Which medication is contraindicated if the patient has a history of severe bronchospasm?

The correct answer is based on the understanding of atenolol's pharmacological effects and its implications for patients with a history of severe bronchospasm. Atenolol is a beta-blocker primarily used to manage hypertension and certain types of arrhythmias. However, beta-blockers can potentially induce bronchospasm, particularly in patients with underlying respiratory conditions such as asthma or chronic obstructive pulmonary disease (COPD). This is especially true of non-selective beta-blockers, but even cardioselective beta-blockers like atenolol may pose a risk in sensitive patients.

In patients with severe bronchospasm, it is essential to avoid medications that could exacerbate breathing difficulties. Atenolol's mechanism of action on beta-receptors can lead to bronchoconstriction, making it contraindicated in this population.

Other options like enalapril, ketorolac, and ibuprofen do not carry the same risk concerning bronchospasm. Enalapril is an ACE inhibitor used primarily for hypertension and heart failure, with no direct link to bronchospasm. Ketorolac and ibuprofen, both nonsteroidal anti-inflammatory drugs (NSAIDs), may pose gastrointestinal and renal risks but do not have a known direct effect on