Nursing Elites

1. A healthcare professional in a provider's clinic is caring for a client who reports erectile dysfunction and requests a prescription for sildenafil. Which of the following medications currently prescribed for the client is a contraindication to taking sildenafil?

• A. Isosorbide
• B. Phenytoin
• C. Metronidazole
• D. Prednisone

Correct answer: A

Rationale: Sildenafil is contraindicated with nitrates like isosorbide due to the risk of severe hypotension. Isosorbide is a nitrate that can potentiate the hypotensive effects of sildenafil, leading to a dangerous drop in blood pressure. Therefore, it is essential to avoid concurrent use of isosorbide and sildenafil to prevent adverse effects. Phenytoin, metronidazole, and prednisone do not have significant interactions with sildenafil and are not contraindicated when used together.

2. A client has a new prescription for Atenolol. Which of the following instructions should be included by the healthcare provider?

• A. Take this medication in the morning.
• B. Monitor your heart rate regularly.
• C. Avoid foods high in potassium.
• D. Increase your fluid intake.

Correct answer: B

Rationale: The correct answer is B. Atenolol is a beta-blocker that can cause bradycardia, leading to a decreased heart rate. Monitoring heart rate regularly is essential to detect any significant decreases promptly and seek medical attention. While choices A, C, and D may be relevant to the client's overall health, monitoring heart rate is the priority instruction due to the nature of Atenolol's effects. Taking the medication in the morning can be individualized based on the client's needs and preferences. Avoiding foods high in potassium and increasing fluid intake are generally beneficial but not directly related to managing the side effects of Atenolol.

3. A client reports taking Aspirin four times daily for a sprained wrist. Which of the following prescribed medications taken by the client is contraindicated with aspirin?

• A. Digoxin
• B. Metformin
• C. Warfarin
• D. Nitroglycerin

Correct answer: C

Rationale: Aspirin inhibits platelet aggregation, which can increase the effect of anticoagulants like warfarin, leading to an elevated risk of bleeding. Therefore, the concurrent use of aspirin and warfarin is generally contraindicated due to this potential interaction. Digoxin is not contraindicated with aspirin in most cases. Metformin and nitroglycerin do not have significant interactions with aspirin, making them less likely to be contraindicated in this scenario.

4. A client has a new prescription for Amiodarone. Which of the following instructions should the nurse include?

• A. Take this medication with meals.
• B. Avoid drinking grapefruit juice.
• C. Take this medication at bedtime.
• D. Increase your intake of sodium-rich foods.

Correct answer: B

Rationale: The correct instruction the nurse should include is to advise the client to avoid drinking grapefruit juice while taking Amiodarone. Grapefruit juice can inhibit the metabolism of Amiodarone, leading to increased blood levels of the medication and raising the risk of adverse effects, such as cardiac toxicity. Choices A, C, and D are incorrect. Taking Amiodarone with meals, at bedtime, or increasing intake of sodium-rich foods are not necessary instructions for this medication.

5. While providing an Angiotensin-converting enzyme (ACE) inhibitor, the patient asks what the action of the drug is. As a healthcare provider, you explain that the action of an ACE inhibitor is:

• A. To lower blood pressure by blocking the conversion of angiotensin I to vasoconstrictor angiotensin II
• B. To inhibit reabsorption of sodium back into the body, ultimately increasing urine output and lowering blood pressure
• C. To decrease heart rate and blood pressure by competing with Beta1 and Beta2 receptors in the heart and lungs
• D. To lower blood glucose by stimulating the release of insulin

Correct answer: A

Rationale: ACE inhibitors lower blood pressure by blocking the conversion of angiotensin I to vasoconstrictor angiotensin II. Angiotensin II is a potent vasoconstrictor, and by inhibiting its formation, ACE inhibitors help dilate blood vessels, reduce blood pressure, and decrease the workload on the heart. Choice B is incorrect as it describes the mechanism of action of diuretics, not ACE inhibitors. Choice C is incorrect as it refers to the action of beta-blockers, not ACE inhibitors. Choice D is incorrect as it describes the mechanism of action of antidiabetic medications, not ACE inhibitors.

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