Ch. 54, 57, 58

A patient presents at the clinic with signs and symptoms of seasonal allergic rhinitis. The patient is prescribed a nasal steroid to relieve symptoms. Two days later, the patient calls the clinic and tells the nurse that he is frustrated and wants a new drug. What is the most appropriate response by the nurse? a) "It may take up to 2 weeks to get the full clinical effect. Try to keep using the drug as ordered." b) "The drug must not work for you. Let's change to an oral steroid." c) "You probably are administering the drug incorrectly. Come in and we can review the process." d) "You probably need to try a different nasal steroid. This one should be effective by now."

a) "It may take up to 2 weeks to get the full clinical effect. Try to keep using the drug as ordered."

After providing teaching to a patient prescribed lansoprazole (Prevacid), the nurse evaluates the patient understands the action of this medication when the patient makes what statement? a) "The medication inhibits acid secretions." b) "The medication is an antibiotic." c) "The medication is an analgesic." d) "The medication will promote healing of my ulcer."

a) "The medication inhibits acid secretions."

The nurse, teaching a patient to be discharged with an order to use chemical stimulant laxatives PRN, instructs the patient that one of the most common adverse effects of this type of laxative is what? a) Abdominal cramping b) Rectal bleeding c) Confusion d) Iron deficiency anemia

a) Abdominal cramping

A student nurse is doing research consisting of chart audits of 25 patients with diagnosed chronic pharyngitis; she is attempting to determine what medication has been prescribed most frequently. What type of medication would this nurse expect to find in most of the chart audits? a) Antitussives b) Nasal sprays c) Oral decongestants d) Mucolytics

a) Antitussives

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)

A 71-year-old man with a history of heart disease and diabetes has had an antihistamine prescribed. The nurse is concerned with this prescription because of the risk for what? a) Cardiac arrhythmias b) Increased salivation and choking c) Severe constipation d) Insomnia

a) Cardiac arrhythmias

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 collects a stool culture from a patient diagnosed with traveler's diarrhea. What bacterium does the nurse expect the culture to grow? a) Escherichia coli b) Staphylococcus aureus c) Streptococcus type B d) Pseudomonas

a) Escherichia coli

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

Parents who treat their children's cold and flu symptoms at home should be educated concerning the reading and understanding of over-the-counter (OTC) labels. Why is this statement true? a) Many of these preparations contain the same active ingredients so that inadvertent overdose is a common problem. b) Each product is best used for alleviating a particular symptom. c) Some of these products do not contain any drugs. d) Some of these products could interfere with breast-feeding.

a) Many of these preparations contain the same active ingredients so that inadvertent overdose is a common problem.

The nurse advises that patient to avoid long-term use of nasal decongestants because it may lead to what condition? a) Mucosal ulcerations b) Decreased drainage c) Increased risk of infection d) Asthma

a) Mucosal ulcerations

The nurse administers ranitidine (Zantac) cautiously to patients with evidence of what conditions? a) Renal disease b) Diabetes mellitus c) Pulmonary disease d) Migraine headaches

a) Renal disease

The 59-year-old patient has peptic ulcer disease and is started on sucralfate (Carafate). What is an appropriate nursing diagnosis related to this medication? a) Risk for constipation related to GI effects b) Risk for injury: bleeding c) Imbalanced nutrition related to nausea d) Deficient fluid volume

a) Risk for constipation related to GI effects

The nurse is caring for a 27-year-old female patient who has just been prescribed misoprostol. What is a priority teaching point for this patient? a) You will need to use a barrier-type contraceptive b) Do not take NSAIDs with this drug c) Adverse effects include nausea and diarrhea d) It protects the lining of the stomach

a) You will need to use a barrier-type contraceptive

What nursing interventions are included in the plan of care for a patient receiving antacids to relieve GI discomfort? a) Administer this drug with other drugs or food. b) Administer the antacid 1 hour before or 2 hours after other oral medications. c) Limit fluid intake to decrease dilution of the medication in the stomach. d) Have the patient swallow the antacid whole and do not crush or chew the tablet.

b) Administer the antacid 1 hour before or 2 hours after other oral medications.

A patient comes to the clinic with symptoms as seen in a cold. What group of upper respiratory drugs causes local vasoconstriction, which decreases blood flow and shrinks swollen membranes to improve air flow? a) Antitussives b) Decongestants c) Expectorants d) Mucolytics

b) Decongestants

A patient presents at the clinic with a dry nonproductive cough. The patient is diagnosed with bronchitis and it has been determined that assistance is needed in thinning the sputum so the cough can become productive. What does the nurse expect the physician will prescribe? a) Benzonatate (Tessalon) b) Guaifenesin (Mucinex) c) Dextromethorphan (Benylin) d) Hydrocodone (Hycodan)

b) Guaifenesin (Mucinex)

The patient will receive ranitidine (Zantac) 150 mg PO at bedtime. Prior to administration, the nurse will inform the patient that common adverse effects related to this medication include what? a) Tremors b) Headache c) Visual disturbances d) Anxiety

b) Headache

A 29-year-old female patient has sinusitis, so the physician orders a topical nasal decongestant. What instructions should be given? a) Avoid becoming pregnant during decongestant therapy. b) Increase fluids to 2 L/d. c) Restrict fluids to 500 mL/d. d) Take the medication with meals.

b) Increase fluids to 2 L/d.

What drug does the nurse administer that inhibits intestinal peristalsis through direct effects on the longitudinal and circular muscles of the intestinal wall? a) Bismuth subsalicylate b) Loperamide c) Paregoric d) Magnesium citrate

b) Loperamide

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)

The nurse teaches the patient to best maintain optimal GI function by including what in the daily routine? a) Exercise, adequate sleep, and avoiding caffeine b) Proper diet, fluid intake, and exercise c) Proper diet, avoiding alcohol, and cautious use of laxatives d) Avoiding prescription medications, increased fluid intake, and vigorous exercise

b) Proper diet, fluid intake, and exercise

What would be the nurse's best response if a patient calls the clinic and reports that he has had a persistent cough for 2 weeks and asks the nurse for a recommendation for a cough medicine? a) "Look for dextromethorphan as an ingredient in any OTC cough preparation." b) "The doctor could order an antihistamine, which might dry up your secretions and stop the cough." c) "You should come to the clinic to be evaluated. A cough that lasts that long might be an indication of an underlying medical problem." d) "Drink a lot of fluids and take aspirin, which should reduce the irritation in your throat."

c) "You should come to the clinic to be evaluated. A cough that lasts that long might be an indication of an underlying medical problem."

The nurse is preparing a patient for discharge with a prescription for sucralfate (Carafate) and teaches the patient to take the medication when? a) With meals b) With an antacid before breakfast c) 1 hour before or 2 hours after meals and at bedtime d) After each meal

c) 1 hour before or 2 hours after meals and at bedtime

What priority teaching point does the nurse include when instructing patients about the use of antacids? a) Reduce calorie intake to reduce acid production. b) Take before each meal and before bed. c) Be aware of risk of acid rebound with long-term use. d) Consider liquid diet if diarrhea occurs.

c) Be aware of risk of acid rebound with long-term use.

When comparing the histamine-2 antagonists to each other the nurse recognizes that cimetidine (Tagamet) is more likely to cause which adverse effect? a) Dizziness b) Headache c) Gynecomastia d) Somnolence

c) Gynecomastia

The nursing instructor is teaching the lab students the best position for the administration of nasal sprays. What position would the instructor teach the students? a) Supine b) Semi-Fowler's c) High Fowler's d) Side-lying

c) High Fowler's

The home health nurse is caring for a 72-year-old man in his home. He complains about almost daily diarrhea. The nurse assesses for what common cause of diarrhea in older adults? a) Diabetes b) Hypertensive medications c) Laxative overuse d) Glaucoma

c) Laxative overuse

A patient has an important presentation to make in 4 hours and he needs relief from the congestion of seasonal rhinitis. The patient calls the nurse, explains the situation, and tells the nurse that he cannot afford to be drowsy. Which antihistamine would be a good choice for this patient? a) Diphenhydramine (Benadryl) b) Dexchlorpheniramine (Polaramine) c) Loratadine (Claritin) d) Hydroxyzine (Atarax)

c) Loratadine (Claritin)

What classification of drugs does the nurse administer to treat peptic ulcers by suppressing the secretion of hydrochloric acid into the lumen of the stomach? a) Antipeptic agents b) Histamine-2 antagonists c) Proton pump inhibitors d) Prostaglandins

c) Proton pump inhibitors

The nurse is teaching a group of patients with allergic rhinitis about the use of their medications. What would be the most essential information to give these patients about preventing possible drug interactions? a) Over-the-counter (OTC) medications are safe to use. b) Use only one pharmacy so the pharmacist can check drug interactions. c) Read drug labels before taking OTC medications. d) Ask the pharmacy tech for assistance in selecting an OTC medication.

c) Read drug labels before taking OTC medications.

What statement by a 61-year-old patient who is to take an antitussive with codeine indicates that the nurse's teaching has been effective? a) "I will take this medication anytime I start to cough." b) "This medication may make me anxious and nervous." c) "I should call the physician if I develop nausea, diarrhea, or stomach cramps while taking this medication." d) "This medication can cause drowsiness, so I will avoid driving or using power equipment while I take it."

d) "This medication can cause drowsiness, so I will avoid driving or using power equipment while I take it."

An adult patient is prescribed cimetidine (Tagamet). A nurse will instruct the patient that an appropriate dosage and frequency of cimetidine is what? a) 20 mg PO b.i.d b) 150 mg PO b.i.d c) 300 mg PO at bedtime d) 800 mg PO at bedtime

d) 800 mg PO at bedtime

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

Which of these patients would the nurse expect to be the best candidate for misoprostol (Cytotec)? a) A 12-year-old with obsessive-compulsive disorder b) A 22-year-old pregnant patient c) A 46-year-old trial lawyer with hypertension d) An 83-year-old man with rheumatoid arthritis

d) An 83-year-old man with rheumatoid arthritis

The nurse teaches the patient who was prescribed a chemical stimulant laxative that this medication may have either a slow, steady effect or may cause severe cramping and rapid evacuation of the contents of the large intestine. What drug is the nurse teaching this patient about? a) Bismuth salts b) Bisacodyl c) Castor oil d) Cascara

d) Cascara

What disorders would the pharmacology instructor tell the nursing students may be exacerbated by the use of nasal decongestants? a) Pneumonia b) Rheumatoid arthritis c) Acid reflux d) Hypothyroidism

d) Hypothyroidism

For what action would the nurse administer magnesium citrate? a) Block absorption of fats b) Directly stimulate the nerve plexus in the intestinal wall c) Form a slippery coat on the contents of intestine d) Increase motility, increase fluid, and enlarge bulk of fecal matter

d) Increase motility, increase fluid, and enlarge bulk of fecal matter

What antidiarrheal would the nurse administer to reduce the volume of discharge from the patient's ileostomy? a) Diphenoxylate (Lomotil) b) Octreotide (Sandostatin) c) Psyllium (Metamucil) d) Loperamide (Imodium)

d) Loperamide (Imodium)

The nurse would question an order for misoprostol if the patient was diagnosed with what condition? a) Diabetes b) Hypertension c) Arthritis d) Pregnancy

d) Pregnancy