A male client tells the nurse that he obtained sildenafil without a prescription over the internet, and asks the nurse if it is safe to take. In addition to advising the client to obtain medical evaluation, it is important that the nurse immediately determines if he takes which other type of medication?
Statins, such as atorvastatin.
Analgesics, such as acetaminophen.
Anticoagulants, such as warfarin.
Nitrates, such as nitroglycerin.
The Correct Answer is D
A. Statins, such as atorvastatin: Statins primarily lower cholesterol and have no significant interaction with sildenafil that would cause an urgent safety concern. Although monitoring for muscle-related side effects is important with statins, it is not the priority here.
B. Analgesics, such as acetaminophen: Acetaminophen is generally safe and does not interact dangerously with sildenafil. There is no immediate concern related to combining these two medications.
C. Anticoagulants, such as warfarin: There is a potential for increased bleeding risk when sildenafil is combined with anticoagulants, but this is generally not an acute, life-threatening interaction requiring immediate determination before other more critical concerns.
D. Nitrates, such as nitroglycerin: Taking sildenafil with nitrates can cause profound, life-threatening hypotension. Both sildenafil and nitrates can cause vasodilation, and their combined use can lead to a dangerous and potentially fatal drop in blood pressure. This combination is absolutely contraindicated, and the nurse must immediately assess whether the client uses any nitrate medication to prevent a serious adverse event.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. Positive guaiac of stool: A positive guaiac test indicates the presence of blood in the stool, suggesting gastrointestinal bleeding. Given the client’s history of frequent ibuprofen use, which can cause gastric ulcers and GI bleeding, this is a critical finding that must be reported immediately to the healthcare provider.
B. Hemoglobin 13 g/dL (130 g/L): Although slightly below the normal reference range for males, a hemoglobin of 13 g/dL is not critically low. It suggests mild anemia but is not an urgent finding compared to evidence of active gastrointestinal bleeding.
C. Hematocrit 42% (0.42 volume fraction): A hematocrit of 42% falls within the normal reference range for a male client. Therefore, this finding is stable and does not require immediate reporting in the context of the client's current symptoms.
D. Gastric pH 2: A gastric pH of 2 is within the normal range for stomach acid levels (1.5 to 3.5). The current gastric pH suggests that their acid production is within expected limits and is not the immediate concern. This value does not indicate any acute problem by itself and would not require immediate notification of the healthcare provider.
Correct Answer is B
Explanation
A. Obtain a specimen for a urine culture: A urine culture is necessary when infection is suspected, typically indicated by symptoms like burning, urgency, or foul odor. Darker urine alone in a client on carbidopa/levodopa is not an indication for infection testing.
B. Explain the color change is normal: Carbidopa/levodopa can cause harmless discoloration of bodily fluids, including darker urine, sweat, and saliva due to the metabolism and excretion of the medication. This is a well-known and non-threatening side effect that does not require intervention beyond client reassurance.
C. Measure the client's urinary output: Monitoring urinary output is important in cases of suspected dehydration or renal dysfunction, but simply darker urine without changes in volume or symptoms does not justify additional measurement in this scenario.
D. Encourage an increase in oral intake: While adequate hydration is always encouraged, the urine color change reported here is due to the medication itself, not dehydration. Therefore, increasing fluid intake will not reverse or prevent the discoloration.
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