A nurse is caring for a client with hypertension who asks about a prescription for propranolol. The nurse should inform the client that this medication is contraindicated in clients with a history of which of the following conditions?

Correct Answer: A

Rationale: Propranolol is contraindicated in clients with a history of asthma because it can cause bronchospasms due to its non-selective beta-blocking properties. By blocking beta-2 receptors in the lungs, propranolol can lead to bronchoconstriction, potentially triggering asthma symptoms and exacerbating respiratory issues. It is essential for individuals with asthma to avoid medications like propranolol that can worsen their condition.

Correct Answer: C

Rationale: In this scenario, the correct answer is C) The client consumed alcohol while taking the medication. Disulfiram is a medication used to support individuals with alcohol use disorder by causing unpleasant effects if alcohol is consumed. Disulfiram interacts with alcohol metabolism, leading to an accumulation of acetaldehyde, which results in symptoms like severe nausea and vomiting. Option A) The client demonstrated an allergic response to the medication is incorrect because the symptoms described are typical of the medication's known side effects, not an allergic reaction. Option B) The client experienced a common side effect of the medication is incorrect as it does not address the specific reason for the distress in this case, which is related to alcohol consumption. Option D) The client took an overdose of the medication is also incorrect because the symptoms described are not indicative of an overdose but rather a reaction due to alcohol intake while on disulfiram. Educationally, this question highlights the importance of understanding how certain medications interact with substances like alcohol and the need for individuals to adhere to prescribed guidelines to avoid adverse effects. It emphasizes the role of healthcare providers in educating clients on medication use and lifestyle modifications to ensure therapeutic effectiveness and safety.

Correct Answer: B

Rationale: The correct instruction for a client using nitroglycerin transdermal patches is to remove the patch every night before bedtime. This is essential to prevent tolerance to the medication's effects. Continuous exposure to nitroglycerin can lead to the body becoming less responsive to its therapeutic effects over time, making it less effective in managing the condition it is prescribed for.

Correct Answer: B

Rationale: In pharmacology, it is crucial to provide accurate and detailed instructions to patients to ensure the safe and effective use of medications. In the case of hydrochlorothiazide, a diuretic commonly used to treat hypertension, the correct instruction to include is to increase intake of potassium-rich foods. This is because hydrochlorothiazide can deplete potassium levels in the body, leading to hypokalemia. By increasing potassium-rich foods such as bananas, oranges, spinach, and potatoes, the patient can help maintain their potassium levels within the normal range. Option A, taking the medication in the morning, is not specifically related to hydrochlorothiazide but rather a general instruction for some medications. Hydrochlorothiazide can be taken at any time of the day, so this instruction is not a priority. Option C, avoiding sun exposure while taking the medication, is unrelated to hydrochlorothiazide use. This instruction may be relevant for certain medications that increase sensitivity to sunlight, but it is not applicable in this case. Option D, limiting fluid intake to 1 liter per day, is incorrect because hydrochlorothiazide is a diuretic that increases urination to reduce fluid retention. Restricting fluid intake too severely can lead to dehydration, which is not advisable while taking this medication. Educationally, understanding the rationale behind each instruction helps students grasp the importance of patient education in pharmacology. By explaining why certain instructions are correct and others are not, students can develop critical thinking skills in applying pharmacological knowledge to real-world scenarios, ultimately ensuring safe and effective patient care.

Correct Answer: C

Rationale: In this scenario, the correct laboratory result to review for an indication of a therapeutic effect of epoetin alfa in a client with chronic renal disease is the hematocrit (Hct). Epoetin alfa is a medication that stimulates red blood cell production, and an increase in the hematocrit level indicates a positive response to the treatment. Option A, the leukocyte count, is not relevant in this context as it measures white blood cells, which are not directly affected by epoetin alfa therapy. Option B, the platelet count, is also unrelated to the medication's therapeutic effect on red blood cell production. Option D, the erythrocyte sedimentation rate (ESR), is a nonspecific indicator of inflammation and not specifically related to the action of epoetin alfa in stimulating erythropoiesis. Understanding the rationale behind monitoring specific laboratory values in response to pharmacological interventions is crucial in nursing practice. By recognizing the significance of changes in hematocrit levels with epoetin alfa therapy, nurses can effectively evaluate the medication's efficacy and adjust treatment as needed to optimize patient outcomes in clients with chronic renal disease.