The nurse plans medication education for a client who receives a prescription for sildenafil (Viagra). What will the best plan by the nurse include?

Correct Answer: C

Rationale: Sildenafil (Viagra), a phosphodiesterase-5 inhibitor, has a dosing limit of one pill per 24 hours to avoid risks like prolonged erections or hypotension, a key safety point for education. Grapefruit juice increases sildenafil levels by inhibiting metabolism, not decreasing effects, risking intensified side effects. It's optimally taken 1 hour before sex, effective up to 4 hours-not 6-setting realistic timing expectations. Food, especially high-fat meals, delays absorption, so it's best on an empty stomach. The 24-hour limit ensures safe use, balancing efficacy with minimizing adverse effects, aligning with prescribing standards and making it the priority in client teaching.

Correct Answer: B

Rationale: One important side effect to watch for when administering the drug lithium is seizures. Lithium is commonly used to treat bipolar disorder, but it can lower the seizure threshold and increase the risk of seizures in some patients. It is crucial to monitor individuals taking lithium for any signs of seizures or seizure activity and to promptly address any such occurrences. Regular monitoring of lithium levels and adjusting the dosage as necessary can help minimize the risk of seizures in patients receiving this medication.

Correct Answer: B

Rationale: Therapeutic index (TI), the ratio of toxic to effective dose, gauges safety-wide TI means safer dosing, helping the student assess if doses are within safe limits. Best drug choice is clinical, not TI-based. Interactions aren't TI-specific. Monitoring needs tie to narrow TI drugs (e.g., lithium), but safety is broader. TI ensures safe dosing, a key review point.

Correct Answer: B

Rationale: Pentazocine, a mixed opioid agonist-antagonist, acts as a kappa receptor agonist and a partial mu receptor agonist, providing analgesia in opioid-naive patients. However, in a heroin addict with high mu receptor tolerance, pentazocine's partial antagonism at mu receptors can displace full agonists like heroin, precipitating withdrawal symptoms—sweating, restlessness, and heightened pain perception. Tolerance to pentazocine itself wouldn't typically increase pain; it would reduce efficacy. Pentazocine is an effective analgesic in appropriate contexts, so ineffectiveness isn't the issue. Incorrect dosing might alter efficacy or toxicity but wouldn't specifically cause this withdrawal-like reaction. The patient's history of heroin use explains this response, as pentazocine's antagonist properties disrupt the opioid equilibrium, unmasking withdrawal in a dependent individual.

Correct Answer: C

Rationale: When administering IV potassium to a hypokalemic patient who is not on a heart monitor, it's important to ensure a controlled rate of infusion to prevent dangerous cardiac arrhythmias. The recommended maximum rate for IV potassium replacement in this scenario is typically no more than 20 mEq/hour. Faster administration rates can increase the risk of hyperkalemia and potentially lead to serious cardiac complications. Monitoring the patient closely for signs of hyperkalemia such as ECG changes or muscle weakness is also crucial during potassium replacement therapy.