pharm 2 exam

The nurse administers loperamide (Imodium) to decrease the number and liquidity of stool by what mechanism? A) Decreasing intestinal motility B) Absorbing toxins C) Binding with fecal material to increase bulk D) Blocking the chemoreceptor trigger zone (CTZ)

A) Decreasing intestinal motility

The nurse teaches the patient that a common adverse effect of loperamide (Imodium) is what? A) Fatigue B) Flatulence C) Disorientation D) Tremors

A) Fatigue

The hospice nurse is caring for a patient diagnosed with bone cancer who is receiving large doses of opioid medications to relieve pain. The patient has used other laxatives in the past to treat opioid-induced constipation but nothing is working now. What drug would the nurse request the family doctor to order for this patient?A) Methylnaltrexone (Relistor) B) Castor oil C) Paregoric D) Mineral oil

A) Methylnaltrexone (Relistor)

Which lab result would be a priority to report to the prescriber of warfarin if a patient has self-prescribed orlistat (Alli)? a. ALT 30 IU/L b. BUN 22 mg/dL c.INR 5.2 d.Potassium 5.2 mEq/L

c.INR 5.2

What drug does the nurse recognize as being classified as a chemical stimulant? A) Bisacodyl (Dulcolax) B) Polycarbophil (FiberCon )C) Magnesium hydroxide (Milk of Magnesia) D) Docusate (Colace)

A) Bisacodyl (Dulcolax)

how to properly take antacids

1 and 3 hours after meals and at bedtime

A client has been prescribed with Sucralfate (Carafate) for the treatment of gastric ulcer. The nurse instruct the client that this medication is taken? 1 hour before meals. 1 hour after meals. At the same time with an antacid.

1 hour before meals. Sucralfate is a gastric protective agent. It works by forming a protective layer on the ulcer to serve as a barrier against acid, bile salts, and enzymes in the stomach. Taken by mouth on an empty stomach at least 1 hour before or 2 hours after eating.

The physician prescribes metoclopramide hydrochloride (Reglan) for the client with hiatal hernia. The nurse plans to instruct the client that this drug is used in hiatal hernia therapy to accomplish which of the following objectives?1. Increase tone of the esophageal sphincter.2. Neutralize gastric secretions.3. Delay gastric emptying.4. Reduce secretion of digestive juices.

1. Increase tone of the esophageal sphincter. Metoclopramide hydrochloride (Reglan) increases esophageal sphincter tone and facilitates gastric emptying; both actions reduce the incidence of reflux.

What drug does the nurse recognize as being classified as a chemical stimulant? A) Bisacodyl (Dulcolax) B) Polycarbophil (FiberCon) C) Magnesium hydroxide (Milk of Magnesia) D) Docusate (Colace)

A) Bisacodyl (Dulcolax)

An 80- year-old client has recently been started on cimetidine (Tagamet). The nurse monitors the client for which most frequent central nervous system (CNS) side effect of this medication?1. Tremors2. Dizziness3. Confusion4. Hallucination

3. Confusion

The client has been taking magnesium hydroxide (milk of magnesia) at home in an attempt to control hiatal hernia symptoms. The nurse should assess the client for which of the following conditions most commonly associated with the ongoing use of magnesium-based antacids?1. Anorexia.2. Weight gain.3. Diarrhea.4. Constipation.

3. Diarrhea.The magnesium salts in magnesium hydroxide are related to those found in laxatives and may cause diarrhea.

The nurse should instruct the client to avoid which of the following drugs while taking metoclopramide hydrochloride (Reglan)?1. Antacids.2. Antihypertensives.3. Anticoagulants.4. Alcohol.

4. Alcohol. .Metoclopramide hydrochloride (Reglan) can cause sedation. Alcohol and other central nervous system depressants add to this sedation. A client who is taking this drug should be cautioned to avoid driving or performing other hazardous activities for a few hours after taking the drug.

Which instructions will the nurse include when teaching a patient about cephalosporin therapy? (Select all that apply.) A. "Notify your healthcare provider if you develop diarrhea." B. "Take aspirin if you develop a headache." C. "Notify your healthcare provider if you develop a rash. "D. "Cephalosporins may not be taken with food." E. "Do not take cephalosporins if you have lactose intolerance."

A. "Notify your healthcare provider if you develop diarrhea." C. "Notify your healthcare provider if you develop a rash." Cephalosporins may enhance bleeding tendencies, so drugs such as aspirin that may promote bleeding should be avoided. Cephalosporins may be taken with food, and they are safe to take if a patient has lactose intolerance. Severe diarrhea should be reported, because it may indicate the development of C. difficile infection. Any indication of an allergic reaction, including a rash, should be reported to the healthcare provider.

A geriatric patient is prescribed with Cimetidine (Tagamet) for the treatment of heartburn. Which of the following is the most frequent CNS side effect? A. Agitation. B. Drowsiness. C. Headache. D. Somnolence

A. Agitation. Cimetidine an H2-receptor antagonist passes the blood brain barrier, and central nervous system side effects can happen. Most common serious side effects are confusion, agitation, depression, and disorientation.

A patient is receiving penicillin G (Bicillin C-R). Which assessment should the nurse monitor as an indicator of an undesired effect?A. Cardiac rhythmB. Serum sodium levelC. Lung soundsD. Red blood cell (RBC) count

A. Cardiac rhythm Penicillin G in high IV doses may cause hyperkalemia, which can result in dysrhythmias or cardiac arrest.

A nurse is giving discharge instructions to a client who is receiving a bulk-forming laxative as part of the home medications. All of which are examples of bulk-forming laxative, except? A. Docusate Sodium (Colace). B. Methylcellulose (Citrucel). C. Polycarbophil (Fibercon). D. Psyllium (Metamucil)

A. Docusate Sodium (Colace). Option A is an example of surfactant laxative

Both IV ampicillin/sulbactam (Unasyn) and gentamicin (Garamycin) are ordered for a patient. When administering these medications, the nurse will do what?A. Ensure that separate IV solutions are used.B. Use two different peripheral IV sites.C. Administer the gentamicin first.D. There are no necessary precautions.

A. Ensure that separate IV solutions are used. When penicillins are present in high concentrations, they interact chemically with aminoglycosides, causing inactivation of the aminoglycoside. Therefore, penicillins and aminoglycosides should not be mixed in the same IV solution. Rather, these drugs should be administered separately.

The nurse identifies which statements about penicillins as true? (Select all that apply.)A. Penicillins are the safest antibiotics available.B. The principal adverse effect of penicillins is allergic reaction.C. A patient who is allergic to penicillin always has a cross-allergy to cephalosporins.D. A patient who is allergic to penicillin is also allergic to vancomycin, erythromycin, and clindamycin.E. Penicillins are normally eliminated rapidly by the kidneys but can accumulate to harmful levels if renal function is severely impaired.

A. Penicillins are the safest antibiotics available. B. The principal adverse effect of penicillins is allergic reaction. E. Penicillins are normally eliminated rapidly by the kidneys but can accumulate to harmful levels if renal function is severely impaired. A patient who is allergic to penicillin has a 1% chance of also being allergic to cephalosporins. Patients who are allergic to penicillin are safely able to take vancomycin, erythromycin, and clindamycin. The other three statements are true.

Select all the medications a physician may order to treat a H. Pylori infection that is causing a peptic ulcer? A. Proton-Pump Inhibitors B. Antacids C. Anticholinergics D. 5-Aminosalicylates E. Antibiotics F. H2 Blockers G. Bismuth Subsalicylates

A. Proton-Pump Inhibitors E. Antibiotics F. H2 Blockers G. Bismuth Subsalicylates

A patient develops flushing, rash, and pruritus during an IV infusion of vancomycin (Vancocin). Which action should a nurse take? A. Reduce the infusion rate. B. Administer diphenhydramine (Benadryl). C. Change the IV tubing. D. Check the patency of the IV.

A. Reduce the infusion rate. When vancomycin is infused too rapidly, histamine release may cause the patient to develop hypotension accompanied by flushing and warmth of the neck and face; this phenomenon is called red man syndrome. Diphenhydramine is not necessary if the infusion is administered slowly over at least 60 minutes. Changing the IV tubing would not help the symptoms. The patency of the IV needs to be checked before the administration is started.

A client has been taking Ibuprofen for some quite time and was given Misoprostol (Cytotec). Which of the following is exhibiting the therapeutic effect of Cytotec? A. Relief of gastric ulcer. B. Relief of diarrhea. C. Relief of vomiting. D. Relief of constipation.

A. Relief of gastric ulcer. Misoprostol (Cytotec) is a synthetic (man-made) prostaglandin that is used to reduce the risk of stomach ulcers in patients treated with nonsteroidal antiinflammatory drugs (NSAIDs, for example, aspirin, ibuprofen, etc.).

The physician prescribes docusate sodium (Colace) fo the client. The client asks the nurse to explain why the medication is needed. Which explanation given by the nurse correctly states the purpose of medication?A. To ease bowel evacuation and its related discomfortB. To irriatate the bowel and promote stool eliminationC. To stimulate peristalsis to remove wastes after the digestionD. To reduce intestinal activity and decrease stool size

A. To ease bowel evacuation and its related discomfor docusate sodium (colase) is a surfactant laxative

Which statements about vancomycin (Vancocin) does the nurse identify as true? (Select all that apply.) A. Vancomycin is the most widely used antibiotic in U.S. hospitals. B. Vancomycin is effective in the treatment of Clostridium difficile infection. C. Vancomycin is effective in the treatment of MRSA infections. D. Patients who are allergic to penicillin are also allergic to vancomycin .E. The major toxicity of vancomycin therapy is liver failure.

A. Vancomycin is the most widely used antibiotic in U.S. hospitals. B. Vancomycin is effective in the treatment of Clostridium difficile infection. C. Vancomycin is effective in the treatment of MRSA infections. Patients who are allergic to penicillin are able to take vancomycin. The major toxicity of vancomycin therapy is kidney failure. The other three statements are true.

A client has been given Ondansetron (Zofran). For which condition should the nurse administer this medication to the postoperative patient? A. Vomiting. B. Incisional pain. C. Abdominal infection. D. Atelectasis

A. Vomiting. Ondansetron is used to prevent nausea and vomiting that may be caused by surgery or by medicine to treat cancer (chemotherapy or radiation).

A nurse is reviewing medications for a client who has a diagnosis of small bowel obstruction. The nurse should withhold Senna (Senoket) prescribed orally based on an understanding of which of the following?A. laxatives are contraindicated in clients who have small bowel obstructionB. Only bulk-forming laxatives such as psyllium (Metamucil) should be prescribedC. Medication should be administered via NG tube than oral routeD. Opioid analgesics, rather than laxative should be prescribed to alleviate discomfort

A. laxatives are contraindicated in clients who have small bowel obstructionRationale: Laxatives are contraindicated in clients who have fecal impactation, bowel obstruction, and acute abdominal surgery to prevent perforation. Laxatives will cause increased abdominal cramping and discomfort

A nurse is providing education about tetracycline (Sumycin). Which statement by the patient best demonstrates understanding of the administration of this medication? A."I should not take this medication with milk or other dairy products." B. "I should not worry if I experience an acnelike rash with this medication." C. "I should take an antacid, such as Tums, if I experience gastrointestinal distress." D. "I should take this antibiotic with a calcium supplement to improve absorption."

A."I should not take this medication with milk or other dairy products."

A clinic patient with a history of heart failure requires a laxative for treatment of chronic constipation. What medication would be most appropriate for this patient? A) Senna (Senokot) B) Lactulose (Chronulac) C) Magnesium sulfate (Milk of Magnesia) D) Castor oil (Neoloid)

B) Lactulose (Chronulac)

What is the antidiarrheal of choice the nurse will administer to children older than 2 years of age with diarrhea? A) Bismuth salts (Pepto-Bismol) B) Loperamide (Imodium) C) Paregoric (generic) D) Difenoxin (Motofen)

B) Loperamide (Imodium)

Which instructions should a nurse provide to a patient who is to start taking amoxicillin/clavulanate (Augmentin)?A. "Take Augmentin once per day and only at bedtime."B. "Augmentin may be taken with food or meals."C. "Avoid taking Augmentin with grapefruit juice."D. "Use a minimal amount of liquid to swallow the Augmentin."

B. "Augmentin may be taken with food or meals." Amoxicillin/clavulanate is a broad-spectrum aminopenicillin that may be taken with meals. Most other oral penicillins must be taken with a full glass of water 1 hour before or 2 hours after meals.

A client with a duodenal ulcer is diagnosed with H. pylori infection. The physician prescribed Amoxicillin (Wymox), Pantoprazole (Prevacid), and Clarithromycin (Biaxin). Which statement made by the nurse correctly explains the purpose of these medications? A. "These medicines will minimize acid production and will coat the ulcer". B. "These medicines will stop the acid production and will kill the bacteria". C. "The ulcer will heal because the medications will kill the bacteria". D. "These medicines will control the ulcer and motion sickness".

B. "These medicines will stop the acid production and will kill the bacteria". the triple therapy treatment of H-pylori infection is the includes 2 antibiotics (Clarithromycin and Amoxicillin) and one proton pump inhibitor such as omeprazole, lansoprazole, pantoprazole, or esomeprazole.

Before administering intravenous (IV) penicillin, the nurse should do what?A. Flush the IV site with normal saline.B. Assess the patient for allergies.C. Review the patient's intake and output record.D. Determine the latest creatinine clearance result.

B. Assess the patient for allergies The principal adverse effect of penicillins is allergic reaction. Penicillins are contraindicated in patients with a history of severe allergic reactions to penicillins, cephalosporins, or carbapenems. IV patency is important, as is monitoring renal function, because impairment can cause penicillins to reach toxic levels; however, these are not as important as determining allergy status.

A nurse assisting a nursing student with medications asks the student to describe how penicillins (PCNs) work to treat bacterial infections. The student is correct in responding that penicillins:A. disinhibit transpeptidases.B. disrupt bacterial cell wall synthesis.C. inhibit autolysins.D. inhibit host cell wall function.

B. Disrupt cell wall synthesis PCNs weaken the cell wall, causing bacteria to take up excessive amounts of water and subsequently rupture. PCNs inhibit transpeptidases and disinhibit autolysins. PCNs do not affect the cell walls of the host.

A patient taking a sulfonamide is breast-feeding an infant. Which complication in the infant would the nurse associate with kernicterus?A. Hemolytic anemiaB. Neurologic deficitsC. Hepatocellular failureD. Ophthalmic infection

B. Neurologic deficits Kernicterus is a disorder in newborns caused by deposition of bilirubin in the brain, which leads to severe neurologic deficits and death. Sulfonamides promote kernicterus by displacing protein-bound bilirubin from the proteins, leaving newly freed bilirubin access to brain sites. Sulfonamides are not administered to infants under 2 years old, nor are they given to pregnant patients near term or nursing mothers.

A patient with a peptic ulcer is suddenly vomiting dark coffee ground emesis. On assessment of the abdomen you find bloating and an epigastric mass in the abdomen. Which complication may this patient be experiencing? A. Obstruction of pylorus B. Upper gastrointestinal bleeding C. Perforation D. Peritonitis

B. Upper gastrointestinal bleeding

A physician prescribes bisacodyl (Dulcolax) for a client in preparation for a diagnostic test and wants the client to achieve a rapid effect from the medication. The nurse then tells the client to take the medication:A. With a large mealB. On an empty stomachC. At bedtime with a snackD. With two glasses of juice

B. on an empty stomach, bisacodyl (Dulcolax) is a stool softner. it is in the stimulant group.

How should the patient be taking (Prilosec) Omeprazole?A. take drugs 2 hours after a mealB. take 1 hour before meals and swallow tablets as wholeC. take it with juice and crush tabletsD. all of the above

B. take 1 hour before meals and swallow tablets as whole DO NOT CRUSH OR CHEW!!!!!

The home health nurse is caring for a patient with encopresis who was started on mineral oil therapy. The nurse teaches the patient and family that a common adverse effect is what? A) Nausea B) Vomiting C) Leakage D) Vitamin C deficiency

C) Leakage

A patient is admitted with lower abdominal pain and nausea. The nurse performing the initial assessment notes that the patient's abdomen is distended and firm, and hypoactive bowel sounds are present. The patient has not had a stool for 3 days. The nurse will contact the provider, who will: Multiple Choice expand_more A) order a bulk-forming laxative. B) order extra fluids and fiber. C) perform diagnostic tests. D) prescribe a cathartic laxative.

C) perform diagnostic tests. Laxatives are contraindicated for patients with abdominal pain, nausea, cramps, or other symptoms of abdominal disease or an acute surgical abdomen. Laxatives should not be used in patients with obstruction or impaction.

Which drug works by blocking serotonin receptors in the GI tract, vomiting center, and CTZ? A. Meclizine (Antivert) B. Metoclopramide (Reglan) C. Ondansetron (Zofran) D. Droperidol (Inapsine)

C. Ondansetron (Zofran)

Which of the following condition can you safely administer Metoclopramide (Reglan)? A. Patient with bowel obstruction. B. Patient with gastrointestinal hemorrhage. C. Patient undergoing radiation. D. Patients with pheochromocytoma

C. Patient undergoing radiation. Metoclopramide can be safely administered to patients having vomiting episodes following radiation, chemotherapy, and surgery. Options A and B: It is contraindicated in patients with conditions where stimulation of gastrointestinal motility might be harmful, such as mechanical bowel obstruction, bowel perforation, or gastrointestinal hemorrhage. Option D: Hypertensive crises may occur in patients with pheochromocytoma due to induction of catecholamine release from the tumor.

Before administering a cephalosporin to a patient, it is most important for the nurse to assess the patient for an allergy history to what? A. Soy products B. Peanuts C. Penicillins D. Opioids

C. Penicillins The cephalosporins are beta-lactam antibiotics similar in structure and actions to the penicillins. They are contraindicated in patients with a history of severe allergic reactions to penicillins.

An osmotic laxative will be prescribed for a client. The nurse understands that which medications are osmotic laxative? Select all that apply A. Senna (Senokot). B. Mineral Oil. C. Polyethylene glycol and electrolytes (GoLYTELY). D. Sodium Phosphate (Fleet enema). E. Bisacodyl (Dulcolax)

C. Polyethylene glycol and electrolytes (GoLYTELY). D. Sodium Phosphate (Fleet enema). Osmotics are used to attract water into the large intestines to produce bulk and stimulate peristalsis. Other osmotic are Magnesium hydroxide (Milk of Magnesia) and Magnesium citrate (Citrate of Magnesia).

A patient is receiving vancomycin (Vancocin). The nurse identifies what as the most common toxic effect of vancomycin therapy? A. Ototoxicity B. Hepatotoxicity C. Renal toxicity D. Cardiac toxicity

C. Renal toxicity The most common toxic effect of vancomycin (Vancocin) therapy is renal toxicity. Although ototoxicity may occur, it is rare. The liver and heart are not affected when vancomycin is used.

Your patient is diagnosed with peptic ulcer disease due to h.pylori. This bacterium has a unique shape which allows it to penetrate the stomach mucosa. You know this bacterium is: A. Rod shaped B. Spherical shaped C. Spiral shaped D. Filamentous shaped

C. Spiral shaped

A nurse teaches a client taking metoclopramide (Reglan) to discontinue the medication immediately and call the physician if which side effect occurs with long- term use?A. Excessive excitabilityB. Anxiety or irritabilityC. Uncontrolled rhythmic movements of the face or limbsD. Dry mouth not helped by the use of sugar-free hard candy

C. Uncontrolled rhythmic movements of the face or limbs

The nurse administers psyllium hydrophilic mucilloid (Metamucil) expecting it to have what action? A) Slows peristalsis B) Promotes reabsorption of water into bowel C) Has antibacterial properties D) Adds bulk to the stool

D) Adds bulk to the stool

A new mother required an episiotomy during the birth of her baby. Two days after delivery, the patient is in need of a laxative. What will be the most effective drug for the nurse to administer? A) Bisacodyl (Dulcolax) B) Castor oil (Neolid) C) Magnesium sulfate (epsom salts) D) Docusate (Colace)

D) Docusate (Colace) a surfactant!!

The nurse admits to the clinic a 7-month-old infant whose mother reports that the baby has not had a bowel movement in 6 days. What drug would be appropriate to treat this patient? A) Cascara (generic) B) Magnesium hydroxide (Milk of Magnesia) C) Polyethylene glycol-electrolyte solution (GoLYTELY) D) Glycerin (Sani-Supp)

D) Glycerin (Sani-Supp)

A nurse teaches a patient about sulfonamides. Which statement by the patient indicates a need for further teaching?A. "I need to drink extra fluids while taking this medication."B. "I need to use sunscreen when taking this drug."C. "I should call my provider if I develop a rash while taking this drug."D. "I should stop taking this drug when my symptoms are gone."

D. "I should stop taking this drug when my symptoms are gone." Patients should always be advised to complete the prescribed course of the antibiotic even when symptoms subside. Patients should also understand the need to drink 8 to 10 glasses of water a day, to use sunscreen, and to notify the provider if they develop a rash.

The nurse is giving instructions to a client receiving Cholestyramine (Prevalite). Which statement made by the client indicates a need for further teachings? A. "I will include a high fiber rich food in my diet". B. "I will continue taking my multivitamins". C. "This medication will help lower my cholesterol". D. "I will sip the cholestyramine powder for a long time for faster absorption"

D. "I will sip the cholestyramine powder for a long time for faster absorption" Cholestyramine is a bile acid sequestrant. It works by helping the body remove bile acids, which can lower cholesterol levels in the blood. A powder form of this medication can cause tooth problems such as discoloration, erosion of enamel, or decay. Other side effects of this medication are decreased vitamin absorption and constipation.

A patient who is receiving vancomycin (Vancocin) IV for a methicillin-resistant Staphylococcus aureus (MRSA) infection asks a nurse, "Why can't I take this medicine in a pill?" Which response should the nurse make?' A. "The prescription could be changed, because vancomycin comes in two forms." B. "You're allergic to penicillin, and this is the only way this medication can be given." C. "It will cause too much loss of appetite and nausea if given in the oral form." D. "It is more effective by IV, because the pill form will stay in the digestive tract."

D. "It is more effective by IV, because the pill form will stay in the digestive tract." Because of its chemical size and weight, vancomycin is absorbed poorly in the gastrointestinal (GI) tract and is given parenterally for most infections. It is used for serious infections caused by organisms such as MRSA and in patients with susceptible organisms allergic to penicillins. Oral administration is used only for infections of the intestine. It is not associated with loss of appetite or nausea.

Thirty minutes after receiving an intramuscular (IM) injection of penicillin G (Pfizerpen), a patient reports itching and redness at the injection site. Which action should the nurse take first?A. Elevate the lower legs.B. Place an ice pack on the site.C. Make sure the patient stays calm.D. Administer subcutaneous epinephrine.

D. Administer subcutaneous epinephrine Itching and redness at the IM injection site indicate an allergy to penicillin. The primary treatment is epinephrine (subcutaneous, IM, or IV) plus respiratory support. Elevation, ice packs, and calming the patient are done once epinephrine has been administered.

A nurse assessing a patient who is 12 years old should associate which complication with the patient's receiving tetracycline (Sumycin) as a younger child? A. Delay in long bone growth B. Early onset of puberty C. Severe face and body acne D. Discoloration of the teeth

D. Discoloration of the teeth

Which laboratory result should a nurse monitor more frequently when a patient is receiving clarithromycin (Biaxin) and warfarin (Coumadin)?A. Activated partial thromboplastin time (aPTT)B. Platelet countC. Erythrocyte sedimentation rate (ESR)D. International normalized ratio (INR)

D. International normalized ratio (INR

What is the priority nursing intervention for a client receiving an antiemetic? A. Monitor intake and output. B. Keep items far away from the bed. C. Give the client privacy by letting him walking around the room. D. Keep bed in low position with side rails up

D. Keep bed in low position with side rails up Antiemetics can cause drowsiness; hence the priority nursing intervention is to protect the client from injury such as raising the side rails and keeping the bed in low position.

A client has been prescribed with Pancrelipase (Pancrease). Which of the following symptoms would prompt the nurse that the medication is having its therapeutic effect if which of the following is noted? A. Negative abdominal pain. B. An absence of constipation. C. An absence of diarrhea. D. Reduction of excess fat in feces.

D. Reduction of excess fat in feces. Pancrelipase is used to help improve food digestion in certain conditions (cystic fibrosis, pancreatitis) where the pancreas is not working properly. This medicine minimizes the amount of steatorrhea (fatty stools).

A client is prescribed with Omeprazole (Prilosec). The nurse determines that the client is receiving its therapeutic effect if which of the following is stated by the client: A. Relief of nausea and vomiting. B. Decrease diarrheal episodes. C.The absence of constipation. D. Relief from GERD

D. Relief from GERD Omeprazole is used to treat symptoms of gastroesophageal reflux disease (GERD) and other conditions caused by excess stomach acid. It is also used to promote healing of erosive esophagitis (damage to your esophagus caused by stomach acid).

In the stomach lining, the parietal cells release _________ and the chief cells release __________ which both play a role in peptic ulcer disease. A. pepsin, hydrochloric acid B. pepsinogen, pepsin C. pepsinogen, gastric acid D. hydrochloric acid, and pepsinogen

D. hydrochloric acid, and pepsinogen

A charge nurse and a newly licensed nurse are providing care for a client who reports nausea and has a presciption for metoclopramide (Reglan) as an antiemetic. Which of the following statements by the newly licensed nurse indicates a correct understanding of the actions of the medication. "Metoclopramide":A. depresses vagal nerve activityB. decreases gastric acid secretionsC. slows peristalsisD. promotes gastric emptying

D. promotes gastric emptyingRationale: Metoclopramide is a gastrointestinal stimulant used to relieve nausea, vomiting, heartburn, stomach pain, bloating, and persistent feeling of fullness after meals.- Metoclopramide works by promoting gastric emptying

A nurse is giving medicine instructions to a client with hemorrhoids who is receiving a Mineral oil. Which of the following statements made by the client indicates a further teaching? A. "I can take it at least 2 hours before bedtime". B. "It can interfere with the absorption of the vitamin E that I am taking". C. "If I miss a dose of mineral oil liquid, I'll take it as soon as I remember". D."I can use mineral oil liquid for an extended period to prevent further damage"

D."I can use mineral oil liquid for an extended period to prevent further damage" Mineral oil liquid is a lubricant laxative that works by slowing the absorption of water from the bowel, which softens the stool. The use of mineral oil liquid for a long time may result in loss of normal bowel function. Options A, B, and C are true regarding mineral oil.

The parent of a child with cerebral palsy reports that the child has pebble-like stools most of the time and seems uncomfortable if several days have passed between stools. The nurse will suggest that the parent discuss which medication with the child's provider? a. Bisacodyl [Dulcolax] suppositories b. Magnesium citrate c. Methylcellulose [Citrucel] d. Polyethylene glycol [MiraLax]

Polyethylene glycol is an osmotic laxative widely used for chronic constipation, which this child has, because it provides relief from abdominal discomfort, improves stool consistency, and increases frequency

A physician prescribes a Proton-Pump Inhibitor to a patient with a gastric ulcer. Which medication is considered a PPI? A. Pantoprazole B. Famotidine C. Magnesium Hydroxide D. Metronidazole

The answer is A. Pantoprazole is the only PPI listed. Remember PPIs tend to end with the letters "prazole".

Which statement is INCORRECT about Histamine-receptor blockers? A. "H2 blockers block histamine which causes the chief cells to decrease the secretion of hydrochloric acid." B. "Ranitidine and Famotidine are two types of histamine-receptor blocker medications." C. "Antacids and H2 blockers should not be given together." D. All the statements are CORRECT.

The answer is A. This statement is false. H2 blockers block histamine which causes the PARTIETAL (not chief) cells to decrease the secretion of hydrochloric acid.

. You are providing discharge teaching to a patient taking Sucralfate (Carafate). Which statement by the patient demonstrates they understand how to take this medication? A. "I will take this medication at the same time I take Ranitidine." B. "I will always take this medication on an empty stomach." C. "It is best to take this medication with antacids." D. "I will take this medication once a week."

The answer is B. This statement is the only correct statement about how to take Carafate. It should always be taken on an empty stomach without food so it can coat the site of ulceration. This medication should NOT be taken with H2 blockers (Ranitidine) or antacids because these drugs affect the absorption of Carafate.

You're educating a group of patients at an outpatient clinic about peptic ulcer formation. Which statement is correct about how peptic ulcers form? A. "An increase in gastric acid is the sole cause of peptic ulcer formation." B. "Peptic ulcers can form when acid penetrates unprotected stomach mucosa. This causes histamine to be released which signals to the parietal cells to release more hydrochloric acid which erodes the stomach lining further." C. "Peptic ulcers form when acid penetrates unprotected stomach mucosa. This causes pepsin to be released which signals to the parietal cells to release more pepsinogen which erodes the stomach lining further." D. "The release of prostaglandins cause the stomach lining to breakdown which allows ulcers to form."

The answer is B. Ulcers form when acid penetrates unprotected stomach mucosa. This causes histamine to be released which signals to the parietal cells to release more hydrochloric acid which erodes the stomach lining further...hence why option C is wrong. Option A is wrong because although peptic ulcers can from with increase gastric acid, this is not the sole cause of peptic ulcer formation. A breakdown in the defense mechanisms along with gastric acid leads to peptic ulcer formation. For example, h. pylori and regular NSAID usage leads to the breakdown of the stomach lining which allows stomach acid to penetrate and erode the lining. Option D is wrong because prostaglandins actually protect the stomach lining by causing the stomach cells to release mucous rich in bicarb, controls acid amounts via the parietal cells, and regulates perfusion to the stomach.

The physician orders a patient with a duodenal ulcer to take a UREA breath test. Which lab value will the test measure to determine if h. pylori is present? A. Ammonia B. Urea C. Hydrochloric acid D. Carbon dioxide

The answer is D. If h. pylori are present, the bacteria will release urease which produces ammonia and carbon dioxide. For the test, the patient will ingest a urea tablet and breath samples will be analyzed for carbon dioxide levels.

A patient has developed a duodenal ulcer. As the nurse, you know that which of the following plays a role in peptic ulcer formation. Select ALL that apply: A. Spicy foods B. Helicobacter pylori C. NSAIDs D. Milk E. Zollinger-Ellison Syndrome

The answers are B, C, and E. Helicobacter pylori and NSAIDS are the most common causes for peptic ulcer formation. Zollinger-Ellison Syndrome can cause peptic ulcers but it is not as common as H. pylori or NSAIDS. Foods and stress are no longer thought to cause ulcers. Certain foods and stress can irritate ulcers or prolong healing but there is no evidence to suggest they cause them

calcium carbonate is

Tums!

in which of the following situations should the nurse intervene? a female patient taking Cytotec states she is pregnant a female patient taking Carafate reports dry mouth a male client taking cimetidine reports gynecomastia a male client taking pantoprazole who reports N/V

a female client taking cytotec states she is pregnant! this medication can cause preterm labor

The nurse is teaching a pharmacology refresher course to a group of nurses. A student asks what host factors affect the choice of agents in antimicrobial therapy. The nurse will tell the students that such host factors include what? (Select all that apply.)a. Ageb. Genderc. Immune system statusd. Infection sitee. Weight

a. Age c. Immune system status d. Infection site Host factors, such as the patient's age, immune status, and the site of the infection, affect the choice of antimicrobial therapy used to treat an infection. Gender and weight do not affect the choice of antimicrobial but may affect the dose and route of administration.

A 36-year-old woman who is taking bismuth subsalicylate, tetracycline, and metronidazole experiences black-colored stool. What is the priority nursing action at this time? a. Completing an abdominal assessment b. Consulting the prescriber c. Continuing nursing care; this is a harmless effect of bismuth d. Teaching that tetracycline can discolor fetal teeth if the patient gets pregnant

a. Completing an abdominal assessment Bismuth can impart a harmless black coloration to the tongue and stool. Patients should be warned. However, stool discoloration may confound interpretation of gastric bleeding. Therefore, an abdominal assessment is a priority.

sucralfate (carafate) vs misoprostol (cytotec)

both mucosal protectants but sucralfate (carafate) treats duodenal ulcers and misoprostol (cytotec) prevents gastric ulcers

which antacid can be used in patients with renal failure?

aluminum hydroxide. but avoid use in HTN and HF due to the high amount of sodium.

A patient with diabetes has been experiencing episodes of abdominal pain, nausea, and vomiting of undigested food, especially at night. Metoclopramide (Reglan) 10mg orally four times/day is prescribed. Because the drug promotes gastric motility, the nurse would expect to administer the doses within which time frame? a. After meals and at bedtime b. Before meals and at bedtime c. Every 6 hours d. With meals and at bedtime

b. Before meals and at bedtime

Famotidine and omeprazole act the same way to decrease gastric acid. a. True b. False

b. False Omeprazole, by inhibiting the proton pump, blocks the final step of gastric acid production. Famotidine decreases gastric acid by acting as a histamine receptor antagonist.

Mrs. C. should receive sucralfate one hour after meals. Select an answer and submit.\ a. True b. False

b. False Sucralfate should be given 1 hour before meals and at bedtime. sucralfate is a mucosal protectant.

a provider prescribes a PPI for a patient with a gastric ulcer. which is a PPI? A: carafate b: metronidazole c: pantoprazole d: ranitidine

b: metronidazole c: pantoprazole PPI's end in -prazole!! carafate is an antacid and ranitidine is a H2 blocker.

A patient's provider has recommended a bulk-forming laxative for occasional constipation. Which statement by the patient indicates understanding of the teaching about this agent?a. "I can take this medication long term."b. "I should not take this drug if I have diverticulitis."c. "I should take each dose with a full glass of water."d. "This drug can cause severe diarrhea."

c. "I should take each dose with a full glass of water."Bulk-forming laxatives provide insoluble substances that swell in water to both soften and increase the size of the fecal mass. Patients should be taught to take the dose with a full glass of water. Laxatives in general are not recommended for long-term use. Bulk-forming laxatives are safe for patients with diverticulitis. They are often used to treat diarrhea, because they help form the fecal mass.

The nurse is teaching a nursing student about the mechanism by which antimicrobial agents achieve selective toxicity. Which statement by the student indicates a need for further teaching?a. "Some agents disrupt the bacterial cell wall."b. "Some agents act to block the conversion of para-aminobenzoic acid (PABA) to folic acid."c. "Some agents cause phagocytosis of bacterial cells."d. "Some agents weaken the cell wall, causing cell wall lysis."

c. "Some agents cause phagocytosis of bacterial cells." Antimicrobial agents do not cause phagocytosis of bacterial cells. They do disrupt and weaken the bacterial cell wall; because human cells do not have cell walls, antimicrobial agents are not toxic to human cells. Some agents block the conversion of PABA to folic acid; humans do not synthesize folic acid and are not harmed by this process.

When clarifying a patient's complaint of constipation, what priority information does the nurse need to obtain? a. Amount of stool b. Color of stool c. Consistency of stool d. Frequency of stool

c. Consistency of stool

A recent campaign, initiated by the Centers for Disease Control (CDC), to delay the emergence of antibiotic resistance in hospitals, has what as one of its objectives?a. Allowing patients to stop antibiotics when symptoms subsideb. Allowing prescribers to develop their own prescribing guidelinesc. Increased adherence to prescribed antibioticsd. Increased use of antibiotics among parents of young children

c. Increased adherence to prescribed antibiotics The CDC initiative has identified three objectives to help delay the emergence of resistance to antibiotics in hospitals. One of the objectives is to increase adherence to prescribed antibiotics among users. Allowing patients to stop using antibiotics before the prescription ends is not one of the objectives and may increase the risk of resistance. Other objectives include ensuring that prescribers adhere to appropriate prescribing guidelines instead of developing their own and decreasing antibiotic use among parents of small children.

What is the rationale for giving Mrs. C. a drug such as misoprostol along with nonsteroidal anti-inflammatory drugs or steroids such as prednisone? a. It is an antacid. b. It is a proton pump inhibitor. c. It enhances the gastric mucosal barrier. d. It forms a chemical barrier

c. It enhances the gastric mucosal barrier. Misoprostol, a synthetic prostaglandin analog, enhances the mucosal barrier and also reduces gastric acid production. Anti-inflammatory agents damage the mucosal barrier. The primary rationale for giving Cytotec is to prevent ulcer formation by enhancing the mucosal barrier.

Acts in the GI tract to reduce absorption of fat a. Lorcaserin b. Phentermine c. Orlistat d. psyllium

c. Orlistat

aluminum hydroxide antacids commonly cause

constipation

calcium carbonate antacids commonly cause

constipation

calcium carbonate adverse effects

constipation eructation and flatulence due to CO2 production

A patient who has a history of T2DM and hypertension who takes insulin, hydrochlorothiazide, and losartan is having bowel prep for a colonoscopy. The patient asks why the prescriber has ordered polyethylene glycol electrolyte solutions (goLYTELY) instead of the Fleets Phospho-Soda (sodium phosphate) that she took in the past. Which statement would not be included in the nurse's response? a. "GoLYTELY does not cause electrolyte imbalances." b. "Sodium phosphate can harm the kidneys." c. "You are at greater risk for kidney damage due to your medical history and drug therapy." d. "This preparation (GoLYTELY) is better because you do not have to drink as much liquid."

d. "This preparation (GoLYTELY) is better because you do not have to drink as much liquid."

A patient has been taking senna [Senokot] for several days, and the nurse notes that the urine is yellowish-brown. What does the nurse know about this symptom?a. It indicates that renal failure has occurred.b. It is caused by dehydration, which is a laxative side effect.c. It is a sign of toxicity, indicating immediate withdrawal of the drug.d. It is an expected, harmless effect of senna.

d. It is an expected, harmless effect of senna.

A patient has been taking psyllium [Metamucil] two to three times daily for several days. The patient complains of stomach pain but has not had a stool. What will the nurse do? a. Ask the patient to drink a full glass of water. b. Give another dose of the psyllium. c. Request an order for a bisacodyl [Dulcolax] suppository. d. Palpate the patient's abdomen and auscultate for bowel sounds.

d. Palpate the patient's abdomen and auscultate for bowel sounds. Psyllium is a bulk-forming laxative and can cause a fecal impaction or obstruction. Abdominal pain can be a sign of impaction or obstruction, so the nurse should assess the patient for this complication. Giving fluids by mouth, administering more laxative, or giving a suppository are all contraindicated if an obstruction has developed and should not be done until this condition is ruled out.

The nurse has been caring for a patient who has been taking antibiotics for 3 weeks. Upon assessing the patient, the nurse notices the individual has developed oral thrush. What describes the etiology of the thrush?a. Antibiotic resistanceb. Community-acquired infectionc. Nosocomial infectiond. Superinfection

d. Superinfection Oral thrush is a manifestation of a superinfection. The development of thrush is not a symptom of antibiotic resistance. Oral thrush typically is not a community-acquired infection. The development of thrush is not a nosocomial infection.The nurse is caring for a patient on a medical-surgical unit who has a fever of unknown origin.

The nurse is caring for a patient on a medical-surgical unit who has a fever of unknown origin. The prescriber has ordered a broad-spectrum antibiotic. Which intervention is the priority? a. Administering the antibiotic immediately b. Administering antipyretics as soon as possible c. Delaying administration of the antibiotic until the culture results are available d.Obtaining all cultures before the antibiotic is administered

d.Obtaining all cultures before the antibiotic is administered

adverse effect of magnesium hydroxide

diarrhea

magnesium hydroxide should not be used in

patients with severe renal failure and undiagnosed abdominal pain

which antiemetic drug can cause EPS side effects

prochlorperazine (compazine) a dopamine receptor antagonist

what drug class is metoclopramide (reglan)

prokinetic agent

when providing patient teaching what is an important statement regarding taking bulk forming laxatives?

they should be administered with 8 ounces of water or juice

sodium bicarb is used

to increase pH! NOT agent of choice for PUD.