A healthcare provider is reviewing the health care record of a client who reports urinary incontinence and asks about a prescription for Oxybutynin. The provider should recognize that Oxybutynin is contraindicated in the presence of which of the following conditions?

Correct Answer: D

Rationale: Oxybutynin is an anticholinergic medication that can increase intraocular pressure. It is contraindicated in clients with glaucoma, as it can worsen the condition. Glaucoma is a condition characterized by increased intraocular pressure, and using Oxybutynin can further elevate this pressure, potentially leading to serious complications such as vision impairment or damage to the optic nerve.

Correct Answer: A

Rationale: In this scenario, the client is experiencing severe hypotension due to Verapamil administration. The appropriate medication to counteract the vasodilation caused by Verapamil and reverse severe hypotension is Calcium gluconate, which should be administered slowly IV. Therefore, the correct choice is Calcium gluconate (Choice A).

Correct Answer: B

Rationale: The healthcare professional should withhold the medication and notify the provider of the client's previous reaction to penicillin. This information is crucial for the provider to prescribe an alternative antibiotic. Allergic reactions to penicillin can range from mild to severe anaphylaxis, so prior sensitization should be reported to the provider to avoid potential adverse reactions.

Correct Answer: B

Rationale: Coarse tremors are a common sign of Lithium toxicity. It is important for healthcare providers to monitor for this symptom as it indicates a potential overdose of the medication. Severe hypertension, constipation, and muscle spasms are not typically associated with Lithium toxicity.

Correct Answer: A

Rationale: A persistent dry cough is a common adverse effect of Enalapril, an ACE inhibitor. This cough is a result of increased bradykinin levels due to ACE inhibition. The client should be educated to monitor for a dry cough and notify the healthcare provider if it occurs, as it may indicate the need for a medication adjustment.

Correct Answer: B

Rationale: The correct answer is B. A 17-year-old can receive the influenza vaccine via nasal spray (LAIV) even if they have a hypersensitivity to penicillin, as this is not a contraindication for the influenza immunization. Therefore, in this scenario, the 17-year-old with a hypersensitivity to penicillin is a candidate for the nasal spray vaccine.

Correct Answer: A

Rationale: St. John's wort should be avoided by clients taking Warfarin as it can reduce the medication's effectiveness. The nurse should also advise the client to avoid other supplements that may interact with Warfarin, such as garlic and ginseng.

Correct Answer: C

Rationale: A serum potassium level of 5.2 mEq/L indicates hyperkalemia. Spironolactone is a potassium-sparing diuretic that can cause potassium retention. Hyperkalemia is a serious condition that can lead to cardiac dysrhythmias. The healthcare professional should withhold the medication and promptly notify the provider to prevent potential complications.

Correct Answer: C

Rationale: The correct answer is increased urine output. Dopamine increases cardiac output and improves renal perfusion, leading to increased urine output. This response indicates that the medication is effective in treating shock by enhancing renal function and perfusion.