A 73-year-old male patient is in the clinic for a yearly physical and is asking for a prescription for sildenafil. He has listed on his health history that he is taking a nitrate for angina. The nurse is aware that which problem may occur if sildenafil is taken with a nitrate?
Reduced effectiveness of the sildenafil
Significant increase in pulse rate
Increased risk of bleeding
Significant decrease in blood pressure
The Correct Answer is D
Choice A reason: This is incorrect because sildenafil and nitrates do not affect each other's effectiveness, but rather their side effects. Sildenafil is a phosphodiesterase-5 inhibitor that enhances the effect of nitric oxide, which causes vasodilation and increases blood flow to the penis. Nitrates are vasodilators that also increase nitric oxide levels and reduce the workload of the heart.
Choice B reason: This is incorrect because sildenafil and nitrates do not cause a significant increase in pulse rate, but rather a decrease. This is because the vasodilation caused by both drugs lowers the blood pressure and the cardiac output, which reduces the heart rate.
Choice C reason: This is incorrect because sildenafil and nitrates do not increase the risk of bleeding, unless they are combined with other drugs that affect the blood clotting process, such as anticoagulants or antiplatelets.
Choice D reason: This is correct because sildenafil and nitrates can cause a significant decrease in blood pressure when taken together, as they both cause vasodilation and increase nitric oxide levels. This can lead to hypotension, dizziness, fainting, or even a heart attack or stroke. The patient should avoid taking sildenafil and nitrates within 24 hours of each other.

Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A reason: This is incorrect because insulin can be given intravenously in certain situations, such as diabetic ketoacidosis, hyperglycemic hyperosmolar state, or perioperative care.
Choice B reason: This is correct because regular insulin is the only type of insulin that can be administered intravenously, as it is a short-acting insulin that has a rapid onset and peak. Other types of insulin, such as intermediate-acting or long-acting, are not suitable for intravenous use, as they have a delayed onset and peak and may cause hypoglycemia.
Choice C reason: This is incorrect because insulin aspart and insulin lispro are rapid-acting insulins that have a faster onset and peak than regular insulin. They are not recommended for intravenous use, as they may cause severe hypoglycemia. They are usually given subcutaneously before meals to control postprandial blood glucose levels.
Choice D reason: This is incorrect because not all forms of insulin can be administered intravenously, as explained above. Only regular insulin can be given intravenously, and the dose may differ from the subcutaneous dose depending on the patient's blood glucose level and insulin sensitivity.
Correct Answer is D
Explanation
Choice A reason: This is incorrect because hypotension is not a common effect of long-term corticosteroid therapy. Corticosteroids can cause fluid retention and sodium retention, which can lead to hypertension, not hypotension.
Choice B reason: This is incorrect because muscle weakness is not the most impactful effect of long-term corticosteroid therapy on the patient's recovery. Corticosteroids can cause muscle wasting and loss of muscle mass, which can affect the patient's mobility and strength, but not as much as delayed wound healing.
Choice C reason: This is incorrect because osteoporosis is not the most impactful effect of long-term corticosteroid therapy on the patient's recovery. Corticosteroids can cause bone loss and increased risk of fractures, which can affect the patient's bone health and stability, but not as much as delayed wound healing.
Choice D reason: This is correct because delayed wound healing is the most impactful effect of long-term corticosteroid therapy on the patient's recovery. Corticosteroids can impair the inflammatory response and the immune system, which can slow down the healing process and increase the risk of infection. This can affect the patient's recovery time and quality.
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