What medication is a contraindication to Nitroglycerin

Correct Answer: D

Rationale: Erectile dysfunction drugs like Viagra (sildenafil), Cialis (tadalafil), and Levitra (vardenafil) are contraindicated with Nitroglycerin. Both Nitroglycerin and erectile dysfunction drugs work by lowering blood pressure. When taken together, they can cause a significant drop in blood pressure leading to dizziness, fainting, and even serious complications like low blood pressure and decreased oxygen supply to the heart. Therefore, it is important to avoid using these medications together to prevent potential harm.

Correct Answer: B

Rationale: Adrenergic blocking agents prevent norepinephrine from being released from the adrenal medulla or from the nerve terminal from activating the receptor, which blocks sympathetic nervous system effects. Epinephrine, serotonin, and GABA are not associated with this process. Norepinephrine is the primary neurotransmitter targeted by these agents, as it plays a key role in the sympathetic nervous system's fight-or-flight response.

Correct Answer: A

Rationale: The therapeutic serum range for phenobarbital (luminal) when used for anxiety is typically between 5-10 mcg/ml. This range is considered effective in controlling anxiety symptoms while minimizing the risk of toxicity. Higher serum levels (options B, C, D) may increase the risk of adverse effects such as sedation, respiratory depression, and overdose. Therefore, monitoring the serum levels of phenobarbital is essential to ensure the medication is at a therapeutic range for the intended treatment.

Correct Answer: D

Rationale: Prednisone is a corticosteroid medication that can cause side effects such as fluid retention, electrolyte imbalance, and increased blood pressure. On the other hand, high-dose aspirin, especially when taken for arthritis, can have blood-thinning effects that may also contribute to lowering blood pressure. Given these potential effects of both medications, the nurse should be vigilant for the development of hypotension in the patient. Monitoring for signs and symptoms of low blood pressure, such as dizziness, lightheadedness, and weakness, is crucial in this situation to ensure the patient's safety.

Correct Answer: D

Rationale: MRSA treatment causing anemia, jaundice, and Heinz bodies suggests dapsone (sulfa drug), which inhibits folic acid metabolism . Oxidative stress from dapsone in G6PD-deficient patients (common in African Americans) leads to hemolysis. Options and are macrolide and tetracycline mechanisms. Option is penicillin's action. RNA polymerase inhibition (E) is rifampin's. Dapsone's sulfa action fits the clinical picture, with hemolysis as a side effect, not its primary MRSA mechanism, but the question's focus on outcome aligns with folate pathway disruption.

Correct Answer: A

Rationale: In hypovolemic shock due to significant blood loss, the primary goal is to quickly restore the lost volume of red blood cells to improve tissue perfusion and oxygen delivery. Packed Red Blood Cells (PRBCs) are the most appropriate blood product for this situation as they contain a high concentration of red blood cells and minimal plasma, making them the most efficient way to replace lost red blood cells. Whole blood, Cryoprecipitate, and Fresh Frozen Plasma (FFP) contain other blood components which are not the immediate priority in this scenario.

Correct Answer: B

Rationale: The nurse's best response would be, "It takes 6 to 8 weeks to see a change in cholesterol levels." Statin drugs typically take around 6 to 8 weeks before a noticeable effect on serum cholesterol levels is seen. This timeframe allows the medication to fully take effect and lower the cholesterol levels in the blood. Patients should continue with the prescribed treatment regimen and have their cholesterol levels monitored regularly to assess the effectiveness of the medication.

Correct Answer: D

Rationale: Erectile dysfunction drugs like Viagra (sildenafil), Cialis (tadalafil), and Levitra (vardenafil) are contraindicated with Nitroglycerin. Both Nitroglycerin and erectile dysfunction drugs work by lowering blood pressure. When taken together, they can cause a significant drop in blood pressure leading to dizziness, fainting, and even serious complications like low blood pressure and decreased oxygen supply to the heart. Therefore, it is important to avoid using these medications together to prevent potential harm.

Correct Answer: C

Rationale: Lipid-soluble drugs distribute widely, crossing membranes like the blood-brain barrier easily, unlike water-soluble ones. The barrier blocks some, not all, drugs. High blood flow aids delivery, not hinders. Protein complexes limit free drug, not enable crossing. Lipid solubility enhances distribution, a pharmacokinetic truth.