A 55-year-old client has levothyroxine ordered. Which of the below past medical history concerns may contraindicate with her medication management of hypothyroidism?
- A. Scleroderma
- B. Osteoporosis
- C. Asthma
- D. Peripheral Vascular Disease
Correct Answer: B
Rationale: The correct answer is B: Osteoporosis. Osteoporosis is a concern with levothyroxine as it can increase the risk for fractures, particularly in older adults. Levothyroxine treatment can exacerbate bone loss in individuals with osteoporosis. Choices A, C, and D are not directly contraindicated with levothyroxine therapy for hypothyroidism.
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A client prescribed hydromorphone for severe pain has a decreased respiratory rate from 16 breaths per minute to 6. Which of the following medications should the nurse prepare to administer?
- A. Flumazenil
- B. Naloxone
- C. Activated charcoal
- D. Aluminum hydroxide
Correct Answer: B
Rationale: Naloxone is the correct answer as it is used to reverse opioid-induced respiratory depression. Hydromorphone is an opioid medication that can cause respiratory depression at high doses. Naloxone is an opioid antagonist that competes with opioids at receptor sites, reversing the effects of opioids like hydromorphone. Flumazenil (Choice A) is a benzodiazepine antagonist used for benzodiazepine overdose, not opioid overdose. Activated charcoal (Choice C) is used for toxin ingestion to prevent absorption in the gastrointestinal tract, but it is not indicated for opioid overdose. Aluminum hydroxide (Choice D) is an antacid and would not be the appropriate intervention for respiratory depression caused by opioid overdose.
A client is prescribed HMG CoA reductase inhibitor, atorvastatin. Which of the following should be monitored while this medication is prescribed?
- A. Liver function tests
- B. Renal function tests
- C. Visual acuity screening
- D. Hearing screenings
Correct Answer: A
Rationale: The correct answer is A: Liver function tests. Atorvastatin, an HMG CoA reductase inhibitor, can lead to hepatotoxicity, making it essential to monitor liver function tests regularly. Choices B, C, and D are incorrect because atorvastatin primarily affects the liver, not the kidneys, vision, or hearing.
A nurse is caring for a client prescribed clopidogrel. Which of the following client histories is a contraindication to the administration of this medication?
- A. Recent surgery
- B. Peptic ulcer disease
- C. Bleeding disorder
- D. Uncontrolled hypertension
Correct Answer: D
Rationale: The correct answer is D: Uncontrolled hypertension. Clopidogrel should not be administered to clients with uncontrolled hypertension due to the increased risk of bleeding. Recent surgery, peptic ulcer disease, and bleeding disorders are not absolute contraindications for clopidogrel administration.
A client has been prescribed metoclopramide. Which of the following should the nurse include in client education regarding this medication?
- A. Notify your provider if you experience restlessness or spasms of the face or neck
- B. This medication can cause insomnia
- C. Decrease your fluid intake while taking this medication
- D. This medication can cause urinary frequency
Correct Answer: A
Rationale: The correct answer is A: 'Notify your provider if you experience restlessness or spasms of the face or neck.' Metoclopramide can lead to extrapyramidal symptoms such as restlessness or facial spasms, which are serious and require immediate medical attention. Choices B, C, and D are incorrect. Insomnia is not a common side effect of metoclopramide. Increasing fluid intake is usually recommended to prevent dehydration caused by potential side effects like diarrhea. Urinary frequency is not a typical side effect associated with metoclopramide.
A client prescribed lisinopril for hypertension may experience which of the following side effects that the nurse should monitor for?
- A. Cough
- B. Weight gain
- C. Dry mouth
- D. Hyperglycemia
Correct Answer: A
Rationale: A persistent dry cough is a common side effect of lisinopril. Lisinopril is an ACE inhibitor that can cause a cough due to the accumulation of bradykinin. Weight gain, dry mouth, and hyperglycemia are not typically associated with lisinopril use, making them incorrect choices in this scenario.