Correct Answer: A

Rationale: Methylergonovine is a medication that causes uterine contractions to control postpartum hemorrhage. It is contraindicated in clients with hypertension because it can cause vasoconstriction and elevate blood pressure, increasing the risk of stroke or heart attack.
Choice B is wrong because migraine headaches are not a contraindication for methylergonovine, although the medication may exacerbate headaches in some clients.
Choice C is wrong because asthma is not a contraindication for methylergonovine, as it does not affect the respiratory system directly.
Choice D is wrong because diabetes mellitus is not a contraindication for methylergonovine, as it does not affect blood glucose levels or insulin requirements.

Correct Answer: A

Rationale: Monitoring for signs of liver dysfunction (e.g., jaundice, abdominal pain) is critical with valproic acid, a mood stabilizer, as it can cause hepatotoxicity, requiring regular liver function tests.
Choice B is incorrect because valproic acid can be taken with or without food; a high-fat meal is not necessary.
Choice C is incorrect because valproic acid takes 1-2 weeks to stabilize mood, not immediately.
Choice D is incorrect because valproic acid should not be discontinued abruptly, even if symptoms improve, to avoid withdrawal or relapse; it requires provider guidance.

Correct Answer: D

Rationale: Reporting insomnia or agitation to the provider is critical, as these are common side effects of bupropion, an antidepressant that stimulates norepinephrine and dopamine, and may require dose adjustment or alternative therapy.
Choice A is incorrect because bupropion is typically taken in the morning or twice daily, as it can cause insomnia if taken at bedtime.
Choice B is incorrect because moderate caffeine intake is generally safe, though excessive caffeine may exacerbate agitation.
Choice C is incorrect because bupropion is more likely to cause weight loss, not weight gain, unlike some other antidepressants.

Correct Answer: A

Rationale: Maintaining the head of the bed at a 30-degree angle promotes venous drainage from the brain, reducing intracranial pressure in clients with traumatic brain injury.
Choice B is incorrect because suctioning the endotracheal tube every 2 hours is not routine; it should be done only as needed to avoid hypoxia and ICP spikes.
Choice C is incorrect because, while mannitol is used to reduce ICP, its administration is a medical order, not a nursing action, and requires monitoring for side effects.
Choice D is incorrect because hyperventilation is no longer recommended, as it can cause cerebral vasoconstriction, reducing blood flow and worsening brain injury.

Correct Answer: B

Rationale: Reporting signs of hyperkalemia is critical with spironolactone due to potassium-sparing effects. Potassium intake should not increase, it's taken in the morning, and diuresis is not immediate.