A 73-year-old male patient is in the clinic for a yearly physical and is asking for a prescription for sildenafil (Viagra). 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 decrease in blood pressure
Significant increase in pulse rate
Increased risk of bleeding
The Correct Answer is B
A. Reduced effectiveness of the sildenafil: Sildenafil’s effect is not the primary concern when combined with nitrates; the interaction is about additive vasodilation rather than sildenafil becoming ineffective.
B. Significant decrease in blood pressure: Combining sildenafil (a PDE-5 inhibitor) with nitrates causes marked vasodilation that can produce a dangerous drop in blood pressure (severe hypotension), which is why coadministration is contraindicated.
C. Significant increase in pulse rate: Although reflex tachycardia can occur with hypotension, the main clinically significant and consistently reported problem with sildenafil + nitrates is large decreases in blood pressure rather than a primary sustained pulse increase.
D. Increased risk of bleeding: There is no direct mechanism by which sildenafil combined with nitrates causes increased bleeding risk; the major safety issue is hypotension.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["3.3"]
Explanation
Convert weight to kilograms:
12lb×0.45359237=5.4431kg.
Dose = 15mg/kg×5.4431kg=81.65mg.
Concentration = 125mg/5mL=25mg/mL.
Volume = 81.65mg÷25mg/mL=3.2659mL
rounded to the nearest tenth = 3.3 mL.
Correct Answer is ["100"]
Explanation
Use formula
gtt/min=ml × drop factor/min
(200mL×15gtt/mL)÷30min
=3000÷30
=100gtt/min.
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