# A new nitroglycerin transdermal patch is scheduled, and the nurse finds the previous patch still attached to the client. Which action should the nurse take?

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=568892&lang=en  
> language: en  
> subject: Medication Administration  
> category: PPT

## Question

A new nitroglycerin transdermal patch is scheduled, and the nurse finds the previous patch still attached to the client. Which action should the nurse take?

## Option

1. Apply the new patch beside the old patch and document both patches for the next nurse
2. Cut the new patch in half and place both halves over the patch that is already attached
3. Leave the old patch in place until the next scheduled patch-free interval begins
4. Remove the old patch, clean the skin, and place the new patch on a different site **✔ Correct answer**

**Correct answer: 4**

## Explanation

The previous transdermal system is removed before the scheduled replacement, and the new system is applied to a different clean, dry site. Leaving both patches on can deliver unintended medication and increase hypotension or other adverse effects.

## In-depth explanation

Quick answer
Remove the previous patch before applying the scheduled replacement to a different clean, dry site.

Why this is correct
A transdermal patch continues releasing medication while attached. Removing the prior system prevents unintended overlapping delivery, while site rotation reduces local skin irritation and keeps administration consistent with the prescribed schedule.

Easy analogy or mental picture
A patch is like a slow medication tap that stays open while attached; adding another tap increases flow. The comparison explains overlap, but the exact on-off schedule must still follow the prescription and product label.

Memory hook
Patch change sequence: find, remove, clean, rotate, apply, document.

NCLEX decision rule
Before applying a scheduled transdermal medication, inspect for and remove the previous system, verify the ordered schedule, rotate the site, and document removal and application. Never alter or stack patches without an explicit order.

Why the other choices are wrong
Stacking patches risks excess drug delivery. Cutting a system can alter delivery, and postponing removal beyond the ordered schedule leaves medication active longer than intended.References

- [1]NCSBN: 2026 NCLEX-RN Test PlanNational Council of State Boards of Nursing

- [2]Nitroglycerin Transdermal System Prescribing InformationDailyMed, U.S. National Library of Medicine

## Clinical scenario

Clinical Practice Guide
For Insulin glargine mixing question, compare the complete cue pattern with the client's current stability, ordered data, and expected nursing scope.

Caution
Do not choose an action from one isolated cue when the full scenario changes priority or safety.

## Key concepts

- **Insulin Glargine** — A long-acting basal insulin used for background glucose control.
- **Rapid-Acting Insulin** — Insulin used around meals or corrections with a faster onset.
- **Medication Safety** — Practices that reduce medication errors and adverse effects.

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