A nurse is reviewing a client's medical history before administering a new prescription for atropine. Which of the following client conditions is contraindicated?

Glaucoma

Bronchospasms

Diverticulitis

Diarrhea

Answer and Explanation

The Correct Answer is A

) Glaucoma: Atropine is contraindicated in clients with glaucoma due to its potential to exacerbate intraocular pressure. Glaucoma is a condition characterized by increased intraocular pressure, which can lead to optic nerve damage and vision loss if left untreated or if pressure is further increased. Atropine, as an anticholinergic medication, works by dilating the pupil and inhibiting accommodation, thereby increasing intraocular pressure. Administering atropine to a client with glaucoma can worsen their condition and potentially cause acute angle-closure glaucoma, which is a medical emergency. Therefore, it is essential to avoid using atropine in clients with glaucoma to prevent irreversible vision loss and other serious complications.

B) Bronchospasms: Atropine can be used to treat bronchospasms by dilating the bronchi and bronchioles, making it easier to breathe. While it may not be the first-line treatment for bronchospasms, it is not contraindicated in this condition. The bronchodilatory effects of atropine help relieve airway constriction and improve airflow, which can be beneficial in managing bronchospasms associated with conditions such as asthma or chronic obstructive pulmonary disease (COPD). Therefore, atropine can be considered as part of the treatment regimen for bronchospasms when indicated.

C) Diverticulitis: Atropine does not have any specific contraindications related to diverticulitis. However, caution should be exercised in clients with pre-existing gastrointestinal conditions due to potential anticholinergic effects, such as decreased gastrointestinal motility. While atropine can inhibit gastrointestinal motility and secretions, which may exacerbate symptoms in some individuals with diverticulitis, it is not considered a contraindication. The decision to use atropine in clients with diverticulitis should be based on the overall assessment of the client's condition and the potential benefits versus risks of treatment.

D) Diarrhea: Atropine can be used to treat diarrhea by reducing gastrointestinal motility and secretions. Therefore, it is not contraindicated in clients with diarrhea. By slowing down gastrointestinal motility and reducing secretions, atropine can help alleviate diarrhea and promote better bowel control. While other treatment options may be considered depending on the underlying cause of diarrhea, atropine can be effective in managing diarrhea associated with certain conditions or as part of a treatment regimen for specific gastrointestinal disorders.

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Correct Answer is B

Explanation

A) "Inject the medication into the lateral thigh": While the lateral thigh is a common site for subcutaneous injections, enoxaparin is typically administered in the abdomen. Instructing the client to inject into the lateral thigh may lead to incorrect administration. Therefore, this instruction is not appropriate for enoxaparin administration.

B) "Ensure that the air bubble remains in the syringe": This instruction is correct. Enoxaparin prefilled syringes usually come with an air bubble to help ensure the full dose is delivered. Instructing the client to keep the air bubble in the syringe helps prevent the loss of medication during administration, ensuring that the full dose is delivered subcutaneously.

C) "Release the skin fold before injecting the medication": Releasing the skin fold before injecting the medication helps ensure proper needle insertion into the subcutaneous tissue and facilitates medication absorption. This instruction is generally appropriate for subcutaneous injections but is not specific to enoxaparin administration.

D) "Rub the site after injecting the medication": Rubbing the injection site after administration is not recommended, as it can cause irritation and discomfort. Instead, instruct the client to gently press on the injection site without rubbing to help disperse the medication and minimize bruising or discomfort. Therefore, this instruction is not appropriate for enoxaparin administration.

A. Morphine 2 mg IV B. Amitriptyline 25 mg PO C. Ketorolac 15 mg IV D. Acetaminophen 650 mg PO

Correct Answer is C

Explanation

A) Morphine 2 mg IV: Morphine is a potent opioid analgesic commonly used to manage moderate to severe pain. However, in this scenario, the client reports pain as 5 on a scale of 0 to 10, which indicates moderate pain. Morphine 2 mg IV may be excessive for this level of pain and could result in unnecessary sedation, respiratory depression, or other opioid-related adverse effects. Therefore, it is not the most appropriate choice for managing the client's pain.

B) Amitriptyline 25 mg PO: Amitriptyline is a tricyclic antidepressant with analgesic properties, but it is not typically used as a first-line treatment for acute postoperative pain. Additionally, it is administered orally and may not provide rapid pain relief in the immediate postoperative period. Therefore, it is not the most suitable option for managing the client's pain after a total knee replacement surgery.

C) Ketorolac 15 mg IV: Ketorolac is a nonsteroidal anti-inflammatory drug (NSAID) that provides potent analgesic and anti-inflammatory effects. It is commonly used for the management of moderate to severe pain, including postoperative pain. In this scenario, the client reports moderate pain after total knee replacement surgery, making ketorolac an appropriate choice for pain management. Administering ketorolac 15 mg IV can provide effective pain relief without the sedative effects of opioids, making it the most suitable PRN medication for the client's pain level.

D) Acetaminophen 650 mg PO: Acetaminophen is a non-opioid analgesic commonly used for mild to moderate pain relief. While acetaminophen is generally safe and effective, it may not provide sufficient pain relief for a client who reports pain as 5 on a scale of 0 to 10 after total knee replacement surgery. Additionally, oral administration may result in delayed onset of action compared to IV medications. Therefore, acetaminophen 650 mg PO may not be the most optimal choice for managing the client's pain in this situation.

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A nurse is reviewing a client's medical history before administering a new prescription for atropine. Which of the following client conditions is contraindicated?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is providing teaching to a client about how to self-administer subcutaneous injections of enoxaparin. Which of the following instructions should the nurse include?

Correct Answer is B

Explanation

A nurse is preparing to administer pain medication to a postoperative client who had a total knee replacement and reports pain as 5 on a scale of 0 to 10. Which of the following PRN medications should the nurse plan to administer?

Correct Answer is C

Explanation

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