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 C

Explanation

A. Sargramostim is a granulocyte-macrophage colony-stimulating factor (GM-CSF) used to stimulate the production of white blood cells but is not specifically indicated for anemia.

B. Filgrastim is a granulocyte colony-stimulating factor (G-CSF) that increases white blood cell counts and is not used for treating anemia.

C. Epoetin is an erythropoiesis-stimulating agent that stimulates red blood cell production, making it the appropriate choice for treating chemotherapy-induced anemia.

D. Romiplostim is a thrombopoietin receptor agonist used to treat thrombocytopenia (low platelet count) and is not indicated for anemia.

A. Increase fluids while taking the medication. B. Expect an elevation in blood pressure with initial doses of the medication. C. Stop the medication immediately if urine becomes orange in color. D. Take the medication in the morning.

Correct Answer is A

Explanation

A. Increase fluids while taking the medication: Amitriptyline is a tricyclic antidepressant that can cause anticholinergic side effects such as dry mouth and constipation. Increasing fluid intake helps to mitigate these effects and prevent dehydration and constipation.

B. Expect an elevation in blood pressure with initial doses of the medication: Amitriptyline can cause orthostatic hypotension rather than elevated blood pressure. Clients should be informed about the risk of dizziness or fainting.

C. Stop the medication immediately if urine becomes orange in color: Orange urine is not a common side effect of amitriptyline. Clients should not stop the medication without consulting their provider.

D. Take the medication in the morning: Amitriptyline has sedative effects and is typically taken at night to help manage sleep disturbances and reduce daytime drowsiness.

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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

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Correct Answer is C

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Correct Answer is A

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