A client has a new prescription for Propranolol. Which of the following findings should the healthcare provider identify as a contraindication to this medication?

Correct Answer: A

Rationale: In this scenario, the correct answer is A) Asthma. Propranolol is a non-selective beta-blocker that can cause bronchoconstriction due to its effects on beta-2 receptors in the lungs. For patients with asthma, this can exacerbate their condition and lead to potentially life-threatening bronchospasms. Option B) Diabetes mellitus is not a contraindication for Propranolol. In fact, beta-blockers can be beneficial for patients with diabetes as they can help with managing symptoms such as tachycardia and tremors associated with hypoglycemia. Option C) Hypertension is actually an indication for Propranolol. It is commonly used to treat hypertension by reducing heart rate and blood pressure. Option D) Glaucoma can be worsened by Propranolol due to its potential to reduce aqueous humor production, which can increase intraocular pressure. However, it is not a contraindication unless the client has a specific type of glaucoma called narrow-angle glaucoma. Understanding contraindications is crucial in pharmacology to ensure safe and effective medication administration. It is important for healthcare providers to be aware of such contraindications to prevent adverse reactions and provide optimal care for their patients.

Correct Answer: A

Rationale: In this scenario, the correct answer is A) Dry cough. Enalapril is an angiotensin-converting enzyme (ACE) inhibitor commonly used to treat hypertension and heart failure. One of the most common adverse effects associated with ACE inhibitors like Enalapril is a persistent dry cough. This occurs due to the accumulation of bradykinin, a substance affected by ACE inhibitors, in the lungs leading to irritation and coughing. Weight gain (option B) is not typically associated with Enalapril use. ACE inhibitors can even lead to weight loss due to their effects on the renin-angiotensin-aldosterone system. Diarrhea (option C) and nausea (option D) are less common side effects of Enalapril and not typically the primary adverse effects to monitor for in a patient taking this medication. Educationally, understanding the common adverse effects of specific drug classes like ACE inhibitors is crucial for healthcare providers to effectively educate patients on what to expect and monitor for during treatment. This knowledge ensures patient safety and adherence to the prescribed regimen, ultimately improving health outcomes.

Correct Answer: B

Rationale: In pharmacology, it is crucial to provide accurate discharge teaching to ensure patient safety and medication effectiveness. In the case of Alendronate, the correct instruction is to remain upright for 30 minutes after taking the medication. This is because Alendronate is a bisphosphonate used to treat osteoporosis by inhibiting bone resorption. Remaining upright helps prevent esophageal irritation and reduces the risk of esophageal ulcers, a common side effect of this medication. Option A, taking the medication at bedtime, is incorrect because Alendronate should be taken in the morning on an empty stomach with a full glass of water to enhance absorption. Option C, taking the medication with food, is also incorrect as it can decrease the absorption of Alendronate. Option D, increasing intake of calcium-rich foods, is not relevant to the administration of Alendronate but is important for overall bone health. Educationally, understanding the rationale behind specific medication instructions is essential for nursing practice. It ensures that nurses can provide accurate information to patients, promote medication compliance, and prevent potential complications. By grasping the pharmacokinetics and administration principles of medications like Alendronate, nurses can contribute to improving patient outcomes and safety.

Correct Answer: B

Rationale: Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) that can increase the risk of bleeding when taken with Warfarin due to its antiplatelet effects. The combination of Warfarin, an anticoagulant, and NSAIDs can potentiate the risk of bleeding complications. Clients on Warfarin should avoid NSAIDs and opt for alternative pain relief options to minimize the risk of adverse effects.

Correct Answer: C

Rationale: In this scenario, the correct answer is C) Avoid drinking grapefruit juice. Verapamil is a calcium channel blocker commonly prescribed to manage hypertension, angina, and certain cardiac arrhythmias. Grapefruit juice inhibits the enzyme CYP3A4 in the liver, which can lead to increased levels of Verapamil in the bloodstream, causing potential toxicity or adverse effects. Option A) Take this medication at bedtime is incorrect as Verapamil is typically prescribed to be taken at specific times based on the condition being treated to maintain therapeutic levels throughout the day. Option B) Monitor for signs of hyperglycemia is irrelevant to Verapamil as it does not directly impact blood sugar levels. Option D) Increase your intake of potassium-rich foods is also incorrect as Verapamil does not typically affect potassium levels in the body. Educationally, this question highlights the importance of understanding drug-food interactions and the significance of providing clear instructions to clients to ensure safe and effective medication therapy. Nurses must educate clients on potential interactions to prevent adverse outcomes and promote medication adherence.