Nokea
A nurse is assigned to care for a client with biliary colic in a health care facility. The client has been prescribed atropine. The nurse reviews the client's medical record and determines that the client should not receive this drug because the client has a history of which of the following?
- A. Hepatic disease
- B. Benign prostatic hypertrophy
- C. Myocardial infarction
- D. Urinary retention
Correct Answer: C
Rationale: The nurse should know that the use of atropine is contraindicated in clients with myocardial infarction. Other contraindications include myasthenia gravis, tachyarrhythmia, and congestive heart failure (unless bradycardia is present).
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The nurse instructs the client and family about possible visual and mental adverse reactions that can occur. Which of the following would the nurse include in the teaching to reduce the client's risk for injury?
- A. Removing throw rugs
- B. Moving furniture against the wall
- C. Making sure floors are dry
- D. Avoiding having the floors waxed
- E. Removing electrical cords from walkways
Correct Answer: A,B,C,D,E
Rationale: Objects or situations that may cause falls, such as throw rugs, electrical cords, footstools, furniture, and wet or newly waxed floors, are removed or avoided whenever possible.
A nurse identifies a nursing diagnosis of Constipation related to the effects of the prescribed cholinergic blocking drug. Which of the following would the nurse expect to include in the client's plan of care?
- A. Encuring the intake of a diet high in fiber.
- B. Decreasing the dosage of the cholinergic blocking medication
- C. Increasing client's fluid intake to at least 2000 mL daily
- D. Withholding the drug until the client resumes usual bowel pattern
- E. Encouraging ambulation and exercise as appropriate
Correct Answer: A,C,E
Rationale: Appropriate interventions include encouraging a high-fiber diet, increasing fluid intake, and encouraging ambulation and exercise. It is not the nurse's decision to decrease the dosage. Withholding the drug until the client's bowel patterns return would be inappropriate.
A client has a nursing diagnosis of Impaired Comfort related to xerostomia from the daily administration of a cholinergic blocking drug. When assessing the client, the nurse would be alert for which of the following?
- A. Dysphagia
- B. Tooth decay
- C. Gingivitis
- D. Impeded speech
- E. Gingival hyperplasia
Correct Answer: A,D
Rationale: Dry mouth caused by daily use of cholinergic blocking drugs can result in dysphagia and impeded, difficult-to-understand speech. Tooth decay, gingivitis, and gingival hyperplasia are not associated with dry mouth.
A nurse is providing care to a client with COPD. The nurse anticipates that which of the following would be appropriate to be prescribed for this client?
- A. Darifenacin (Enablex)
- B. Ipratropium (Atrovent)
- C. Benztropine (Cogentin)
- D. Biperiden (Akineton)
- E. Tiotropium (Spiriva)
Correct Answer: B,E
Rationale: Ipratropium (Atrovent) and tiotropium (Spiriva) are inhaled cholinergic blocking drugs used in the treatment of chronic obstructive pulmonary disease (COPD).
If a cholinergic blocking drug is administered prior to surgery, which of the following would be most appropriate?
- A. Encourage the client to void after the drug is given.
- B. Tell the client that his mouth may feel dry.
- C. Allow the client to take sips of fluids.
- D. Have the client remain in bed after drug administration.
- E. Encourage the client to sit in the chair for about 30 minutes.
Correct Answer: B,D
Rationale: If a cholinergic blocking drug is administered prior to surgery, the nurse instructs the client to void before the drug is given, that an extremely dry mouth is normal but that no fluid should be ingested, and that the client should remain in bed, not sit in a chair.