A nurse is providing teaching to a client who has angina and is prescribed nitroglycerin sublingual tablets. Which of the following statements by the client indicates an understanding of the teaching?

Choice A reason: Nitroglycerin is a vasodilator used to relieve angina by dilating coronary arteries, improving blood flow to the myocardium. Standard protocol advises taking one sublingual tablet every 5 minutes for up to three doses. If pain persists after three tablets (15 minutes), it may indicate a myocardial infarction, requiring immediate emergency intervention. This choice reflects correct understanding of the timing and action needed for unresolved angina. Choice B reason: Taking one nitroglycerin tablet and immediately calling 911 if pain persists is incorrect, as it does not follow the standard protocol of administering up to three tablets at 5-minute intervals. This approach risks delaying necessary treatment, as a single dose may not suffice to relieve angina, and premature emergency calls without completing the protocol could lead to unnecessary interventions. Choice C reason: Taking four nitroglycerin tablets over 20 minutes deviates from the standard protocol, which recommends three tablets at 5-minute intervals (total 15 minutes). Extending the duration or number of doses without seeking emergency care could delay critical treatment for a potential myocardial infarction, as persistent pain beyond three doses indicates a serious condition requiring immediate medical attention. Choice D reason: Calling 911 immediately upon experiencing angina before taking nitroglycerin tablets is incorrect. The standard protocol involves administering nitroglycerin first to attempt pain relief, as angina may resolve with vasodilation. Immediate emergency calls without attempting the prescribed treatment could lead to unnecessary hospitalizations and overlook the medication’s potential to alleviate symptoms effectively.