A patient in the emergency department reports taking sildenafil (Viagra) and nitroglycerin 1 hr before sexual activity. Which finding should the nurse immediately report to the physician?

Correct Answer: D

Rationale: The correct answer is D: BP of 70/50. When sildenafil (Viagra) is taken with nitroglycerin, it can cause severe hypotension that is unresponsive to treatment. The combination of these medications can lead to a dangerous drop in blood pressure. It is crucial to immediately report hypotension in this scenario. It is recommended to allow at least 24 hours to elapse between the last dose of sildenafil and nitroglycerin to prevent such adverse effects. The other vital signs and lab values may be abnormal but do not have the immediate life-threatening implications that severe hypotension does in this context.

Correct Answer: B

Rationale: The patient is exhibiting symptoms of anaphylaxis triggered by a peanut allergy, which is a severe and potentially life-threatening allergic reaction. The appropriate medication for anaphylaxis is epinephrine. Epinephrine acts quickly to reverse the symptoms by constricting blood vessels, relaxing bronchial muscles, and reducing laryngeal edema, making it the drug of choice for this situation. Promethazine, diphenhydramine, and hydroxyzine are not the first-line treatments for anaphylaxis and may not address the severe manifestations seen in this case.

Correct Answer: B

Rationale: In this scenario, the most important question for the nurse to ask the patient with Parkinson's disease who is taking levodopa/carbidopa (Sinemet) is option B: "Are you having vivid dreams or hallucinations?" This question is crucial because levodopa, a common medication for Parkinson's disease, can lead to side effects such as vivid dreams or hallucinations. It is essential for the nurse to assess for these symptoms as they can impact the patient's overall well-being and quality of life. Option A, asking about swelling in the feet, is less relevant in this case as it is not a common side effect of levodopa/carbidopa. Option C, inquiring about changes in stool, is also less important as it is not directly related to the medication or the management of Parkinson's disease. Option D, asking about the flu vaccine, while important for overall health, is not as pertinent during a semi-annual physical examination specifically for a patient with Parkinson's disease on levodopa/carbidopa. Educationally, this question highlights the importance of understanding common side effects of medications used to treat specific conditions. It emphasizes the need for nurses to be knowledgeable about potential medication side effects and to prioritize assessments based on the specific medications and conditions their patients have. This rationale underscores the significance of comprehensive patient assessments in providing safe and effective care.

Correct Answer: A

Rationale: The correct answer is A. Isotretinoin is highly teratogenic, which means it can cause birth defects. Therefore, it is crucial for patients, especially females of childbearing potential, to use effective forms of birth control to prevent pregnancy while taking this medication. This is a key component of patient teaching to ensure the safe use of isotretinoin.

Correct Answer: C

Rationale: In pediatric nursing, understanding therapeutic techniques is crucial for providing effective care to children. The correct answer to the question is C) Grading. Grading refers to the process in therapy where the therapist adjusts the level of an activity to match the child's current abilities, making it slightly more challenging as the child progresses. A) Compensating involves making up for a deficiency or disability, which is not the case in this scenario. B) Adapting typically refers to changing the environment or task to suit the child's needs, rather than bringing the toy closer for better access. D) Modifying usually involves altering the activity itself, not just adjusting the distance of an object. Educationally, understanding these terms is vital for pediatric nurses to effectively communicate with therapists and implement appropriate interventions for children in their care. Grading specifically helps promote skill development in a progressive manner, supporting the child's growth and success in therapy sessions.