Nokea
A client is admitted for a surgical procedure. Which of the following preexisting conditions can be a contraindication for the use of Ketamine as an intravenous anesthetic?
- A. Peptic ulcer disease
- B. Breast cancer
- C. Diabetes mellitus
- D. Schizophrenia
Correct Answer: D
Rationale: Ketamine is known to produce psychological effects, such as hallucinations. Therefore, individuals with schizophrenia are at increased risk of experiencing exacerbation of their symptoms if given Ketamine, making it a contraindication for its use as an intravenous anesthetic. Peptic ulcer disease, breast cancer, and diabetes mellitus are not contraindications for Ketamine use as an intravenous anesthetic.
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While assessing a client taking Amiodarone to treat Atrial Fibrillation, which of the following findings is indicative of Amiodarone toxicity?
- A. Light yellow urine
- B. Report of tinnitus
- C. Productive cough
- D. Blue-gray skin discoloration
Correct Answer: C
Rationale: Productive cough can indicate pulmonary toxicity, which is a known adverse effect of Amiodarone. Clients on Amiodarone should be monitored for signs of pulmonary toxicity such as cough, dyspnea, and chest pain. This is important to detect early and prevent serious complications. The other options are not typically associated with Amiodarone toxicity. Light yellow urine is not a common sign, tinnitus is more related to ear problems, and blue-gray skin discoloration is not a recognized symptom of Amiodarone toxicity.
A healthcare professional is preparing to administer an IV bolus of Morphine to a client for pain management. Which of the following assessments is the healthcare professional's priority?
- A. Respiratory rate
- B. Pain level
- C. Blood pressure
- D. Level of consciousness
Correct Answer: A
Rationale: The priority assessment for a client receiving an IV bolus of Morphine is the respiratory rate. Morphine can cause respiratory depression, which is a serious adverse effect. Monitoring the respiratory rate is crucial to detect any signs of respiratory compromise early and intervene promptly. Assessing pain level, blood pressure, and level of consciousness are also important but not the priority in this situation. Pain level can be assessed after ensuring the client's respiratory status is stable. Blood pressure and level of consciousness should be monitored but do not take precedence over the respiratory rate when administering Morphine.
A client has a new prescription for Hydrochlorothiazide. Which of the following instructions should the nurse include?
- A. Take this medication in the morning.
- B. Consume foods rich in potassium.
- C. Take this medication with a meal.
- D. Monitor for signs of dehydration.
Correct Answer: D
Rationale: Hydrochlorothiazide is a diuretic that can lead to dehydration due to increased urination. Signs of dehydration include dry mouth, increased thirst, and decreased urine output. It is essential to educate the client to monitor these signs and seek medical attention if they occur. Choice A is incorrect because Hydrochlorothiazide is usually taken in the morning to prevent disruption of sleep due to increased urination during the night. Choice B is incorrect because while Hydrochlorothiazide can lead to potassium loss, consuming foods rich in potassium is not a specific instruction related to this medication. Choice C is incorrect because taking Hydrochlorothiazide with a meal is not a specific requirement for its administration.
A healthcare provider is reviewing the health history of a client who is starting therapy with tamoxifen. The healthcare provider should recognize that tamoxifen is contraindicated in which of the following clients?
- A. A client with a history of deep-vein thrombosis
- B. A client with a history of migraine headaches
- C. A client with a history of hypertension
- D. A client with a history of anemia
Correct Answer: A
Rationale: Tamoxifen is contraindicated in clients with a history of thromboembolic events, such as deep-vein thrombosis, due to the increased risk of blood clots forming and leading to serious complications like pulmonary embolism. Clients with a history of deep-vein thrombosis are at a higher risk of recurrent thromboembolic events when taking tamoxifen, making it unsafe for such individuals. Choices B, C, and D are not contraindications for tamoxifen therapy, as migraine headaches, hypertension, and anemia do not directly interact with tamoxifen's mechanism of action or pose significant risks when used together.
A healthcare provider is reviewing the health history of a client who is starting therapy with tamoxifen. The healthcare provider should recognize that tamoxifen is contraindicated in which of the following clients?
- A. A client with a history of deep-vein thrombosis
- B. A client with a history of migraine headaches
- C. A client with a history of hypertension
- D. A client with a history of anemia
Correct Answer: A
Rationale: Tamoxifen is contraindicated in clients with a history of thromboembolic events, such as deep-vein thrombosis, due to the increased risk of blood clots. The estrogenic effects of tamoxifen can further increase the risk of thromboembolic events, making it unsafe for individuals with a history of deep-vein thrombosis. Choice B (migraine headaches), Choice C (hypertension), and Choice D (anemia) are not contraindications for tamoxifen therapy. Migraine headaches, hypertension, and anemia do not pose the same risk of adverse effects related to blood clot formation as deep-vein thrombosis does.