A male client reports to the nurse that he took sildenafil for erectile dysfunction but did not achieve an erection. Which of the following considerations should the nurse evaluate to determine possible reasons for the lack of response?

The client's level of sexual stimulation

If taken with a high fat meal, the medication is more effective

The client's recent consumption of caffeine

If client took an additional dose to achieve an erection

Answer and Explanation

The Correct Answer is A

A. The client's level of sexual stimulation
Sildenafil requires sexual stimulation to be effective. It enhances blood flow to the penis but does not automatically cause an erection. The client should be educated that adequate sexual arousal is necessary for the medication to work.

B. If taken with a high-fat meal, the medication is more effective
Taking sildenafil with a high-fat meal can actually delay its absorption and reduce effectiveness. Clients should be advised to take it on an empty stomach or with a light meal for optimal results.

C. The client's recent consumption of caffeine
Caffeine intake does not interfere with sildenafil’s effectiveness. However, excessive caffeine consumption may contribute to vasoconstriction, which could indirectly affect erectile function.

D. If client took an additional dose to achieve an erection
Taking an extra dose of sildenafil is not recommended and can increase the risk of serious side effects such as hypotension, priapism (prolonged erection), and cardiovascular complications. The client should follow prescribed dosing guidelines.

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Correct Answer is B

Explanation

A. Retained placental fragments
This is incorrect because retained placental fragments are more commonly associated with prolonged third-stage labor or incomplete placental expulsion, rather than fetal macrosomia.

B. Uterine atony
This is correct because a large baby (macrosomia) causes overdistension of the uterus, increasing the risk of uterine atony (failure of the uterus to contract effectively). This can lead to postpartum hemorrhage.

C. Puerperal infection
This is incorrect because puerperal infection is usually related to prolonged rupture of membranes, poor hygiene, or invasive procedures, rather than fetal size alone.

D. Thrombophlebitis
While pregnancy increases the risk of clot formation, the most immediate concern for this client is uterine atony and postpartum hemorrhage.

A. "We will monitor your blood pressure to see if it decreases." B. "We will check for a reduction in swelling and fluid retention." C. "We will assess for a decrease in seizure activity and improved reflexes." D. "You should feel less pain and have fewer headaches."

Correct Answer is C

Explanation

A. "We will monitor your blood pressure to see if it decreases."
While magnesium sulfate may have a mild antihypertensive effect, it is not primarily given to lower blood pressure; antihypertensives are used for that purpose.

B. "We will check for a reduction in swelling and fluid retention."
Edema in preeclampsia is due to capillary leakage and kidney dysfunction, not directly affected by magnesium sulfate.

C. "We will assess for a decrease in seizure activity and improved reflexes."
Magnesium sulfate is used primarily as a seizure prophylaxis in preeclampsia by stabilizing the central nervous system and reducing hyperreflexia and clonus, which are signs of worsening preeclampsia.

D. "You should feel less pain and have fewer headaches."
While magnesium sulfate can improve symptoms, it is not an analgesic and does not directly relieve pain.

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A male client reports to the nurse that he took sildenafil for erectile dysfunction but did not achieve an erection. Which of the following considerations should the nurse evaluate to determine possible reasons for the lack of response?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who is 5 hr postpartum following a vaginal birth of a newborn weighing 9 lb 6 oz. (4252 g). The nurse should recognize that this client is at risk for which of the following postpartum complications?

Correct Answer is B

Explanation

A nurse is monitoring a client who is receiving magnesium sulfate for severe preeclampsia. The client asks, "How will I know if the medication is working?" Which response by the nurse is most appropriate?

Correct Answer is C

Explanation

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