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: Vaginal cultures are not necessary for oral contraceptive therapy. They are used to diagnose infections such as bacterial vaginosis, yeast infection, or sexually transmitted diseases.
Choice B reason: Complete blood count is not essential for oral contraceptive therapy. It is used to measure the number and types of blood cells, such as red blood cells, white blood cells, and platelets.
Choice C reason: Serum potassium level is the most important laboratory test for oral contraceptive therapy. This is because some oral contraceptives can increase the risk of hyperkalemia, which is a high level of potassium in the blood. Hyperkalemia can cause serious complications such as cardiac arrhythmias, muscle weakness, and paralysis.
Choice D reason: Pregnancy test is not a laboratory test, but a urine test. It is important to rule out pregnancy before starting oral contraceptive therapy, but it is not the most important test for the nurse to assess.
Correct Answer is B
Explanation
Choice A reason: Insulin glargine is not the type of insulin to use for diabetic ketoacidosis, as it is a long-acting insulin that has a duration of 24 hours and no peak effect. It is used to provide basal insulin coverage and prevent hyperglycemia.
Choice B reason: Regular insulin is the type of insulin to use for diabetic ketoacidosis, as it is a short-acting insulin that has an onset of 30 to 60 minutes and a peak of 2 to 4 hours. It is used to lower the blood glucose level rapidly and correct the acidosis.
Choice C reason: Insulin detemir is also not the type of insulin to use for diabetic ketoacidosis, as it is a long-acting insulin that has a duration of 12 to 24 hours and no peak effect. It is also used to provide basal insulin coverage and prevent hyperglycemia.
Choice D reason: NPH insulin is also not the type of insulin to use for diabetic ketoacidosis, as it is an intermediate-acting insulin that has an onset of 2 to 4 hours and a peak of 4 to 12 hours. It is used to provide intermediate insulin coverage and prevent hyperglycemia.
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