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 C
Explanation
Choice A reason: Increased intestinal peristalsis is not an effect of adrenergic agonist drugs, but rather of cholinergic drugs, which stimulate the parasympathetic nervous system. Adrenergic agonist drugs activate the sympathetic nervous system, which decreases intestinal motility.
Choice B reason: Bronchial constriction is also not an effect of adrenergic agonist drugs, but rather of cholinergic drugs, which cause bronchoconstriction and increased secretions. Adrenergic agonist drugs cause bronchodilation and decreased secretions.
Choice C reason: Increased heart rate is an effect of adrenergic agonist drugs, which stimulate the beta-1 receptors in the heart, causing increased cardiac output and blood pressure. This is why adrenergic agonist drugs are used to treat conditions such as shock, cardiac arrest, and heart failure.
Choice D reason: Constricted pupils is not an effect of adrenergic agonist drugs, but rather of cholinergic drugs, which cause miosis or pupil constriction. Adrenergic agonist drugs cause mydriasis or pupil dilation.
Correct Answer is A
Explanation
Choice A reason: Tachycardia is a possible adverse effect of theophylline, as it is a methylxanthine that stimulates the central nervous system and the cardiac muscle. The nurse should instruct the client to monitor their pulse rate and report any palpitations, chest pain, or irregular heartbeat.

Choice B reason: Drowsiness is not a likely adverse effect of theophylline, as it is a stimulant that increases alertness and energy. The nurse should caution the client to avoid taking the medication close to bedtime, as it may cause insomnia.
Choice C reason: Constipation is not a common adverse effect of theophylline, as it does not affect the gastrointestinal motility or secretion. The nurse should advise the client to maintain a balanced diet, adequate fluid intake, and regular exercise to prevent constipation.
Choice D reason: Oliguria is not a typical adverse effect of theophylline, as it does not impair the renal function or cause fluid retention. The nurse should encourage the client to drink enough fluids to prevent dehydration and maintain a normal urine output.
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