What adverse reaction does the nurse anticipate if a client takes nitroglycerin with sildenafil?
Hypotension
Bradycardia
Chest pain
Nausea
The Correct Answer is A
A. The combination of nitroglycerin and sildenafil can lead to severe hypotension due to the vasodilatory effects of both medications. This is the most critical adverse reaction the nurse should anticipate.
B. Bradycardia is not a direct effect of this combination; rather, hypotension is a more significant concern.
C. Chest pain may occur if hypotension leads to inadequate perfusion, but it is not a direct adverse effect of the drug interaction.
D. Nausea can occur with various medications, but it is not specifically linked to the interaction between nitroglycerin and sildenafil.
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Correct Answer is D
Explanation
A. While historical context is useful, the development of antimicrobials primarily began in the early 20th century, notably with penicillin discovered by Alexander Fleming in 1928.
B. This statement is incorrect; fluoroquinolones primarily inhibit bacterial DNA synthesis rather than directly affecting the cell wall.
C. Selective toxicity is a principle of antimicrobial action but does not directly explain how a specific antimicrobial works therapeutically.
D. Penicillin specifically interferes with the synthesis of the bacterial cell wall, leading to cell lysis and death of the bacteria, which is a fundamental mechanism of action for this antibiotic.
Correct Answer is A
Explanation
A. "There can be an unsafe reaction between your antidepressant and St. John's wort, which is why taking them both is discouraged." is correct; St. John's wort can reduce the effectiveness of SSRIs and may increase the risk of serotonin syndrome, making it vital for the nurse to address this safety concern.
B. "Herbal remedies often contain unknown doses of the desired ingredient, which can be dangerous." is a valid point, but it does not specifically address the interaction with the client’s current medication.
C. "It's very important that you not take the St. John's wort at the same time of day as your antidepressant." is misleading; the concern is not just about timing but about taking both together at all.
D. "It's very important that you comply with your prescribed treatment." while true, this response does not directly address the specific risks associated with combining St. John's wort and citalopram.