A nurse is preparing to administer ketorolac to a client. Which of the following conditions should the nurse include as a contraindication for taking this medication?

History of gastrointestinal bleeding

Liver impairment

Allergy to codeine

History of glaucoma

Answer and Explanation

The Correct Answer is A

A. History of gastrointestinal bleeding: Ketorolac is a nonsteroidal anti-inflammatory drug (NSAID) that can inhibit prostaglandin synthesis, increasing the risk of gastrointestinal bleeding or ulceration. A history of GI bleeding is a contraindication due to the heightened risk of serious complications.

B. Liver impairment: While caution is warranted, mild to moderate liver impairment is not an absolute contraindication. Liver function should be monitored, but it does not automatically prevent ketorolac use.

C. Allergy to codeine: Ketorolac is not an opioid and does not contain codeine. An allergy to codeine does not contraindicate its administration.

D. History of glaucoma: Ketorolac does not typically affect intraocular pressure or exacerbate glaucoma. It is not contraindicated in clients with this condition.

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Correct Answer is A

Explanation

A. Hyperglycemia: TPN contains high concentrations of glucose, which can lead to elevated blood sugar levels. Clients receiving TPN should have frequent blood glucose monitoring, and insulin may be required to manage hyperglycemia.

B. Hyperkalemia: While electrolyte imbalances can occur with TPN, potassium is typically added in controlled amounts to the solution. Hyperkalemia is not a common direct adverse effect unless the formulation is incorrect or the client has impaired renal function.

C. Hypermagnesemia: Magnesium levels in TPN are carefully regulated, and hypermagnesemia is uncommon. Over-supplementation could cause this, but it is not a typical adverse effect for most clients receiving standard TPN.

D. Urine output of 160 mL in 4 hr: This urine output falls within normal limits (approximately 0.5 mL/kg/hr). Oliguria or significantly reduced urine output would be concerning, but 160 mL in 4 hours does not indicate an adverse effect of TPN.

A. Tell the client they will get used to the side effects. B. Check the client's other medications for potential interactions. C. Report the client's refusal to the nursing supervisor. D. Explain how harmful herbal medications can be.

Correct Answer is B

Explanation

A. Tell the client they will get used to the side effects: Minimizing or dismissing the client’s concerns about medication side effects does not respect their autonomy or provide safe guidance. It could undermine trust and does not address the risks of alternative therapies.

B. Check the client's other medications for potential interactions: Saw palmetto can interact with other medications, including anticoagulants and hormonal therapies. Reviewing the client’s current medications ensures safety and helps prevent adverse effects if they choose to use the herbal supplement.

C. Report the client's refusal to the nursing supervisor: While documentation of medication refusal is necessary, immediately reporting without addressing safety and interactions does not support client-centered care or informed decision-making.

D. Explain how harmful herbal medications can be: Not all herbal supplements are inherently harmful. Providing balanced information about potential benefits, risks, and interactions is more appropriate than blanket statements that may seem judgmental.

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A nurse is preparing to administer ketorolac to a client. Which of the following conditions should the nurse include as a contraindication for taking this medication?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is A

Explanation

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Correct Answer is B

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