A nurse is reviewing the medical history of a client who has myasthenia gravis and is asking about starting neostigmine. The nurse should identify which of the following client conditions as a potential contraindication for cholinesterase inhibitor therapy?

Cataracts

Hypertension

Hypothyroidism

Peptic ulcer disease

Answer and Explanation

The Correct Answer is D

A. Cataracts are not a contraindication for cholinesterase inhibitors like neostigmine.

B. Hypertension is not a direct contraindication for cholinesterase inhibitor therapy, although caution may be exercised depending on the overall health status of the client.

C. Hypothyroidism is not contraindicated for cholinesterase inhibitors; however, it should be managed appropriately.

D. Peptic ulcer disease is a significant contraindication for cholinesterase inhibitors like neostigmine because these medications can increase gastric secretions and motility, potentially exacerbating ulcer conditions and leading to complications.

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Free Nursing Study Resources

Correct Answer is B

Explanation

A. "Remove the patch for two to four hours daily.": This is incorrect because transdermal nitroglycerin patches should be worn continuously for 24 hours, with a scheduled time to remove them (usually overnight) to prevent tolerance.

B. "Apply a new patch each day after waking up.": This instruction is correct; clients should apply a new patch daily to ensure continuous therapeutic effects while also allowing a break to reduce tolerance.

C. "Cover the patch with plastic wrap.": This is incorrect; covering the patch with plastic wrap can alter the absorption of the medication and is not necessary.

D. "Replace the existing patch with a new patch as soon as anginal pain begins.": This is incorrect; clients should not replace the patch immediately for angina. Instead, they should use sublingual nitroglycerin for immediate relief and follow the prescribed patch schedule.

A. Muscle rigidity of the extremities B. Bounding radial pulses C. Depressed deep tendon reflexes D. Increased bowel motility

Correct Answer is C

Explanation

A. Muscle rigidity of the extremities: This finding is more indicative of hyperkalemia or severe electrolyte imbalances but is not a common symptom of hypokalemia.

B. Bounding radial pulses: This finding is more associated with hypervolemia or hyperkalemia, not with hypokalemia caused by furosemide.

C. Depressed deep tendon reflexes: This is the correct response, as low potassium levels (hypokalemia) can lead to diminished reflexes due to its role in neuromuscular function.

D. Increased bowel motility: This is incorrect, as hypokalemia typically results in decreased bowel motility and may cause constipation rather than increased motility.

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A nurse is reviewing the medical history of a client who has myasthenia gravis and is asking about starting neostigmine. The nurse should identify which of the following client conditions as a potential contraindication for cholinesterase inhibitor therapy?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is providing teaching to a client who has a new prescription for transdermal nitroglycerin patches to treat angina pectoris. Which of the following instructions should the nurse include in the teaching?

Correct Answer is B

Explanation

A nurse is assessing a client who started taking furosemide 2 days ago and has a potassium level of 3.1 mEq/L (3.5 to 5 mEq/L). Which of the following findings should the nurse expect?

Correct Answer is C

Explanation

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