Nursing practice questions with comprehensive rationales
NurseDive Free Nursing Practice Question
A nurse is reviewing the medical record of an adult client who has a fever and a prescription for acetaminophen.
Which of the following findings should the nurse identify as a contraindication for receiving this medication?
A. Hepatitis B vaccine within the last week.
Choice A is wrong because hepatitis B vaccine within the last week is not a contraindication for receiving acetaminophen. There is no evidence that acetaminophen interferes with the immune response to the vaccine or causes adverse effects.
B. Chronic kidney disease.
Choice B is wrong because chronic kidney disease is not a contraindication for receiving acetaminophen. Acetaminophen is mainly metabolized by the liver and has minimal renal excretion. However, patients with chronic kidney disease should consult their doctor before taking acetaminophen as they may have other conditions that affect its use.
C. Diabetes mellitus.
Choice C is wrong because diabetes mellitus is not a contraindication for receiving acetaminophen. Acetaminophen does not affect blood glucose levels or interact with oral antidiabetic drugs. However, patients with diabetes mellitus should consult their doctor before taking acetaminophen as they may have other conditions that affect its use.
D. Alcohol use disorder.
Acetaminophen is contraindicated in patients with severe hepatic impairment or severe active liver disease1 and should be used with caution in patients with hepatic impairment or active liver disease. Alcohol use disorder can cause liver damage and increase the risk of acetaminophen toxicity.
This question is an excerpt from Nurse Dive's nursing test bank - ATI RN Pharmacology 2019 Proctored Exam. Take the full exam now
Full Explanation
Acetaminophen is contraindicated in patients with severe hepatic impairment or severe active liver disease1 and should be used with caution in patients with hepatic impairment or active liver disease. Alcohol use disorder can cause liver damage and increase the risk of acetaminophen toxicity.
Choice A is wrong because hepatitis B vaccine within the last week is not a contraindication for receiving acetaminophen.
There is no evidence that acetaminophen interferes with the immune response to the vaccine or causes adverse effects.
Choice B is wrong because chronic kidney disease is not a contraindication for receiving acetaminophen.
Acetaminophen is mainly metabolized by the liver and has minimal renal excretion.
However, patients with chronic kidney disease should consult their doctor before taking acetaminophen as they may have other conditions that affect its use.
Choice C is wrong because diabetes mellitus is not a contraindication for receiving acetaminophen.
Acetaminophen does not affect blood glucose levels or interact with oral antidiabetic drugs.
However, patients with diabetes mellitus should consult their doctor before taking acetaminophen as they may have other conditions that affect its use.
Similar Questions
A nurse is planning care for a client who requires treatment for high cholesterol. Which of the following prescriptions should the nurse expect to administer?
A. Chlorpromazine.
Chlorpromazine is wrong because it is an antipsychotic medication that has no effect on cholesterol levels.
B. Colesevelam.
Colesevelam is a bile acid sequestrant that lowers cholesterol by binding to bile acids in the intestine and preventing their reabsorption into the bloodstream.
C. Colchicine.
Colchicine is wrong because it is an anti-inflammatory drug that is used to treat gout and other inflammatory conditions, not high cholesterol.
D. Cimetidine.
Cimetidine is wrong because it is a histamine H2 receptor antagonist that reduces stomach acid production and is used to treat ulcers and gastroesophageal reflux disease (GERD), not high cholesterol.
Full Explanation
Colesevelam is a bile acid sequestrant that lowers cholesterol by binding to bile acids in the intestine and preventing their reabsorption into the bloodstream. Some possible explanations for the other choices are:
Choice A. Chlorpromazine is wrong because it is an antipsychotic medication that has no effect on cholesterol levels.
Choice C. Colchicine is wrong because it is an anti-inflammatory drug that is used to treat gout and other inflammatory conditions, not high cholesterol.
Choice D. Cimetidine is wrong because it is a histamine H2 receptor antagonist that reduces stomach acid production and is used to treat ulcers and gastroesophageal reflux disease (GERD), not high cholesterol.
Normal ranges for cholesterol levels vary depending on the type of cholesterol and the risk factors of the individual, but generally, total cholesterol should be less than 200 mg/dL, LDL cholesterol should be less than 100 mg/dL, HDL cholesterol should be more than 40 mg/dL for men and 50 mg/dL for women, and triglycerides should be less than 150 mg/dL.
A nurse is caring for a client who is taking digoxin to treat heart failure. Which of the following factors predisposes this client to developing digoxin toxicity?
A. Taking an HMG CoA reductase inhibitor.
Choice A is wrong because taking an HMG CoA reductase inhibitor (also called a statin) does not increase the risk of digoxin toxicity. Statins are lipid-lowering medications used to prevent coronary heart disease by blocking an enzyme involved in cholesterol synthesis. Statins do not affect the blood potassium level or the sensitivity of the heart to digoxin.
B. Having a 10-year history of COPD.
Choice B is wrong because having a 10-year history of COPD (chronic obstructive pulmonary disease) does not increase the risk of digoxin toxicity. COPD is a lung condition that causes breathing difficulties and chronic inflammation. COPD does not affect the blood potassium level or the sensitivity of the heart to digoxin.
C. Taking a high-ceiling diuretic.
Taking a high-ceiling diuretic predisposes this client to developing digoxin toxicity because it can cause hypokalemia (low blood potassium level), which increases the sensitivity of the heart to digoxin. Digoxin is a medicine that is used to treat heart failure or arrhythmias (abnormal heart rhythms) by increasing cardiac contractility and controlling the heart rate. Digoxin toxicity happens when there is too much digoxin in the body and it becomes harmful, causing symptoms such as nausea, vomiting, headache, confusion, vision disturbance, and irregular heartbeat.
D. Having a prolapsed mitral valve.
Choice D is wrong because having a prolapsed mitral valve does not increase the risk of digoxin toxicity. A prolapsed mitral valve is a condition where the valve between the left atrium and left ventricle of the heart does not close properly, allowing some blood to leak back into the atrium. A prolapsed mitral valve does not affect the blood potassium level or the sensitivity of the heart to digoxin.
Full Explanation
Taking a high-ceiling diuretic predisposes this client to developing digoxin toxicity because it can cause hypokalemia (low blood potassium level), which increases the sensitivity of the heart to digoxin. Digoxin is a medicine that is used to treat heart failure or arrhythmias (abnormal heart rhythms) by increasing cardiac contractility and controlling the heart rate. Digoxin toxicity happens when there is too much digoxin in the body and it becomes harmful, causing symptoms such as nausea, vomiting, headache, confusion, vision disturbance, and irregular heartbeat.
Choice A is wrong because taking an HMG CoA reductase inhibitor (also called a statin) does not increase the risk of digoxin toxicity.
Statins are lipid-lowering medications used to prevent coronary heart disease by blocking an enzyme involved in cholesterol synthesis.
Statins do not affect the blood potassium level or the sensitivity of the heart to digoxin.
Choice B is wrong because having a 10-year history of COPD (chronic obstructive pulmonary disease) does not increase the risk of digoxin toxicity. COPD is a lung condition that causes breathing difficulties and chronic inflammation.
COPD does not affect the blood potassium level or the sensitivity of the heart to digoxin.
Choice D is wrong because having a prolapsed mitral valve does not increase the risk of digoxin toxicity.
A prolapsed mitral valve is a condition where the valve between the left atrium and left ventricle of the heart does not close properly, allowing some blood to leak back into the atrium.
A prolapsed mitral valve does not affect the blood potassium level or the sensitivity of the heart to digoxin.
A nurse is teaching a client who has pernicious anemia to self-administer nasal cyanocobalamin.
Which of the following information should the nurse include in the teaching?
A. Plan to self-administer this medication for the next 6 months.
Choice A is wrong because the duration of treatment depends on the individual’s response and blood levels of vitamin B. Some people may need to use this medication for longer than 6 months.
B. Administer the medication into one nostril once per week.
This is the recommended dosage for cyanocobalamin nasal spray for pernicious anemia and vitamin B12 deficiency. Cyanocobalamin nasal gel is used to prevent a lack of vitamin B12 that may be caused by various factors.
C. Lie down for 1 hour after administering the medication.
Choice C is wrong because there is no need to lie down for 1 hour after administering the medication. This may cause nasal irritation or drainage.
D. Use a nasal decongestant 15 minutes before the medication if you have a stuffy nose.
Choice D is wrong because using a nasal decongestant 15 minutes before the medication may interfere with the absorption of cyanocobalamin. If you have a stuffy nose, you should talk to your doctor about alternative ways to take vitamin B.
Full Explanation
This is the recommended dosage for cyanocobalamin nasal spray for pernicious anaemia and vitamin B12 deficiency. Cyanocobalamin nasal gel is used to prevent a lack of vitamin B12 that may be caused by various factors.
Choice A is wrong because the duration of treatment depends on the individual’s response and blood levels of vitamin B. Some people may need to use this medication for longer than 6 months.
Choice C is wrong because there is no need to lie down for 1 hour after administering the medication.
This may cause nasal irritation or drainage.
Choice D is wrong because using a nasal decongestant 15 minutes before the medication may interfere with the absorption of cyanocobalamin. If you have a stuffy nose, you should talk to your doctor about alternative ways to take vitamin B.
