A nurse is reviewing the medical record of a client who is taking acetaminophen to relieve headache pain.

Which of the following conditions in the client's history should the nurse identify as a contraindication?

Choice A reason:

Goal – oriented is the correct answer. Obsessive-compulsive personality disorder (OCPD) is a personality disorder characterized by a pattern of preoccupation with orderliness, perfectionism, and control. Individuals with OCPD tend to be highly organized, detail-oriented, and focused on achieving their goals. They often set strict standards for themselves and others and are driven by a strong need for perfection in all aspects of their lives.

Choice B reason

Provocative behaviour is not a characteristic commonly associated with obsessive-compulsive personality disorder (OCPD). In fact, individuals with OCPD tend to be more reserved, cautious, and serious in their interactions with others.

Choice C reason:

Lack of empathy While individuals with OCPD may struggle with interpersonal relationships due to their rigid standards and expectations, they typically do not lack empathy. They might find it challenging to understand and relate to emotions or perspectives that do not align with their own, but this is different from a complete lack of empathy, which is more commonly seen in certain other personality disorders

Choice D reason.

Lability refers to emotional instability or rapid and extreme shifts in emotions. This is not a typical feature of obsessive-compulsive personality disorder (OCPD). Individuals with OCPD tend to be emotionally restrained and might have difficulty expressing emotions, rather than experiencing emotional lability.

The correct answer is choice D. Decreased hemoglobin.

Choice A rationale:

Cigarette smoking typically causes an increase in blood pressure due to the nicotine’s stimulating effects on the cardiovascular system, not a decrease.

Choice B rationale:

Smoking is more likely to cause tachycardia (increased heart rate) rather than bradycardia (decreased heart rate) because nicotine stimulates the release of adrenaline.

Choice C rationale:

Somnolence (drowsiness) is not a common adverse effect of cigarette smoking. Smoking usually has a stimulating effect due to nicotine.

Choice D rationale:

Decreased hemoglobin can occur as a result of smoking because it can lead to chronic obstructive pulmonary disease (COPD) and other respiratory issues, which can impair oxygen transport in the blood. Additionally, smoking can cause carbon monoxide to bind with hemoglobin, reducing its oxygen-carrying capacity.