Advanced Emergency Medical Technician (AEMT) Practice Test

What is a contraindication for administering nitroglycerin?

1. Chest pain associated with tachycardia and dyspnea

2. Previous coronary arterial bypass graft (CABG)

3. Associated hypertension within the last 24 to 36 hours

4. Use of erectile dysfunction medications within 24 to 36 hours

The correct answer is: Use of erectile dysfunction medications within 24 to 36 hours

The correct answer identifies the use of erectile dysfunction medications within the past 24 to 36 hours as a contraindication for administering nitroglycerin. This is crucial because both nitroglycerin and these medications, such as sildenafil (Viagra) or vardenafil (Levitra), work as vasodilators, which means they can significantly lower blood pressure. When taken together, they may lead to severe hypotension, potentially causing life-threatening complications such as syncope or shock. In contrast, chest pain associated with tachycardia and dyspnea is often an indication for nitroglycerin administration, as it may alleviate cardiac workload and improve symptoms. A previous coronary arterial bypass graft (CABG) does not contraindicate nitroglycerin; in fact, patients who have undergone CABG may still benefit from its use under appropriate conditions. Finally, associated hypertension can complicate treatment decisions, but it does not serve as an outright contraindication unless it is severe and debilitating. Thus, the major concern with the simultaneous use of nitroglycerin and erectile dysfunction medications informs the criticality of the correct answer.