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 D
Explanation
Choice A reason: You should avoid alcohol intake while taking codeine, not limit it to 12 ounces daily. Alcohol can increase the risk of side effects such as drowsiness, dizziness, and respiratory depression.
Choice B reason: You should not expect to experience diarrhea while taking codeine. Codeine can cause constipation, not diarrhea. You should increase your fluid and fiber intake and use laxatives as prescribed to prevent constipation.
Choice C reason: You should not take the medication on an empty stomach to prevent nausea. Codeine can cause nausea and vomiting, especially on an empty stomach. You should take the medication with food or milk to reduce nausea.
Choice D reason: You should change positions slowly while taking codeine. Codeine can cause orthostatic hypotension, which is a sudden drop in blood pressure when you stand up. This can cause dizziness, fainting, and falls. You should change positions slowly and use caution when walking or climbing stairs.
Correct Answer is C
Explanation
Choice A reason: Rotating the injection sites within the same location for a week is not correct. The client should rotate the injection sites within the same location each day to prevent lipodystrophy and ensure consistent absorption.
Choice B reason: Storing the unopened vials of insulin in the freezer is not correct. The client should store the unopened vials of insulin in the refrigerator, not the freezer, to prevent damage to the insulin.
Choice C reason: Drawing up the regular insulin before the NPH insulin is correct. The client should draw up the clear (regular) insulin before the cloudy (NPH) insulin to prevent contamination of the regular insulin with the NPH insulin.
Choice D reason: Injecting the insulin into the muscle for faster absorption is not correct. The client should inject the insulin into the subcutaneous tissue, not the muscle, to ensure appropriate absorption and prevent hypoglycemia.
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