Week 12 Powerpoint Questions

A patient is experiencing chemotherapy-induced nausea. Which prescribed medication would be most effective for this patient? A. Ondansetron [Zofran] B. Prochlorperazine [Compazine] C. Dexamethasone [Decadron] D. Promethazine [Phenergan]

A. Ondansetron [Zofran] Rationale: Ondansetron is a serotonin receptor antagonist and is the most effective drug available for suppressing nausea and vomiting caused by chemotherapy.

Which patient would most likely need intravenous antibiotic therapy to treat a urinary tract infection? A. A patient with an uncomplicated urinary tract infection caused by Escherichia coli B. A patient with pyelonephritis with symptoms of high fever, chills, and severe flank pain C. A patient with acute cystitis who complains of dysuria, frequency, and urgency D. A patient with acute bacterial prostatitis with a mild fever, chills, and nocturia

B. A patient with pyelonephritis with symptoms of high fever, chills, and severe flank pain Rationale: Severe pyelonephritis requires intravenous antibiotic therapy.

A patient is prescribed amoxicillin and tetracycline to treat peptic ulcer disease. The nurse will instruct the patient that these medications will do what? A. Prevent GI infections that cause gastric bleeding. B. Destroy the bacteria in the stomach that are causing ulceration. C. Reduce gastric acid production and alkalize the stomach fluids. D. Reduce the secretion of pepsin in the stomach.

B. Destroy the bacteria in the stomach that are causing ulceration. Rationale: Helicobacter pylori-associated ulcers are treated with a combination of two or more antibiotics, such as amoxicillin and tetracycline

A patient asks the nurse what he can do to prevent influenza. What should the nurse do? A. Teach the patient about antiviral medications. B. Instruct the patient to obtain an influenza vaccination. C. Tell the patient that frequent hand washing is effective. D. Have the patient wear a mask when in public areas.

B. Instruct the patient to obtain an influenza vaccination. Rationale: Influenza is managed by vaccination with drugs. Vaccination is the primary management strategy to prevent influenza.

The nurse identifies which of the following laxatives as having the added response of ridding the body of ammonia? A. Polyethylene glycol B. Lactulose C. Lubiprostone D. Mineral oil

B. Lactulose Rationale: In addition to its laxative action, lactulose can enhance intestinal excretion of ammonia. This property has been exploited to lower blood ammonia content in patients with portal hypertension and hepatic encephalopathy secondary to chronic liver disease.

A patient is prescribed acyclovir [Zovirax] by mouth. The nurse should assess the patient for which adverse effects associated with oral acyclovir therapy? A. Stomatitis and gastritis B. Nausea, vomiting, and diarrhea C. Hives, difficulty breathing, and angioedema D. Tinnitus and decreased hearing

B. Nausea, vomiting, and diarrhea Rationale: Commonly reported adverse reactions to oral acyclovir therapy include nausea, vomiting, diarrhea, headache, and vertigo.

Which patient does the nurse identify as most likely to need treatment with trimethoprim/sulfamethoxazole [Bactrim] for a period of 6 months? A. A female patient with acute pyelonephritis B. A male patient with acute prostatitis C. A female patient with recurring acute urinary tract infections D. A male patient with acute cystitis

C. A female patient with recurring acute urinary tract infections Rationale: Female patients with relapses of urinary tract infection may need long-term therapy up to 6 months with trimethoprim/sulfamethoxazole.

A patient with irritable bowel syndrome is prescribed alosetron [Lotronex]. Before this drug is administered, it is most important for the nurse to do what? A. Assess for abdominal bruits. B. Check serum potassium and sodium levels. C. Ask the patient about any problems with constipation. D. Mix the powder in 8 ounces of fruit juice.

C. Ask the patient about any problems with constipation. Rationale: Patients should not take alosetron if constipation develops. Impaction, bowel obstruction, and perforation can occur.

The nurse identifies which of the following as the most common type of laxative abused by the general public? A. Magnesium hydroxide [Milk of Magnesia] B. Docusate sodium [Colace] C. Bisacodyl [Dulcolax] D. Polyethylene glycol [MiraLax]

C. Bisacodyl [Dulcolax] Rationale: Stimulant laxatives (bisacodyl, senna, castor oil) are most commonly abused by the general public. The nurse should discourage use of these drugs for occasional relief of constipation

Which drug does the nurse identify as a urinary tract antiseptic? A. Ciprofloxacin B. Ceftriaxone C. Nitrofurantoin D. Ceftazidime

C. Nitrofurantoin Rationale: Two urinary tract antiseptics currently are available: nitrofurantoin and methenamine. Ciprofloxacin, ceftriaxone, and ceftazidime are antimicrobials.

Which statement about oseltamivir [Tamiflu] does the nurse identify as true? A. Oseltamivir must be administered on an empty stomach. B. The drug is administered via an inhaler. C. Oseltamivir can be used to treat and prevent influenza. D. The drug is approved for use in infants 6 months of age or older.

C. Oseltamivir can be used to treat and prevent influenza. Rationale: Dosing of oseltamivir can be done with or without food, although dosing with food can reduce nausea. The drug is available in capsules (30, 45, and 75 mg) and as a powder (360 mg) to be reconstituted to a 6-mg/mL oral suspension. Oseltamivir [Tamiflu] is an oral drug approved for prevention and treatment of influenza in patients age 1 year or older

A patient has been prescribed docosanol [Abreva] cream for herpes labialis. Which statement will the nurse include in patient teaching? A. Apply the cream twice a day. B. Use of the cream will cut the duration of the herpes simplex lesion in half. C. Many serious adverse effects are associated with use of this medication. D. Apply the cream at the first sign of recurrence.

D. Apply the cream at the first sign of recurrence. Rationale: Application is done 5 times a day, beginning at the first sign of recurrence. Benefits are modest. In one trial, treatment reduced the time to healing from 4.8 to 4.1 days, about the same response seen with penciclovir. Docosanol cream appears to be devoid of adverse effects.

A patient is prescribed bisacodyl. Which of the following should the nurse include in patient teaching? A. Your urine will turn yellow-brown when taking this medication. B. Crush the bisacodyl tablet and sprinkle it on your food. C. Chew the bisacodyl tablet. D. Do not take the bisacodyl with an antacid.

D. Do not take the bisacodyl with an antacid. Rationale: Instruct patients to take oral bisacodyl no sooner than 1 hour after ingesting milk or antacids. Instruct patients to swallow the tablets intact, without crushing or chewing. Inform patients that bisacodyl suppositories may cause a burning sensation, and warn them that prolonged use can cause proctitis. Senna can cause the patient's urine to turn a harmless yellow-brown or pink.

A patient who has been taking a long-acting morphine to treat severe pain for a few months complains of constipation. The nurse anticipates which of the following will be prescribed for the patient? A. Polycarbophil [FiberCon] B. Mineral oil C. Psyllium [Metamucil] D. Senna [Senokot]

D. Senna [Senokot] Rationale: Stimulant laxatives are commonly used to treat opioid-induced constipation

Which medication is used to promote gastric ulcer healing by providing a protective barrier? A. Cimetidine B. Misoprostol C. Omeprazole D. Sucralfate

D. Sucralfate Rationale: Sucralfate promotes ulcer healing by creating a protective barrier against acid and pepsin. Proton pump inhibitors (eg, omeprazole, lansoprazole) suppress acid secretion by inhibiting gastric H＋, K＋-ATPase, the enzyme that makes gastric acid. Misoprostol, an analog of prostaglandin E1, is used to prevent gastric ulcers caused by NSAIDs. Cimetidine and other H2RAs suppress secretion of gastric acid by blocking histamine2 receptors on parietal cells of the stomach. Helicobacter pylori-associated ulcers are treated by a combination of two or more antibiotics such as amoxicillin and tetracycline.

Which statement about metoclopramide [Reglan] does the nurse identify as true? A. High-dose therapy causes nervous excitability. B. High-dose therapy causes constipation. C. Long-term high-dose therapy causes reversible tardive dyskinesia. D. The drug is contraindicated in patients with GI obstruction, perforation, or hemorrhage.

D. The drug is contraindicated in patients with GI obstruction, perforation, or hemorrhage. Rationale: With high-dose therapy, sedation and diarrhea are common. Long-term high-dose therapy can cause irreversible tardive dyskinesia (TD).

1. A patient is prescribed cimetidine [Tagamet] and aluminum hydroxide [Maalox] for the treatment of peptic ulcer disease. What should the nurse teach the patient to do? A. Drink an 8-ounce glass of water when taking these medications. B. Take the medications together to enhance their effectiveness. C. Take the Tagamet 2 hours before the Maalox. D. Wait at least 1 hour between administration of the two medications.

D. Wait at least 1 hour between administration of the two medications. Rationale: Cimetidine and antacids should not be administered together. The patient should be instructed to take the medications at least 1 hour apart.