In what patient is propranolol (Inderal) contraindicated?

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Pharmacology Final ATI Questions

Question 1 of 5

In what patient is propranolol (Inderal) contraindicated?

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.

Question 2 of 5

The patient receives imipramine (Tofranil) as treatment for depression. He is admitted to the emergency department following an intentional overdose of this medication. What will the priority assessment by the nurse include?

Correct Answer: A

Rationale: Imipramine, a tricyclic antidepressant, is cardiotoxic in overdose, causing dysrhythmias (e.g., widened QRS) due to sodium channel blockade. The priority assessment is cardiac status to detect life-threatening arrhythmias, guiding urgent interventions like sodium bicarbonate. Liver and renal effects are secondary in acute overdose. Neurological issues like seizures occur but are less immediately lethal than cardiac collapse. The nurse focuses on cardiac monitoring, aligning with toxicology priorities, making A the critical assessment.

Question 3 of 5

In severe renal failure:

Correct Answer: D

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

Question 4 of 5

The nurse is working with a graduate nurse to prepare an intravenous dose of potassium. Which statement by the graduate nurse reflects a need for further teaching?

Correct Answer: D

Rationale: The statement "The intravenous potassium dose will be given undiluted" reflects a need for further teaching. Potassium should always be diluted before administration to prevent irritation of the veins and potential adverse effects, such as phlebitis or tissue damage. Diluting the medication helps to reduce the risk of complications, making it safer for the patient. Therefore, the correct approach is to dilute intravenous potassium before administering it to the patient.

Question 5 of 5

A 26-year-old man presents to the emergency department with severe right lower quadrant pain. Physical exam reveals rebound tenderness and decreased bowel sounds. An emergent appendectomy is performed. Postsurgically, he is given an NSAID along with morphine for pain control. Which of the following NSAIDs is commonly used as an adjunct to opioids postsurgically?

Correct Answer: D

Rationale: Post-appendectomy pain management often combines opioids like morphine with NSAIDs for synergy. Acetaminophen is an analgesic but not a true NSAID (lacks significant anti-inflammatory action). Celecoxib , a COX-2 inhibitor, is less common acutely due to cost and milder effect. Ibuprofen is effective but less potent parenterally. Ketorolac , a potent NSAID, is widely used postsurgically-available IV/IM, it reduces inflammation and pain, complementing morphine's central action. Naproxen (E) is oral, less ideal acutely. Ketorolac's rapid onset and efficacy in reducing opioid requirements make it standard. Its short-term use minimizes GI risks, aligning with surgical protocols, distinguishing it from other options for acute postoperative pain control.

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