This happened to me several years ago w/ a roofing nail. I pulled the nail out and actually didn't give it a second's thought. It was obvious that the hole was no larger than a spoke hole so I couldn't imagine it would have any more impact on the strength of the wheel than a spoke hole. And since there were already 28 or 32 of those (can't remember), I couldn't imagine that one more would have any impact. Again, I was probaby ignorant to not even consider it would be a problem.

I did get a ride from a co-worker that day because it was my second flat of the morning on my way to work and I just thought I should cut my losses. At home, if I recall, I just put a piece of electrical tape over the hole in the rim tape, patched the tube and put the tire back on. I probably smoothed down the edges of the rim hole too, but I think the protrusion was toward the hub and didn't endanger the tube at all.