A patient is taking sildenafil is diagnosed to have effort angina. Which of the following antianginal drug should be avoided?

Correct Answer: C

Rationale: The correct answer is C: Nitroglycerin should be avoided in a patient taking sildenafil because both drugs can cause a significant drop in blood pressure leading to severe hypotension, syncope, or even cardiovascular collapse. Nitroglycerin is a potent vasodilator, and when combined with sildenafil (a phosphodiesterase type 5 inhibitor), the additive vasodilatory effects can result in dangerous hypotension. A: Amlodipine and B: Diltiazem are calcium channel blockers that are commonly used in combination with sildenafil for the treatment of hypertension and angina. They work through different mechanisms and do not have a significant interaction with sildenafil. D: Metoprolol is a beta-blocker that can be safely used with sildenafil. It helps in reducing heart rate and blood pressure, and its combination with sildenafil can have a beneficial effect in patients with angina.

Correct Answer: D

Rationale: The correct answer is D: Hydrochlorothiazide. When combined with potassium sparing diuretics like spironolactone, hydrochlorothiazide can lead to hyperkalemia due to the additive effects on potassium levels. This combination requires close monitoring to prevent dangerous elevations in potassium levels. Furosemide (A) is a loop diuretic and does not typically interact with spironolactone in the same way. Captopril (B) is an ACE inhibitor, not a diuretic, and does not directly affect potassium levels. Verapamil (C) is a calcium channel blocker and does not interact with spironolactone in terms of potassium levels.

Correct Answer: D

Rationale: The correct answer is D (74 mm Hg). The net filtration pressure can be calculated using the formula: Net Filtration Pressure = Glomerular Capillary Pressure - Capsular Space Pressure - Blood Colloid Osmotic Pressure. Substituting the given values: 59 mm Hg - 15 mm Hg - 30 mm Hg = 14 mm Hg. Since the question states that essentially no plasma proteins are filtered by the glomerulus, the Blood Colloid Osmotic Pressure should not be subtracted. Therefore, the correct calculation is: 59 mm Hg - 15 mm Hg = 44 mm Hg. This is why choice D (74 mm Hg) is the correct answer. Choices A, B, and C are incorrect because they do not consider the proper calculation of net filtration pressure.

Correct Answer: C

Rationale: Hypocapnia refers to low levels of carbon dioxide in the blood. This can result from hyperventilation, leading to excessive elimination of CO2. Choice A (Low oxygen) is incorrect because hypocapnia is not related to oxygen levels. Choice B (Low hemoglobin) is incorrect as hypocapnia is not specifically related to hemoglobin levels. Choice D (blank) is obviously incorrect as it provides no information.

Correct Answer: A

Rationale: The correct answer is A. Warm compresses to the perineum can help the patient relax and provide comfort before ileal prostatectomy. This intervention addresses the patient's psychological and physical well-being. Choice B is incorrect as medication administration to relax the bladder is not directly related to preparing for ileal prostatectomy. Choice C is incorrect as impaired mobility related to muscle limitations and reattempting catheterization are not primary concerns before the surgery. Choice D is incorrect as the patient's knowledge deficit on care of the ileal conduit is not the immediate priority before the surgery.