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

Answer and Explanation

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.

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Correct Answer is C

Explanation

Choice A reason: Respiratory rate and heart rate are not specific indicators of oxygen saturation. They can be affected by many other factors, such as pain, anxiety, or dehydration.

Choice B reason: Blood pressure and temperature are not directly related to oxygen saturation. They can be influenced by other conditions, such as infection, inflammation, or shock.

Choice C reason: Lung sounds and chest expansion are relevant parameters to monitor for a client with low oxygen saturation. They can indicate the presence of respiratory problems, such as pneumonia, asthma, or atelectasis, that can impair gas exchange and oxygen delivery.

Choice D reason: Hemoglobin and hematocrit are measures of red blood cell count and volume. They can affect the oxygen-carrying capacity of the blood, but they are not directly affected by oxygen saturation. They can be altered by other factors, such as bleeding, dehydration, or anemia.

A. Administer with short-acting insulin. B. Assess for hypoglycemia 4 hr after the insulin injection. C. Inject the insulin 15 min before a meal. D. Monitor for polyuria.

Correct Answer is C

Explanation

Choice A reason: This is incorrect because lispro insulin is a rapid-acting insulin that does not need to be administered with another type of insulin. However, the patient may need a long-acting or intermediate-acting insulin to provide basal coverage throughout the day.

Choice B reason: This is incorrect because lispro insulin has a peak action of 30 to 90 min after the injection, which means that the patient is at the highest risk of hypoglycemia during this time. The nurse should assess for hypoglycemia more frequently than 4 hr after the injection.

Choice C reason: This is correct because lispro insulin has a fast onset of action of 15 to 30 min after the injection, which means that the patient should eat a meal within 15 min of the injection to prevent hypoglycemia.

Choice D reason: This is incorrect because polyuria is a sign of hyperglycemia, not hypoglycemia. The nurse should monitor for polyuria before the insulin injection, as it may indicate that the patient's blood glucose level is high.

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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?

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Naxlex Comprehensive Predictor Exams

A nurse is caring for a 58-year-old client who has a low oxygen saturation. The nurse is reviewing the client's data to create a plan of care. Complete the diagram by drawing arrows to connect the condition and two parameters the nurse should monitor to assess the client's progress.

Correct Answer is C

Explanation

A nurse is preparing to administer lispro insulin to a client who has type 1 diabetes mellitus. Which of the following actions should the nurse take?

Correct Answer is C

Explanation

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A woman visits a health center requesting oral contraceptives. Which laboratory test is most important for the nurse to assess before the patient begins oral contraceptive therapy?

A patient will be starting therapy with a corticosteroid. The nurse reviews the prescriber's orders and notes that an interaction may occur if the corticosteroid is taken with which of these drug classes?

During the administration of finasteride, the nurse must remember which important precaution?

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A nurse is reviewing the medication list for a client who has a new diagnosis of type 2 diabetes mellitus. The nurse should recognize which of the following medications can cause glucose intolerance?