A nurse is reviewing a client's prescribed medications. Which of the following situations represents a contraindication to medication administration?
An antibiotic medication that has a side effect of nausea when taken without food.
Administering medications to a client under 4 months of age.
A antihypertensive medication given for high-blood pressure that causes orthostatic hypotension.
A medication with a Blackbox warning that the drug causes tendonitis and the patient has a history of tendonitis.
The Correct Answer is D
A. An antibiotic medication that has a side effect of nausea when taken without food:
Nausea is a common side effect of many medications, including antibiotics, when taken on an empty stomach. While this side effect may cause discomfort, it is generally not a contraindication to medication administration. Patients can often manage this side effect by taking the medication with food or as advised by their healthcare provider.
B. Administering medications to a client under 4 months of age:
While administering medications to very young children requires special considerations and dosing adjustments, it is not inherently a contraindication. The key is to ensure that the medications are appropriate for the age and weight of the infant, and are prescribed and dosed correctly.
C. An antihypertensive medication given for high-blood pressure that causes orthostatic hypotension:
Orthostatic hypotension is a known side effect of some antihypertensive medications. While this side effect needs to be managed carefully, it does not represent a contraindication to the medication. Adjusting the dose or changing medications may be required to manage this side effect.
D. A medication with a Blackbox warning that the drug causes tendonitis and the patient has a history of tendonitis:
A Black Box warning is the strictest warning put in the labelling of a prescription drug by the FDA. It indicates that the drug has significant risk of serious or life-threatening adverse effects. If a medication with a Black Box warning indicates a risk of tendonitis and the patient has a history of tendonitis, this represents a contraindication, as the drug could exacerbate or trigger the condition, posing a serious risk to the patient.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["C","E","F"]
Explanation
A. Nitroglycerin 10mg Sublingual Tablet:
Nitroglycerin taken sublingually (under the tongue) bypasses the gastrointestinal tract and the liver’s first-pass metabolism. It is designed to act quickly and directly enter the bloodstream through the mucous membranes, avoiding significant first-pass effect.
B. Morphine 2mg IV (Intravenously):
Morphine administered intravenously bypasses the gastrointestinal tract and liver, thus avoiding the first-pass effect entirely. The drug directly enters systemic circulation, providing immediate effect.
C. Famotidine 10mg Tablet:
Famotidine, when taken orally, undergoes significant first-pass metabolism. This means that a portion of the drug is metabolized by the liver before it reaches systemic circulation, affecting its bioavailability.
D. Nitroglycerin 4mg Sublingual Tablet:
Similar to the 10mg sublingual tablet, nitroglycerin administered sublingually bypasses the first-pass effect. The medication enters the bloodstream directly through the mucous membranes in the mouth.
E. Acetaminophen 325mg Capsule:
Acetaminophen, when taken orally, undergoes first-pass metabolism. A significant portion of the drug is metabolized in the liver before reaching systemic circulation, which can impact its overall effectiveness.
F. Diphenhydramine (Benadryl) 25mg Tablet:
Diphenhydramine, taken orally, is also affected by the first-pass effect. As with other oral medications, a part of the drug is metabolized by the liver before reaching systemic circulation, which can affect its efficacy and bioavailability.
Correct Answer is D
Explanation
A. Transdermal patch:
A transdermal patch provides a slow, continuous release of medication over a period of time. While it is useful for long-term management of conditions, it does not provide the rapid onset needed for acute situations. The medication gradually enters the bloodstream through the skin, making it less effective for immediate relief.
B. Topical ointment:
Topical ointments are applied to the skin and are absorbed locally at the site of application. They are not designed for rapid systemic absorption and typically have a slower onset compared to other routes like sublingual or intravenous.
C. Suspended-release:
Suspended-release formulations are designed for controlled, extended-release of medication over time. These are not intended for rapid onset but rather for maintaining therapeutic levels of the medication over an extended period. They are suitable for long-term treatment rather than immediate relief.
D. Sublingual:
Sublingual administration (under the tongue) provides the most rapid onset for nitroglycerin. This route allows the medication to be absorbed directly into the bloodstream through the mucous membranes in the mouth, bypassing the gastrointestinal tract and first-pass metabolism in the liver. This results in a quick therapeutic effect, which is crucial for managing acute angina attacks.
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