A client has been taking Viagra and is now experiencing angina. The physician has prescribed nitroglycerine PRN for the angina. Which of the following should the RN include in the discharge instructions?
Nitroglycerine and Viagra should be taken at the same time
Viagra is not effective when used in combination with nitroglycerine
Viagra should not be used within 24 hours of taking nitroglycerine
The effect of nitroglycerine is impaired by concurrent use of Viagra
The Correct Answer is C
A. Nitroglycerine and Viagra should be taken at the same time: Taking nitroglycerine and Viagra together is extremely dangerous. Both drugs cause vasodilation and can lead to severe hypotension, syncope, or even cardiovascular collapse. Patients must be explicitly warned against simultaneous use.
B. Viagra is not effective when used in combination with nitroglycerine: The issue is not the efficacy of Viagra but the risk of life-threatening hypotension when the two medications are combined. Effectiveness of Viagra is not the concern; safety is the priority.
C. Viagra should not be used within 24 hours of taking nitroglycerine: The safest practice is to avoid nitrates for at least 24 hours after taking sildenafil (Viagra) due to the risk of profound hypotension. This instruction directly addresses patient safety and is a critical point for discharge teaching to prevent potentially fatal interactions.
D. The effect of nitroglycerine is impaired by concurrent use of Viagra: Nitroglycerine’s effectiveness is not impaired; instead, the combination potentiates vasodilation, leading to dangerously low blood pressure. The concern is additive hypotensive effects, not reduced efficacy of nitroglycerine.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A. Elevated ST segment: ST-segment elevation is typically associated with acute myocardial injury or infarction, not electrolyte imbalances like hypokalemia. While electrolyte disturbances can indirectly affect myocardial conduction, ST elevation is not a classic sign of low potassium levels.
B. Inverted P wave: Inverted P waves are usually related to atrial rhythm disturbances, such as junctional rhythms or ectopic atrial beats. Hypokalemia primarily affects ventricular repolarization and conduction rather than the morphology of the atrial P wave.
C. Abnormally prominent U wave: A prominent U wave on the EKG is a hallmark sign of hypokalemia, reflecting delayed repolarization of the ventricles. It often appears after the T wave and may be accompanied by flattened T waves and ST-segment depression. Recognizing this pattern is critical because severe hypokalemia can precipitate life-threatening arrhythmias.
D. Wide QRS: A widened QRS complex is more commonly associated with hyperkalemia or conduction blocks rather than hypokalemia. Low potassium typically affects repolarization rather than depolarization duration, so a wide QRS is not characteristic.
Correct Answer is A
Explanation
Identify the ordered dose and available concentration
Ordered Dose: 28 units
Available Concentration: 100 units/mL
Since the question asks for units (not mL), the nurse administers the prescribed units directly. The nurse should administer 28 units.
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