A male client tells the nurse that he obtained sildenafil without a prescription over the internet, and asks the nurse if it is safe to take. In addition to advising the client to obtain medical evaluation, it is important that the nurse immediately determines if he takes which other type of medication?
Statins, such as atorvastatin.
Analgesics, such as acetaminophen.
Anticoagulants, such as warfarin.
Nitrates, such as nitroglycerin.
The Correct Answer is D
A. Statins, such as atorvastatin: Statins primarily lower cholesterol and have no significant interaction with sildenafil that would cause an urgent safety concern. Although monitoring for muscle-related side effects is important with statins, it is not the priority here.
B. Analgesics, such as acetaminophen: Acetaminophen is generally safe and does not interact dangerously with sildenafil. There is no immediate concern related to combining these two medications.
C. Anticoagulants, such as warfarin: There is a potential for increased bleeding risk when sildenafil is combined with anticoagulants, but this is generally not an acute, life-threatening interaction requiring immediate determination before other more critical concerns.
D. Nitrates, such as nitroglycerin: Taking sildenafil with nitrates can cause profound, life-threatening hypotension. Both sildenafil and nitrates can cause vasodilation, and their combined use can lead to a dangerous and potentially fatal drop in blood pressure. This combination is absolutely contraindicated, and the nurse must immediately assess whether the client uses any nitrate medication to prevent a serious adverse event.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["C","D","F","H"]
Explanation
A. The site for the insulin administration: While site selection is important for absorption consistency, double-checking the injection site with another nurse is not required under insulin safety protocols. It is an individual nursing responsibility.
B. The insulin vial for color and clarity: Although inspecting insulin for proper color and clarity is critical, it does not formally require double-checking with another nurse. It is part of standard administration checks performed by the individual nurse.
C. The dose of insulin drawn up in the syringe: Double-checking the correct dose with another nurse is essential to prevent dosing errors. Insulin is considered a high-alert medication, and the dose must be verified to ensure client safety.
D. The insulin concentration: Insulin comes in different concentrations (e.g., U-100, U-500). Verifying the concentration with a second nurse is vital to avoid giving the wrong dose based on an incorrect strength.
E. The expiration date on the insulin vial: Checking the expiration date is necessary, but it does not formally require a second nurse verification. It is part of safe medication administration practices.
F. The sliding scale insulin lispro prescription: Ensuring the sliding scale prescription is accurately followed is crucial. Double-checking that the blood glucose reading matches the correct insulin dose according to the sliding scale prevents errors.
G. The history and physical with the diabetes diagnosis listed: Confirming a diagnosis is useful background information but is not necessary to double-check before insulin administration. The medication order itself already assumes the clinical need.
H. The type of insulin to be administered: Verifying that the correct type of insulin (e.g., insulin lispro for rapid-acting) is being used is mandatory. A second nurse must confirm that the right insulin type matches the order to avoid administration mistakes.
Correct Answer is C
Explanation
A. History of glaucoma: Glaucoma history is relevant for some medications that increase intraocular pressure, but misoprostol primarily affects the gastrointestinal and reproductive systems. It does not typically worsen glaucoma or require caution for that condition.
B. Taking an antiemetic medication: Although gastrointestinal side effects like nausea can occur with misoprostol, concurrent antiemetic use is not a contraindication. This information is less critical before the first dose compared to other more serious concerns.
C. Currently pregnant: Misoprostol is contraindicated during pregnancy because it can stimulate uterine contractions and cause miscarriage. Determining pregnancy status is crucial before administering the drug to prevent serious harm to both the client and fetus.
D. Allergy to aspirin: While clients with certain allergies require careful medication review, misoprostol is not a nonsteroidal anti-inflammatory drug (NSAID) and does not cross-react with aspirin allergies. Confirming pregnancy status is the more immediate priority.
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