For which client would the use of a phenothiazine most likely be contraindicated?

A client being treated for a traumatic brain injury.

A client with a history of ischemic heart disease.

A pediatric client.

A client with type 2 diabetes.

Answer and Explanation

The Correct Answer is A

Phenothiazines are contraindicated in patients with suspected or established subcortical brain damage. Phenothiazines are a class of drugs that have antipsychotic, antiemetic, and sedative effects. They act by blocking dopamine receptors in the brain and can cause extrapyramidal symptoms, hypotension, and anticholinergic effects.

Choice B is wrong because phenothiazines are not contraindicated in patients with ischemic heart disease.

However, they can cause orthostatic hypotension and cardiac arrhythmias, so they should be used with caution and monitored closely in these patients.

Choice C is wrong because phenothiazines are not contraindicated in pediatric patients.

However, they can cause sedation, hypotension, and extrapyramidal symptoms, so they should be used with caution and at lower doses in these patients.

Choice D is wrong because phenothiazines are not contraindicated in patients with type 2 diabetes.

However, they can cause hyperglycemia and weight gain, so they should be used with caution and monitored closely in these patients.

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Correct Answer is B

Explanation

This is because hypothyroidism can reduce the metabolism and clearance of theophylline, leading to higher serum levels and increased risk of toxicity. Therefore, when the thyroid function is restored by levothyroxine or liothyronine, the dose of theophylline may need to be lowered to avoid excessive effects.

Choice A is wrong because decreasing theophylline dosage immediately may result in suboptimal control of asthma symptoms.

The dose adjustment should be based on serum theophylline levels and clinical response.

Choice C is wrong because discontinuing the client’s theophylline may cause worsening of asthma and potentially life-threatening complications.

Theophylline is an important bronchodilator that should not be stopped abruptly without medical supervision.

Choice D is wrong because increasing theophylline dosage immediately may cause overdose and adverse effects such as nausea, vomiting, headache, tachycardia, arrhythmias, seizures and even death.

The dose of theophylline should be carefully titrated according to serum levels and clinical response.

A. Amount of fluid intake. B. Timing of medication administration. C. Previous effectiveness of laxatives. D. The amount of fiber intake.

Correct Answer is A

Explanation

The nurse should ask this question because the client is taking a chemical stimulant laxative, which can cause dehydration and electrolyte imbalance, especially in combination with medications for heart failure and osteoarthritis that may also affect fluid and electrolyte balance. The nurse should assess the client’s hydration status and risk of hypovolemia or hypotension.

Choice B. Timing of medication administration is wrong because it is not the priority question in this situation.

The nurse should ask this question later to determine if the client is taking the medications as prescribed and if there are any drug interactions or adverse effects.

Choice C. Previous effectiveness of laxatives is wrong because it is not relevant to the client’s current condition.

The nurse should ask this question later to evaluate the client’s bowel habits and history of constipation.

Choice D. The amount of fiber intake is wrong because it is not the priority question in this situation.

The nurse should ask this question later to educate the client about dietary measures to prevent constipation and promote bowel health.

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For which client would the use of a phenothiazine most likely be contraindicated?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is caring for a client newly diagnosed with hypothyroidism. The client also takes theophylline to control asthma symptoms. What change may need to be made to the client’s theophylline dose?

Correct Answer is B

Explanation

A client taking a chemical stimulant laxative and medications for heart failure and osteoarthritis calls the clinic and reports, “I’m just not feeling right.” What is the priority question the nurse should ask this client?

Correct Answer is A

Explanation

When providing client teaching to the family of a 12-year-old child receiving somatropin, the nurse stresses the need to notify prescriber if what manifestation occurs?

A client who is prone to motion sickness is going on a fishing trip on a boat and has been prescribed an antiemetic. What action should the nurse recommend?

The nurse is caring for a pediatric client with a new onset of hypercalcemia. What condition would be most likely to cause this altered serum calcium level?

A client has an important presentation to make in 4 hours, and he needs relief from the congestion of seasonal rhinitis. The client calls the nurse, explains the situation, and tells the nurse that he cannot afford to be drowsy. What medication is most likely to meet this client’s needs?

A client has a history of atrial fibrillation and is taking an oral anticoagulant. The client has been newly diagnosed with hypothyroidism and placed on levothyroxine. What assessment should the nurse prioritize?

What statement by a client who is to take an antitussive with codeine indicates that the nurse’s teaching has been effective?

The nurse is instructing a patient who will take psyllium (Metamucil) to treat constipation. What information will the nurse include when teaching this patient?

A college student with migraine headaches that cause nausea and vomiting has been prescribed trimethobenzamide. The nurse should caution the student to avoid using which substance?