A nurse is reviewing the medical history of a client who has myasthenia gravis and is asking about starting neostigmine. The nurse should identify which of the following client conditions as a potential contraindication for cholinesterase inhibitor therapy?

Cataracts

Hypertension

Hypothyroidism

Peptic ulcer disease

Answer and Explanation

The Correct Answer is D

A. Cataracts are not a contraindication for cholinesterase inhibitors like neostigmine.

B. Hypertension is not a direct contraindication for cholinesterase inhibitor therapy, although caution may be exercised depending on the overall health status of the client.

C. Hypothyroidism is not contraindicated for cholinesterase inhibitors; however, it should be managed appropriately.

D. Peptic ulcer disease is a significant contraindication for cholinesterase inhibitors like neostigmine because these medications can increase gastric secretions and motility, potentially exacerbating ulcer conditions and leading to complications.

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Correct Answer is A

Explanation

A. Albuterol: This is a bronchodilator that can cause side effects such as increased heart rate and chest pain due to its stimulant effect on the cardiovascular system.

B. Furosemide: This diuretic is unlikely to cause chest pain directly; however, it may lead to electrolyte imbalances that can indirectly affect cardiac function.

C. Digoxin: While digoxin has several potential side effects, chest pain is not commonly recognized as a direct adverse effect of this medication.

D. Atenolol: This medication is a beta-blocker used to manage hypertension and is unlikely to cause chest pain; rather, it may help alleviate angina symptoms.

A. Educate the client about the possible consequences of not taking the medication. B. Suggest the client take food with the medication to minimize GI effects. C. Document the client's refusal in the medication administration record. D. Offer to administer the medication IM. E. Recommend the client ask the provider to prescribe an enteric-coated medication.

Correct Answer is ["A","B","C","E"]

Explanation

A. Educating the client about the consequences of not taking valproic acid is essential to ensure they understand the importance of adherence to the medication regimen.

B. Suggesting that the client take the medication with food can help minimize gastrointestinal side effects such as nausea.

C. Documenting the client's refusal in the medication administration record is a critical step to maintain accurate medical records and to inform other healthcare providers.

D. Offering to administer the medication IM is not appropriate, as valproic acid is typically given orally and not via intramuscular injection.

E. Recommending the client ask the provider about an enteric-coated formulation may provide a more tolerable option to reduce gastrointestinal side effects.

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A nurse is reviewing the medical history of a client who has myasthenia gravis and is asking about starting neostigmine. The nurse should identify which of the following client conditions as a potential contraindication for cholinesterase inhibitor therapy?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is reviewing the medical record of a client who received medications 1 hour ago and reports having chest pain. The nurse should recognize that chest pain can be an adverse effect of which of the following medications?

Correct Answer is A

Explanation

A nurse is caring for a client who refused a prescribed dose of valproic acid 250 mg PO. The client states, "I don't want to take that pill because it makes me feel nauseated." Which of the following actions should the nurse take? Select all that apply

Correct Answer is ["A","B","C","E"]

Explanation

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