A nurse is reviewing the medical history of a client who has myasthenia gravis and is asking about starting neostigmine. The nurse should identify which of the following client conditions as a potential contraindication for cholinesterase inhibitor therapy?
Cataracts
Hypertension
Hypothyroidism
Peptic ulcer disease
The Correct Answer is D
Rationale:
A. Cataracts are not a contraindication for cholinesterase inhibitors like neostigmine.
B. Hypertension is not a direct contraindication for cholinesterase inhibitor therapy, although caution may be exercised depending on the overall health status of the client.
C. Hypothyroidism is not contraindicated for cholinesterase inhibitors; however, it should be managed appropriately.
D. Peptic ulcer disease is a significant contraindication for cholinesterase inhibitors like neostigmine because these medications can increase gastric secretions and motility, potentially exacerbating ulcer conditions and leading to complications.
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Correct Answer is B
Explanation
Rationale:
A. Diazepam is a benzodiazepine used for anxiety and sedation but is not effective for treating malignant hyperthermia.
B. Dantrolene is the specific antidote for malignant hyperthermia, and the nurse should expect to administer it to help reduce the severe muscle contractions and hypermetabolism associated with this condition.
C. Cyclobenzaprine is a muscle relaxant used for muscle spasms but is not indicated for malignant hyperthermia.
D. Metaxalone is also a muscle relaxant, but like cyclobenzaprine, it is not effective for managing malignant hyperthermia and would not be used in this situation.
Correct Answer is E
Explanation
Rationale:
A. Mostly cloudy: This is an unclear statement. It is not related to a physical manifestation that would result from haloperidol overdose.
B. Constipation: Although haloperidol can cause constipation as a side effect, it is not the most urgent concern. Other manifestations are more immediately life-threatening.
C. Dry mouth: Dry mouth is a common side effect of antipsychotics, but it is not life-threatening and would not be the priority assessment in the case of a medication overdose.
D. Daytime drowsiness: Sedation is a known side effect of haloperidol, but it is not the priority in this scenario where an overdose occurred.
E. Muscle stiffness: Muscle stiffness may indicate extrapyramidal symptoms (EPS) or neuroleptic malignant syndrome (NMS), both of which are serious and potentially life-threatening side effects of haloperidol, especially in cases of overdose. Assessing for these symptoms is the priority.