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A client with migraine headaches is starting prophylaxis therapy with Propranolol. Which finding in the client's history should the nurse report to the provider?
- A. The client had a prior myocardial infarction.
- B. The client takes warfarin for atrial fibrillation.
- C. The client takes an SSRI for depression.
- D. An ECG indicates a first-degree heart block.
Correct Answer: D
Rationale: Propranolol is contraindicated in clients with first-degree heart block due to its negative inotropic and chronotropic effects. The nurse should report this finding to the provider to consider an alternative therapy to prevent potential worsening of cardiac conduction abnormalities. Choices A, B, and C are not directly contraindications to Propranolol therapy for migraine headaches and do not pose immediate risks that would require reporting to the provider.
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A client is admitted for a surgical procedure. Which preexisting condition 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 can produce psychological effects like hallucinations. Patients with schizophrenia may be more prone to experiencing exacerbation of their symptoms when exposed to Ketamine due to its potential to worsen psychotic symptoms. Therefore, schizophrenia can be a contraindication for the use of Ketamine as an anesthetic. Peptic ulcer disease, breast cancer, and diabetes mellitus are not contraindications for the use of Ketamine.
A client is being taught about Terbutaline. Which statement by the client indicates understanding of the teaching?
- A. This medication will stop my contractions.
- B. This medication will prevent vaginal bleeding.
- C. This medication will promote blood flow to my baby.
- D. This medication will increase my prostaglandin production.
Correct Answer: A
Rationale: The correct answer is A. Terbutaline works by blocking beta2-adrenergic receptors, leading to uterine smooth muscle relaxation and stopping contractions. Therefore, the client demonstrating understanding by recognizing that the medication will stop contractions is the most accurate response. Choices B, C, and D are incorrect because Terbutaline is primarily used to inhibit contractions in preterm labor, not prevent vaginal bleeding, promote blood flow to the baby, or increase prostaglandin production.
A client in the operating room received a dose of Succinylcholine. During the operation, the client suddenly develops rigidity, and their body temperature begins to rise. The healthcare provider should anticipate a prescription for which of the following medications?
- A. Neostigmine
- B. Naloxone
- C. Dantrolene
- D. Vecuronium
Correct Answer: C
Rationale: Muscle rigidity and a sudden rise in temperature are manifestations of malignant hyperthermia. Dantrolene acts on skeletal muscles to reduce metabolic activity and treat malignant hyperthermia effectively. Neostigmine (choice A) is used to reverse the effects of non-depolarizing neuromuscular blockers, not to treat malignant hyperthermia. Naloxone (choice B) is an opioid antagonist used for opioid overdose. Vecuronium (choice D) is a non-depolarizing neuromuscular blocker and is not used to treat malignant hyperthermia.
A client has a new prescription for Omeprazole. Which of the following instructions should the nurse include?
- A. Take this medication before meals.
- B. Take this medication with food.
- C. Take this medication at bedtime.
- D. Take this medication with antacids.
Correct Answer: A
Rationale: The correct answer is A: 'Take this medication before meals.' Omeprazole is a proton pump inhibitor that should be taken before meals to be most effective in reducing stomach acid production. Taking it before meals allows the medication to inhibit the proton pumps in the stomach when they are most active, leading to better control of acid secretion. Choice B is incorrect because taking Omeprazole with food may reduce its effectiveness as food can interfere with its absorption. Choice C is incorrect as Omeprazole is more effective when taken before meals. Choice D is incorrect as Omeprazole should not be taken with antacids as they can reduce its absorption.
A client has a prescription for Phenytoin. Which of the following instructions should the nurse include?
- A. Take this medication at bedtime.
- B. Increase your intake of calcium-rich foods.
- C. Brush and floss your teeth regularly.
- D. Avoid eating foods high in potassium.
Correct Answer: C
Rationale: The correct answer is C: 'Brush and floss your teeth regularly.' Phenytoin can cause gingival hyperplasia, a condition that leads to overgrowth of gum tissue. Good oral hygiene practices such as regular brushing and flossing can help prevent or minimize this side effect. In contrast, choices A, B, and D are not directly related to managing the side effects of Phenytoin. Taking the medication at bedtime (choice A) is not a specific instruction related to oral hygiene. Increasing calcium-rich foods intake (choice B) may be beneficial for bone health but is not directly related to preventing gingival hyperplasia. Avoiding foods high in potassium (choice D) is not a necessary instruction for a client taking Phenytoin.