quiz 4 - practice questions

A nurse is teaching a client who has a new prescription for cimetidine to treat peptic ulcer disease. Which of the following statements by the client indicates an understanding of the teaching? (Select all that apply) a. "i can take this medication with or without food" b. "i will take this medication in the morning" c. "i should expect my stools to turn black" d. "i will take this medication with an antacid" e. "i will take this medication when i need it for pain" f. "i will eat five small meals each day"

Answer: a. "i can take this medication with or without food", f. "i will eat five small meals each day" Rationale: Food slows the rate of absorption of cimetidine, but beneficial effects will be prolonged. Cimetidine can be taken with meals, after meals, or at bedtime. The client should eat 5 to 6 small meals each day to enhance the therapeutic effects of cimetidine.

A nurse is providing teaching to a client who takes opioid pain medication and has a new prescription for docusate sodium. Which of the following statements by the client indicates an understanding of the teaching? a. "it might take up to 3 days for the medication to work" b. "i will take the medication for diarrhea" c. "i should drink 4 ounces of water when i take the medication" d. "i can take this medication along with mineral oil"

Answer: a. "it might take up to 3 days for the medication to work" Rationale: the client understands docusate sodium is a stool softener and the therapeutic effect might take up to 3 days to achieve

A nurse is caring for a client who has nausea and a prescription for metoclopramide intermittent IV bolus every 4 hr as needed. The client asks the nurse how metoclopramide will relieve her nausea. Which of the following explanations should the nurse provide? a. "the medication relieves nausea by promoting gastric emptying" b. "the medication works by decreasing gastric acid secretions" c. "the medication relieves nausea by slowing peristalsis" d. "the medication works by relaxing gastric muscles"

Answer: a. "the medication relieves nausea by promoting gastric emptying" Rationale: Metoclopramide (Reglan) is a gastrointestinal stimulant used to relieve nausea, vomiting, heartburn, stomach pain, bloating, and a persistent feeling of fullness after meals. Reglan works by promoting gastric emptying.

A nurse is caring for a client who has cancer and new prescription for ondansetron to treat chemotherapy-induced nausea. For which of the following adverse effects should the nurse monitor? a. headache b. dependent edema c. polyuria d. photosensitivity

Answer: a. Headache Rationale: Headache is a common adverse effect of ondansetron. Analgesic relief is often required.

A client is prescribed methylcellulose. The nurse understands that this medication works through which action? a. Methylcellulose forms a bulk-forming gel that promotes fecal mass and bowel movements b. Methylcellulose suppresses gastrointestinal secretions to reduce fluid loss in the stool c. Methylcellulose stimulates intestinal peristalsis to promote bowel movements d. Methylcellulose softens the stool by increasing water absorption in the intestines

Answer: a. Methylcellulose forms a bulk-forming gel that promotes fecal mass and bowel movements Rationale: Methylcellulose is a bulk-forming laxative used to manage constipation. It works by absorbing water and forming a gel-like substance in the intestines. This bulk-forming action softens the stool and increases its volume, stimulating intestinal motility and promoting bowel movements. Methylcellulose does not stimulate peristalsis directly, but its ability to increase stool volume and promote regular bowel movements makes it effective for relieving constipation.

A nurse is providing teaching to a client who is prescribed aluminum hydroxide. For which of the following adverse effects should the nurse inform the client? a. constipation b. metallic taste c. headache d. muscle spasms

Answer: a. constipation Rationale: Constipation is a common side effect of aluminum-based antacids. The nurse should instruct the client to increase fiber intake and that stool softeners or laxatives may be needed.

A nurse is reviewing the laboratory results of a client who has liver failure with ascites and is receiving spironolactone. Which of the following findings should the nurse expect? a. decreased sodium level b. decreased phosphate level c. decreased potassium level d. decreased chloride level

Answer: a. decreased sodium level Rationale: The nurse should expect a decreased sodium level. Spironolactone is a potassium-sparing diuretic that inhibits the action of aldosterone, resulting in an increased excretion of sodium.

A nurse is teaching a client who has a new prescription for aluminum hydroxide to treat heartburn. The nurse should instruct the client to monitor for and report which of the following adverse reactions? a. fatigue b. flatulence c. palpitations d. headache

Answer: a. fatigue Rationale: Aluminum hydroxide can cause anemia, which can be manifested by fatigue.

A client is prescribed famotidine. The nurse understands that what is the mechanism of action of this medication? a. inhibits histamine H2 receptors in the stomach, reducing gastric acid secretion b. increases histamine release in the stomach, enhancing gastric acid secretion c. blocks proton pump activity in the stomach, reducing gastric acid production d. enhances the production of mucous in the stomach, protecting the gastric lining

Answer: a. inhibits histamine H2 receptors in the stomach, reducing gastric acid secretion Rationale: Famotidine is a histamine H2 receptor antagonist that selectively inhibits the action of histamine at H2 receptors in the stomach, leading to a decrease in gastric acid secretion.

A client is newly diagnosed with Helicobacter pylori (H. pylori) infection. The nurse understands that which first-line treatment for eradicating H. pylori will most likely be prescribed? a. triple therapy with a PPI and two antibiotics b. a single antibiotic, such as amoxicillin c. dual therapy with two antibiotics d. a proton pump inhibitor (PPI) alone

Answer: a. triple therapy with a PPI and two antibiotics Rationale: Triple therapy, consisting of a proton pump inhibitor (PPI) and two antibiotics, is a common first-line treatment for eradicating H. pylori infection. The PPI reduces stomach acid production, creating an environment that is less hostile to the antibiotics and allowing them to effectively target and eradicate the bacteria. The two antibiotics are usually chosen from a group that includes clarithromycin, amoxicillin, and metronidazole. This combination helps to increase treatment efficacy and reduce the risk of antibiotic resistance.

A nurse is providing education to a patient who has been prescribed prochlorperazine. What key information should the nurse include in the patient teaching about prochlorperazine? a. "if the medication works, you can expect to have a soft bowel movement about once a day" b. "avoid alcohol consumption while taking prochlorperazine" c. "limit fluid intake while taking prochlorperazine to avoid fluid retention" d. "Prochlorperazine is an over-the-counter medication, so you can adjust the dose as needed"

Answer: b. "avoid alcohol consumption while taking prochlorperazine" Rationale: Prochlorperazine is an antiemetic medication commonly used to manage nausea and vomiting. It belongs to the class of phenothiazine antipsychotics and can have sedative effects. Alcohol can enhance these sedative effects, leading to increased drowsiness and impaired coordination. Therefore, patients should be advised to avoid alcohol while taking prochlorperazine.

A nurse is caring for a client who reports taking bisacodyl to promote a daily bowel movement. Which of the following assessment questions should be the nurse's priority? a. "what do your bowel movements look like?" b. "how long have you been taking the bisacodyl?" c. "do you take the bisacodyl with a glass of milk?" d. "how often do you have a bowel movement?"

Answer: b. "how long have you been taking the bisacodyl?" Rationale: The greatest risk to this client is injury from dependency on laxatives, as bowel tone can be lost; therefore, the priority question the nurse should ask the client is how long he has been using bisacodyl.

A client is teaching a client who has a new prescription for hydrochlorothiazide for management of hypertension. Which of the following instructions should the nurse include? a. "take this medication before bedtime" b. "monitor for leg cramps" c. "avoid grapefruit juice" d. "reduce intake of potassium rich foods"

Answer: b. "monitor for leg cramps" Rationale: Hydrochlorothiazide can cause hypokalemia. The client should monitor for manifestations of hypokalemia, such as fatigue, tachycardia, leg cramps, and muscle weakness.

A nurse is providing teaching to a client who has peptic ulcer disease and a new prescription for sucralfate tablets. Which of the following information should the nurse provide? a. "an antacid may be taken with the medication if indigestion occurs" b. "take sucralfate 1 hr before meals" c. "take the tablets whole" d. "store sucralfate in the refrigerator"

Answer: b. "take sucralfate 1 hr before meals" Rationale: Sucralfate is a mucosal protectant. The client should take it on an empty stomach, 1 hr before meals, for maximum effectiveness.

A nurse is teaching a client who has a new prescription for docusate. Which of the following information should the nurse include in the teaching? a. "do not take this medication before bedtime" b. "take the medication with a full glass of water" c. "expect abdominal pain with this medication" d. "take this medication on an empty stomach"

Answer: b. "take the medication with a full glass of water" Rationale: The nurse should instruct the client to take this medication with a full glass of water, unless contraindicated, to reduce the risk for constipation.

A nurse is teaching a client who has a duodenal ulcer about his new prescription for cimetidine. The nurse should include which of the following instructions in the teaching? a. "take the medication with an antacid to minimize stomach upset" b. "your doctor might need to reduce your theophylline dose while taking this medication" c. "this medication will coat the ulcer, allowing it to heal" d. "you should plan to take this medication for at least 6 months"

Answer: b. "your doctor might need to reduce your theophylline dose while taking this medication" Rationale: The nurse should instruct the client that the provider might need to reduce his theophylline dose due to the possibility of increased medication levels

Which antibiotic is commonly used to treat H. pylori infections? a. Ciprofloxacin b. Clarithromycin c. Ampicillin d. Azithromycin

Answer: b. Clarithromycin Rationale: Amoxicillin/clarithromycin/omeprazole are used in combination to treat h. pylori

A nurse is providing discharge teaching for a client who has pulmonary edema and is about to start taking furosemide. Which of the following instructions should the nurse include? a. take aspirin if headaches develop b. eat foods that contain plenty of potassium c. expect some swelling in the hands and feet d. take the medication at bedtime

Answer: b. eat foods that contain plenty of potassium Rationale: Furosemide, a high-ceiling (loop) diuretic, can cause potassium loss. The client should add potassium-rich foods to his diet, such as nuts, dried fruits, bananas, and citrus fruits.

A nurse is caring for a client who has heart failure and is receiving IV furosemide. The nurse should monitor the client for which of the following electrolyte imbalances? a. hypernatremia b. hyperuricemia c. hypercalcemia d. hyperchloremia

Answer: b. hyperuricemia Rationale: The nurse should monitor the client who is receiving IV furosemide for hyperuricemia. The nurse should instruct the client to notify the provider for any tenderness or swelling of the joints.

A nurse is caring for a client who is taking sucralfate. Which of the following outcomes indicates a therapeutic effect of the medication? a. alleviate Helicobacter pylori b. relief of gastrointestinal pain c. prevention of opportunistic infections d. improvement of impaired vision

Answer: b. relief of gastrointestinal pain Rationale: Sucralfate, an antiulcer medication, is prescribed for acute or maintenance therapy of duodenal ulcers. A therapeutic effect of the medication is relief of gastrointestinal pain associated with gastric ulcers. Sucralfate also promotes ulcer healing.

A nurse is teaching a client who has a new prescription for omeprazole. Which of the following statements by the client indicates an understanding of the teaching? a. "i wont pass gas as often now that i am taking this medication" b. "i will take this medication each morning with my breakfast" c. "i have an increased risk of getting pneumonia while taking this medication" d. "i will need to take a daily stool softener while taking this medication"

Answer: c. "i have an increased risk of getting pneumonia while taking this medication" Rationale: The client taking this medication is at a greater risk for developing pneumonia due to an elevation of gastric pH, especially during the first few days of treatment. This effect may be due to the medication compromising the stomach's "acid mantle" against gastric colonization pathogenic bacteria which then may be aspirated. The nurse should instruct the client about manifestations of a respiratory infection and to report these findings to the provider if they occur. An increased risk of C. diff may also occur with this medication.

A nurse is preparing to administer magnesium hydroxide to a client with constipation. The nurse understands that this medication will work in what way? a. form a bulk-forming gel that promotes fecal mass and bowel movement b. stimulate intestinal peristalsis and promote bowel movements c. draw water into the intestines, increasing fluid content and promoting bowel movements d. soften the stool by increasing water absorption from the intestines to the bloodstream

Answer: c. draw water into the intestines, increasing fluid content and promoting bowel movements Rationale: Osmotic laxatives work by increasing the osmotic pressure in the intestines, which draws water into the intestines from the surrounding tissues. This increased fluid content in the intestines softens the stool and stimulates bowel movements. Examples of osmotic laxatives include polyethylene glycol (PEG), lactulose, and magnesium-based laxatives.

A nurse is caring for a client who has heart failure and a new prescription for furosemide. For which of the following adverse effects should the nurse monitor? a. hypervolemia b. hypertension c. hypokalemia d. hypoglycemia

Answer: c. hypokalemia Rationale: Hypokalemia is an adverse effect of furosemide

A nurse is providing teaching to a client who has hypertension and a new prescription for hydrochlorothiazide. Which of the following instructions should the nurse provide? a. weigh weekly to monitor therapeutic effect b. take the medication on an empty stomach c. take the medication early in the day d. muscle pain is an expected adverse effect

Answer: c. take the medication early in the day Rationale: The nurse should instruct the client to take hydrochlorothiazide early in the day to avoid nocturia.

A nurse is teaching a client who has a new prescription for sucralfate. Which of the following statements by the client indicates an understanding of the teaching? a. "i will take this medication as needed to reduce pain" b. "i will reduce my fluid intake with this medication" c. "i will take this medication with an antacid" d. "i will take this medication 1 hour before meals and at bedtime"

Answer: d. "i will take this medication 1 hour before meals and at bedtime" Rationale: This medication is used to treat gastric ulcers. The client should take sucralfate on an empty stomach, 1 hr before each meal and at bedtime to create a protective coating over the ulcer.

A nurse is preparing to administer triamterene. The nurse understands that this medication works in what way? a. Triamterene inhibits carbonic anhydrase in the renal tubules b. Triamterene enhances the reabsorption of sodium and water in the distal convoluted tubule c. Triamterene blocks aldosterone receptors in the collecting ducts d. Triamterene inhibits sodium reabsorption in the distal nephron by blocking sodium-potassium exchange

Answer: d. Triamterene inhibits sodium reabsorption in the distal nephron by blocking sodium-potassium exchange Rationale: Triamterene is a potassium-sparing diuretic that works in the distal nephron to inhibit sodium reabsorption by blocking the sodium-potassium exchange mechanism, particularly in the late distal tubule and collecting ducts. This leads to increased sodium excretion and, consequently, potassium retention. Triamterene helps maintain potassium levels while promoting diuresis.

A nurse is assessing a client who has heart failure and is prescribed furosemide. Which of the following findings is an adverse effect of this medication? a. weight gain b. increased blood pressure c. hypoglycemia d. leg cramps

Answer: d. leg cramps Rationale: Leg cramps is a manifestation of hypokalemia, an adverse effect of furosemide. The nurse should assess the client for hypokalemia and monitor the client's potassium level.

A nurse is assessing a client who is on long term omeprazole therapy. Which of the following findings should indicate to the nurse the medication is effective? a. increased appetite b. regular bowel movements c. absence of headache d. reduced dyspepsia

Answer: d. reduced dyspepsia Rationale: Omeprazole, a proton pump inhibitor, reduces gastric acid secretion and treats duodenal and gastric ulcers, prolonged dyspepsia, gastrointestinal reflux disease, and erosive esophagitis.

A nurse is providing teaching to a client with a new prescription for omeprazole. Which of the following instructions should the nurse provide? a. take NSAIDs if headaches occur b. decrease intake of vitamin D c. expect muscle cramps for several weeks d. report diarrhea to the provider

Answer: d. report diarrhea to the provider Rationale: Omeprazole is associated with an increased risk of C. difficile infection. This medication decreases acidity in the stomach, which would normall help kill c. diff. The nurse should instruct the client to contact the provider if diarrhea occurs.