A nurse is reinforcing teaching with a client who has angina and a new prescription for nitroglycerin sublingual. Which of the following statements by the client indicates an understanding of the teaching?

Choice A rationale If pain is not relieved in 20 minutes, taking a second tablet is incorrect. For sublingual nitroglycerin, the client should take one tablet at the onset of angina. If pain persists after 5 minutes, they should take a second tablet. If pain persists after another 5 minutes (a total of 10 minutes), they should take a third tablet and call emergency services. Choice B rationale Storing tablets on a shelf in the bathroom is inappropriate. Nitroglycerin is highly sensitive to light, heat, and moisture, which can degrade its potency. Storing it in a bathroom, a typically warm and humid environment, will significantly reduce its effectiveness. It should be kept in a cool, dry, dark place in its original amber glass bottle. Choice C rationale Swallowing the tablet whole is incorrect for sublingual nitroglycerin. This medication is designed for sublingual absorption, meaning it dissolves under the tongue to allow direct entry into the bloodstream, bypassing first-pass metabolism in the liver. Swallowing it whole would lead to hepatic inactivation, reducing its therapeutic effect. Choice D rationale A dry mouth can impede the dissolution and absorption of sublingual nitroglycerin. Saliva is essential for dissolving the tablet and facilitating its absorption across the mucous membranes. Taking a sip of water beforehand can moisten the oral cavity, ensuring proper dissolution and optimal therapeutic effect of the medication.