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?

Choice A reason: This is incorrect because insulin glargine has a longer duration than 6 to 10 hr. Insulin glargine is a long-acting insulin that provides a steady and continuous level of insulin in the blood. It is usually given once daily at the same time.

Choice B reason: This is incorrect because insulin glargine has a longer duration than 3 to 6 hr. Insulin glargine is not a short-acting or rapid-acting insulin that peaks quickly and lasts for a few hours. It is a long-acting insulin that does not have a peak and lasts for up to 24 hr.

Choice C reason: This is incorrect because insulin glargine has a longer duration than 16 to 24 hr. Insulin glargine is a long-acting insulin that can last for up to 24 hr, but not more than that. It is not an ultra-long-acting insulin that can last for more than 24 hr.

Choice D reason: This is correct because insulin glargine has a duration of 18 to 24 hr. Insulin glargine is a long-acting insulin that provides a steady and continuous level of insulin in the blood. It is usually given once daily at the same time.

Choice A reason: This is incorrect because alendronate is not safe during pregnancy, as it may harm the fetus or cause birth defects. The client should inform the provider if they are pregnant or planning to become pregnant before taking this medication.

Choice B reason: This is incorrect because the client should not lie down for at least 30 minutes after taking alendronate, as this may cause esophageal irritation, ulceration, or bleeding. The client should take alendronate with a full glass of water and swallow it whole, without chewing or crushing.

Choice C reason: This is incorrect because the client should not continue smoking while on alendronate, as smoking can worsen the bone loss and increase the risk of fractures. The client should quit smoking or reduce the amount of cigarettes they smoke.

Choice D reason: This is correct because the client should avoid alcohol with alendronate, as alcohol can also worsen the bone loss and increase the risk of fractures. Alcohol can also interact with alendronate and cause side effects, such as stomach upset, drowsiness, or liver damage.

Choice E reason: This is correct because the client should sit up for at least 30 minutes after taking alendronate, as this can prevent the medication from refluxing back into the esophagus and causing irritation, ulceration, or bleeding. The client should also avoid eating or drinking anything other than water for at least 30 minutes after taking alendronate, as this can reduce its absorption and effectiveness.