A nurse is caring for an older adult client. The nurse informs the client that straining while defecating can cause which of the following?

Dysrhythmias

Dilated pupils

Gastric ulcer

Diarrhea

Answer and Explanation

The Correct Answer is A

A) Dysrhythmias:
Straining while defecating can trigger the Valsalva maneuver, which involves taking a deep breath and bearing down. This can lead to increased intrathoracic pressure, decreased venous return to the heart, and subsequently a sudden drop in blood pressure when the strain is released. These changes can cause cardiac dysrhythmias, particularly in older adults or those with underlying heart conditions.

B) Dilated pupils:
Dilated pupils are not a known consequence of straining while defecating. Pupillary dilation is typically associated with responses to low light, certain medications, or neurological conditions, rather than gastrointestinal strain.

C) Gastric ulcer:
Gastric ulcers are caused by factors such as Helicobacter pylori infection, prolonged use of nonsteroidal anti-inflammatory drugs (NSAIDs), or excessive stomach acid. Straining during defecation does not contribute to the development of gastric ulcers.

D) Diarrhea:
Straining while defecating is more likely to be associated with constipation rather than diarrhea. Diarrhea involves frequent, loose, or watery stools, whereas straining typically occurs due to hard stools and difficulty passing them.

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Correct Answer is A

Explanation

A. Propranolol is a beta-blocker medication commonly used to treat hypertension, angina, and certain heart rhythm disorders. However, it is contraindicated in clients with a history of asthma or other obstructive airway diseases due to its potential to cause bronchoconstriction and exacerbate respiratory symptoms.

B. Migraines:
Propranolol is actually commonly used for the prophylactic treatment of migraines, particularly in individuals with frequent or severe migraines. It helps reduce the frequency and severity of migraine attacks by blocking the release of certain chemicals in the brain.

C. Glaucoma:
Propranolol can be used in the treatment of glaucoma, particularly when other treatments have been ineffective. It works by reducing intraocular pressure, which can help prevent vision loss associated with glaucoma.

D. Depression:
Propranolol is not contraindicated in clients with depression. In fact, it may sometimes be used off-label to manage certain symptoms of anxiety or performance anxiety. However, it is important to monitor clients with depression closely when prescribing propranolol, as it may interact with other medications used to treat depression or worsen certain depressive symptoms.

A. Pain level B. Pulse oximetry C. Blood pressure D. Level of sedation

Correct Answer is D

Explanation

A) Pain level:
While assessing pain is important to determine the effectiveness of the pain management, it is not the immediate priority after administering an opioid.

B) Pulse oximetry:
Monitoring oxygen saturation is critical as opioids can depress respiratory function. However, it is indirectly related to the primary effect of the medication on the central nervous system.

C) Blood pressure:
Monitoring blood pressure is important as opioids can cause hypotension, but it is not as critical as monitoring the level of sedation and respiratory status.

D) Level of sedation:
This is the priority because opioids can cause significant sedation and respiratory depression. Assessing the level of sedation helps determine if the client is at risk of further complications like respiratory arrest. Over-sedation can be a precursor to more serious complications, making this assessment crucial.

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A nurse is caring for an older adult client. The nurse informs the client that straining while defecating can cause which of the following?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse caring for a client who has hypertension and asks the nurse about a prescription for propranolol. The nurse should inform the client that this medication is contraindicated in clients who have a history of which of the following conditions?

Correct Answer is A

Explanation

A nurse is assessing a client who received an opioid narcotic for incisional pain. Which of the following findings is the priority?

Correct Answer is D

Explanation

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