Nokea
Sildenafil (Viagra) is prescribed to treat a client with erectile dysfunction. A nurse reviews the client's medical record and would question the prescription if which of the following is noted in the client's history?
- A. Neuralgia
- B. Insomnia
- C. Use of nitroglycerin
- D. Use of multivitamins
Correct Answer: C
Rationale: Sildenafil (Viagra) enhances the vasodilating effect of nitric oxide in the corpus cavernosum of the penis, thus sustaining an erection. Because of the effect of the medication, it is contraindicated with concurrent use of organic nitrates and nitroglycerin. Sildenafil is not contraindicated with the use of vitamins. Neuralgia and insomnia are side effects of the medication.
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Which of the following is NOT true regarding ligand-gated ion channels?
- A. React quickly to a stimulus or ligand
- B. Can have intracellular binding sites
- C. Can exhibit allosteric binding
- D. Open or close in response to deformations in the cell membrane
Correct Answer: D
Rationale: Ligand-gated channels respond to ligands, not mechanical deformation (which is typical of mechanosensitive channels).
Nicotine has a variety of effects on nicotinic receptors throughout the body. Which of the following is NOT an effect of nicotine?
- A. Vasodilation and decreased heart rate
- B. Increased secretion of gastric acid and motility of the GI smooth muscle
- C. Release of dopamine at the pleasure center
- D. Stimulation of the locus coeruleus
Correct Answer: A
Rationale: Nicotine causes vasoconstriction and increased heart rate, not vasodilation.
Which statement is false of Domperidone
- A. Chemically related to haloperidol
- B. Pharmacologically related to metoclopramide
- C. Extra pyramidal symptoms are common
- D. It counteracts the emetic action but not the therapeutic effect in parkinsonism
Correct Answer: C
Rationale: Domperidone rarely causes extrapyramidal symptoms as it doesn't cross the blood-brain barrier.
Which of the following is antithyroidal drugs:
- A. Thyroxine
- B. Liothironine
- C. Propilthyouracil
- D. Triiodthironine
Correct Answer: C
Rationale: Propilthyouracil (propylthiouracil) is an antithyroid drug that inhibits thyroid hormone synthesis by blocking the iodination of tyrosine residues in thyroglobulin.
The nurse is preparing to administer a prescribed drug to a patient. The patient looks at the tablet and says, 'This doesn't look like my usual pill.' Which response by the nurse would be most appropriate?
- A. This is the same pill your doctor has been ordering.'
- B. It must be from a different manufacturer.'
- C. It looks different? Are you sure?'
- D. Let me double check with your doctor and the order.'
Correct Answer: D
Rationale: If the patient makes any statement about the drug, the nurse needs to hold the drug and investigate the patient's statement, double checking the chart and the order and obtaining clarification and/or confirmation from the prescriber. It may be that the dosage or manufacturer has changed and that is what makes the pill look different. It is always important to err on the side of caution. Telling the patient that the pill is the same or that it is from a different manufacturer may be true, but the nurse needs to confirm that before giving it to the patient. Repeating the patient's statement and then asking him if he is sure is inappropriate because it implies that the patient is incorrect.