# A client taking riociguat for pulmonary arterial hypertension has a new vericiguat prescription after a heart-failure hospitalization. Which action should the nurse take?

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=522931&lang=en  
> language: en  
> subject: Adverse Effects/Contraindications/Interactions  
> category: PPT

## Question

A client taking riociguat for pulmonary arterial hypertension has a new vericiguat prescription after a heart-failure hospitalization. Which action should the nurse take?

## Option

1. Administer both drugs and monitor only the heart rate.
2. Hold vericiguat and clarify the prescription because combining soluble guanylate cyclase stimulators is contraindicated. **✔ Correct answer**
3. Stop riociguat permanently without contacting the prescriber.
4. Give vericiguat only when systolic blood pressure exceeds 180 mm Hg.

**Correct answer: 2**

## Explanation

Vericiguat is contraindicated with another soluble guanylate cyclase stimulator such as riociguat because the combination can produce excessive hypotension.

## In-depth explanation

Quick answer
Do not combine vericiguat with riociguat.

Why this is correct
Both drugs stimulate soluble guanylate cyclase. The nurse holds the new medication and resolves the interacting regimen rather than independently discontinuing chronic therapy.

Easy analogy or mental picture
Build a medication-safety chain: identify the new cue, connect it to the drug mechanism or labeled limitation, stop preventable exposure, stabilize the client, and verify a measurable response.

Memory hook
Drug, urgent cue, protective action, and reassessment endpoint.

NCLEX decision rule
Choose the action that prevents the most immediate medication-related harm while preserving indicated treatment and required monitoring.

Why the other choices are wrong
Options that continue a suspect exposure, normalize a labeled danger cue, substitute an unauthorized dose, or delay escalation leave the client at risk.References
1DailyMed: VERQUVO (vericiguat)Contraindication with other soluble guanylate cyclase stimulators and hypotension-related interaction safety

## Clinical scenario

Medication-safety review
Verify indication, current assessment, dose and route, organ function, interactions, urgent toxicity cues, authorized action, and measurable follow-up.

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