A patient is taking a combination oral contraceptive (OC) and tells the nurse that she is planning to undergo knee replacement surgery in 2 months. What will the nurse recommend for this patient?

Correct Answer: B

Rationale: Combination oral contraceptives (OCs) containing estrogen increase the risk of thromboembolism, especially during surgery with immobilization like knee replacement. Stopping the OC at least 4 weeks prior and switching to an alternative contraception method (e.g., barrier methods) is recommended to minimize this risk. Progestin-only options or timing adjustments don’t address the estrogen-related thrombosis risk, making option B the best recommendation.

Correct Answer: C

Rationale: In this scenario, the correct answer is C) Edema at the IV insertion site, as it would cause the most concern when administering intravenous dopamine. Dopamine is a potent vasoactive medication that can cause extravasation injury if it infiltrates into the surrounding tissues. Edema at the IV insertion site indicates a potential infiltration of dopamine, leading to tissue damage and compromised circulation in the affected area. Option A) Blood pressure of 100/70 mm Hg is not the most concerning finding because dopamine is used to increase blood pressure in patients with hypotension. Increased urine output (Option B) is an expected response to dopamine, as it is a diuretic medication that helps improve kidney function. Option D) Headache is a common side effect of dopamine but is not as concerning as the possibility of tissue damage from infiltration. Educationally, understanding the potential complications of IV medication administration is crucial for nurses, especially in the intensive care unit where patients are often receiving high-risk medications. Recognizing signs of infiltration early can prevent serious complications and promote patient safety. Nurses must be vigilant in assessing IV sites and promptly addressing any signs of infiltration to prevent further harm to the patient.

Correct Answer: D

Rationale: Nonselective beta-blockers are commonly used to treat hypertension and supraventricular arrhythmias due to their ability to block beta receptors in the heart, leading to decreased heart rate and contractility. This helps in reducing cardiac workload and oxygen demand, thereby managing these conditions effectively. Option A, chronic obstructive pulmonary disease (COPD), is incorrect because nonselective beta-blockers can exacerbate bronchoconstriction in patients with COPD due to their action on beta-2 receptors in the lungs, potentially leading to respiratory distress. Option B, heart failure, is incorrect because nonselective beta-blockers are not typically used in heart failure management. Instead, selective beta-blockers targeting beta-1 receptors are preferred as they provide benefits without compromising cardiac function. Option C, heart block, is incorrect because nonselective beta-blockers can worsen heart block by further slowing down the electrical conduction through the heart's conduction system, potentially leading to more serious rhythm disturbances. Educationally, understanding the pharmacological properties of beta-blockers and their selectivity is crucial for healthcare professionals in making informed decisions regarding their use in different clinical scenarios. It is essential to consider the specific effects of medications on different organ systems to optimize patient care and avoid potential complications.

Correct Answer: A

Rationale: In this case, the correct answer is A) hepatic toxicity. Acetaminophen is primarily metabolized in the liver, and when taken in excess or in combination with alcohol, it can lead to liver damage. This is a crucial consideration for the nurse to monitor in a client who regularly consumes acetaminophen and alcohol. Option B) renal damage is incorrect because acetaminophen primarily affects the liver, not the kidneys. Option C) thrombotic effects and Option D) pulmonary damage are also incorrect as they are not commonly associated with acetaminophen use. Educational Context: Understanding the potential adverse effects of medications like acetaminophen is essential for nurses and healthcare professionals to ensure patient safety. It is important to educate clients on the proper use of medications, including dosage and any potential interactions or risks associated with their use. Monitoring for adverse effects is a key role of the nurse in promoting patient well-being and preventing complications.

Correct Answer: B

Rationale: The correct answer is B) sedation. Albuterol is a beta-2 adrenergic agonist commonly used to treat asthma by relaxing the muscles in the airways, making it easier to breathe. Sedation is not a common side effect of albuterol. A) Tachycardia is a potential side effect of albuterol due to its stimulant effect on the heart, causing it to beat faster. This can lead to palpitations and an increased heart rate. C) Temporary dyspnea is a symptom that albuterol aims to relieve, not induce. Albuterol is used to alleviate shortness of breath and help with breathing difficulties in asthma patients. D) Nervousness is a common side effect of albuterol due to its stimulant properties. It can cause feelings of jitteriness, restlessness, and anxiety in some individuals. In an educational context, understanding the side effects of medications like albuterol is crucial for nurses to provide safe and effective care to their patients. By knowing the potential adverse effects, nurses can monitor patients closely, educate them on what to expect, and intervene promptly if needed to ensure optimal outcomes in asthma management.