A client who is receiving edrophonium chloride suddenly is complaining of abdominal cramps and the nurse observes the client is experiencing increased perspiration and salivation. The nurse makes sure the availability of which of the following?

Correct Answer: C

Rationale: Edrophonium chloride is a medication used to diagnose myasthenia gravis, a condition characterized by muscle weakness. When a client receiving edrophonium chloride suddenly experiences symptoms like abdominal cramps, increased perspiration, and salivation, these are suggestive of cholinergic crisis, which is an overdose of acetylcholinesterase inhibitors like edrophonium. Atropine sulfate is an anticholinergic medication used to counteract the effects of excessive acetylcholine in the body, hence it is essential to have it readily available to manage cholinergic crisis in this client. Levodopa, methylphenidate hydrochloride, and carbamazepine are not indicated for managing cholinergic crisis.

Correct Answer: B

Rationale: Beta-adrenergic blocking agents are contraindicated in patients with bradycardia, heart failure, and heart block. The drug would not be contraindicated in the other patients. The nurse should assess the patient’s medical history and contraindications before administering propranolol to ensure safe and effective treatment.

Correct Answer: D

Rationale: In severe renal failure, the clearance of digoxin is reduced, requiring smaller maintenance doses to avoid toxicity.

Correct Answer: C

Rationale: Edrophonium chloride is a medication used to diagnose myasthenia gravis, a condition characterized by muscle weakness. When a client receiving edrophonium chloride suddenly experiences symptoms like abdominal cramps, increased perspiration, and salivation, these are suggestive of cholinergic crisis, which is an overdose of acetylcholinesterase inhibitors like edrophonium. Atropine sulfate is an anticholinergic medication used to counteract the effects of excessive acetylcholine in the body, hence it is essential to have it readily available to manage cholinergic crisis in this client. Levodopa, methylphenidate hydrochloride, and carbamazepine are not indicated for managing cholinergic crisis.

Correct Answer: D

Rationale: Amiodarone inhibits warfarin metabolism, increasing INR, so it affects anticoagulation. Disulfiram also potentiates warfarin via CYP inhibition, enhancing effect. Fluconazole similarly boosts warfarin levels, a significant interaction. Benzodiazepines have no major effect on anticoagulant therapy, a true statement, as they're metabolized differently. Metronidazole, like fluconazole, increases warfarin effect. Benzodiazepines' lack of interaction makes them safer in this context, a key consideration in polypharmacy.