A nurse is obtaining a medical history from a client who is requesting a prescription for bupropion for smoking cessation. Which of the following assessment findings in the client's history should the nurse report to the provider?
Recent head injury
Hepatitis B infection
Hypothyroidism
Knee arthroplasty 1 month ago
The Correct Answer is A
A. Recent head injury:
A recent head injury is a potential concern when considering the prescription of bupropion. Bupropion can lower the seizure threshold, and head injuries might increase the risk of seizures. Therefore, it's important to report a recent head injury to the healthcare provider to assess the client's suitability for bupropion.
B. Hepatitis B infection:
Hepatitis B infection is not a contraindication for bupropion. However, the healthcare provider should be aware of the client's full medical history, including hepatitis B infection, to ensure appropriate monitoring and management, especially if the client is taking other medications or has liver function concerns.
C. Hypothyroidism:
Hypothyroidism, a condition where the thyroid gland does not produce enough thyroid hormones, is not a contraindication for bupropion. However, the healthcare provider should be aware of this condition to monitor the client appropriately, as thyroid function can influence the metabolism of medications.
D. Knee arthroplasty 1 month ago:
Knee arthroplasty (knee replacement surgery) performed one month ago is not a direct contraindication for bupropion use. However, the provider should be informed of recent surgeries or procedures, especially if the client is taking medications or undergoing physical therapy, to ensure there are no potential drug interactions or complications related to the recent surgery. It's essential to monitor for signs of infection or other complications post-surgery.
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Related Questions
Correct Answer is D
Explanation
A. Magnesium hydroxide:
Magnesium hydroxide is an antacid commonly used to relieve indigestion and heartburn. It does not have any known significant interactions with tranylcypromine. MAOIs typically do not interfere with antacids.
B. Ibuprofen:
Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) used to reduce pain and inflammation. It does not have specific interactions with tranylcypromine. However, individuals taking MAOIs should be cautious about using NSAIDs due to the potential risk of bleeding, especially gastrointestinal bleeding. While it's not a direct interaction, it's generally advisable for individuals taking MAOIs to consult their healthcare provider before using NSAIDs.
C. Ranitidine:
Ranitidine is an H2 blocker used to reduce stomach acid production. It does not have any known significant interactions with tranylcypromine. H2 blockers like ranitidine are often used to manage gastrointestinal issues and are generally considered safe when taken with MAOIs.
D. Pseudoephedrine:
Pseudoephedrine is a decongestant commonly found in cold and allergy medications. It can cause a dangerous increase in blood pressure when combined with MAOIs, potentially leading to a hypertensive crisis. Due to this serious interaction, individuals taking MAOIs are strongly advised to avoid medications containing pseudoephedrine.
Correct Answer is D
Explanation
A. Denial:
Denial is a defense mechanism in which a person refuses to accept reality or acknowledge the existence of something that is evident to others. For example, a person diagnosed with a serious illness might deny that they are ill or refuse to believe the diagnosis. In this scenario, the client is not denying a reality; he is expressing anger and directing it toward the nurse.
B. Compensation:
Compensation is a defense mechanism where an individual overachieves in one area to compensate for real or imagined deficiencies in another area. For instance, someone who feels intellectually inferior might excel in sports to compensate for their perceived inadequacy. This is not applicable to the client's situation in the scenario provided.
C. Rationalization:
Rationalization involves providing logical or reasonable explanations to justify behaviors or feelings that might otherwise be unacceptable. For instance, a person might rationalize a failure by blaming external factors rather than accepting personal responsibility. In the scenario, the client is not offering rationalizations but is expressing direct anger.
D. Displacement:
Displacement occurs when emotions, especially anger or frustration, are redirected from the original source to a less threatening target. For example, a person who is angry with their boss might come home and take out their frustration on their family members. In the given situation, the client is displacing his anger from his partner onto the nurse, asking her to leave, making displacement the most appropriate choice.
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