acute episodes of angina only.

Answer: (C)

Tolerance to nitroglycerin happens when it’s used continuously; the body adapts and the drug becomes less effective. To keep it working, a daily break from nitrate exposure is needed. For a transdermal nitroglycerin patch, the best approach is to wear it for about 14 hours and remove it for about 10 hours each day, typically overnight. That nitrate-free interval lets vascular smooth muscle regain responsiveness and prevents tachyphylaxis, preserving the medication’s antianginal effect. Other approaches don’t reliably provide this necessary drug-free window or misplace the patch’s use: using it every other day won’t guarantee a consistent nitrate-free period; relying on sublingual nitroglycerin only during elevated blood pressure doesn’t address tolerance; using the patch for acute episodes is inappropriate because patches are meant for ongoing prophylaxis, not immediate relief.