a nurse is reviewing the health history of a client who has migraine headaches and is to begin prophylaxis therapy with propranolol which of the follo
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Nursing Elites

ATI RN

ATI Pharmacology Proctored Exam

1. A client with a history of migraine headaches is starting prophylaxis therapy with Propranolol. Which of the following findings in the client history should be reported to the provider by the nurse?

Correct answer: D

Rationale: Propranolol is contraindicated in clients with a first-degree heart block due to its negative chronotropic properties that can further slow the heart rate. This can worsen conduction through the atrioventricular node, potentially leading to heart block progression. Therefore, the nurse should report the finding of a first-degree heart block to the provider before initiating Propranolol therapy. Choices A, B, and C are not contraindications for Propranolol therapy. A prior myocardial infarction, taking warfarin for atrial fibrillation, or using an SSRI for depression do not directly impact the initiation of Propranolol therapy in a client with a history of migraine headaches.

2. A client with prostate cancer is receiving leuprolide. Which of the following findings should the nurse monitor?

Correct answer: C

Rationale: The nurse should monitor the client for gynecomastia when receiving leuprolide as it can cause decreased testosterone levels, leading to the development of gynecomastia. Choices A, B, and D are incorrect because leuprolide actually decreases testosterone levels, which would not result in increased testosterone levels or libido. Leuprolide is not associated with hypoglycemia, so monitoring for this is unnecessary in a client receiving this medication.

3. A healthcare professional is administering a Dopamine infusion at a low dose to a client with severe heart failure. Which of the following findings is an expected effect of this medication?

Correct answer: B

Rationale: Dopamine, when administered at a low dose, is expected to increase myocardial contractility by stimulating beta1 receptors. This positive inotropic effect leads to an increase in cardiac output. Therefore, the correct answer is increased myocardial contractility, as it is a desired effect of administering dopamine to a client with severe heart failure.

4. Which of the following is the primary site of activity for the drug Warfarin?

Correct answer: B

Rationale: Warfarin primarily affects the liver where it inhibits the synthesis of clotting factors.

5. When teaching a client about a new prescription for Celecoxib, which of the following information should the nurse include?

Correct answer: A

Rationale: The nurse should educate the client that taking Celecoxib increases the risk of a myocardial infarction due to its suppression of vasodilation. Celecoxib belongs to the class of NSAIDs known to have cardiovascular risks, including an increased risk of heart attacks. Choice B is incorrect because Celecoxib does not decrease the risk of stroke. Choice C is incorrect because Celecoxib selectively inhibits COX-2 rather than COX-1. Choice D is incorrect because Celecoxib does not increase platelet aggregation; in fact, it inhibits platelet aggregation.

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