Pharm final again

Drugs used to treat digestive disorders act on what aspect of the gastrointestinal system?

Drugs used in the treatment of digestive disorders primarily alter GI secretion, absorption, or motility.

Which adverse effect is more likely to be caused by cimetidine than by other H2RAs?

gynecomastia and mental confusion

A client is prescribed a proton pump inhibitor to treat erosive gastritis. How soon will the client's symptoms be resolved?

1 to 2 weeks The symptoms of gastroesophageal reflux disease will most likely be resolved in 1 to 2 weeks after the start of the proton pump inhibitor medication regime

A client who is taking magnesium citrate experiences sweating, palpitations, and flushing. The nurse understands that this is most likely related to which of the following?

Sympathetic stress reaction due to intense GI tract neurostimulation

The nurse is discussing the possible side effects of chemotherapy with a client. What information obtained during the client's admission assessment and interview will have a direct influence on the management of nausea and vomiting

The client has been prescribed phenothiazine for anxiety

The client states that prior to exams at school, the client has abdominal cramping and diarrhea. What does the nurse suspect is the trigger for these signs and symptoms?

The client is describing functional diarrhea disorder where the diarrhea occurs as a result of stress or anxiety.

The nurse is preparing to administer a stimulant cathartic to the client. The nurse should inform the client of the possible adverse effect of:

diarrhea.

The nurse is caring for a patient who has been prescribed a saliva substitute . The patient asks why this medication is necessary. What would be the most appropriate response?

"This medication helps people that have a condition that creates a lack of saliva." Saliva substitute helps in conditions that result in dry mouth—stroke, radiation therapy, chemotherapy, and other illnesses.

A postoperative surgical client, prescribed twice-daily administration of docusate sodium, is concerned about developing diarrhea. What should the nurse teach the client about docusate sodium?

"This medication will only soften your stools over the next couple of days."

A nurse is teaching a client about his prescribed lansoprazole. The nurse instructs the client to take the drug at which time?

1 hour before eating

The nurse should counsel a client to discontinue use of over-the-counter antidiarrheals and seek treatment from a health care provider if diarrhea persists for how long?

2 days The nurse should counsel a client to discontinue use of over-the-counter antidiarrheals and seek treatment from a health care provider if diarrhea persists for more than 2 days. Diarrhea lasting more than 2 days can indicate infection or a condition that will require more intense treatment with prescription medication. Dehydration can occur if untreated. Diarrhea of 12 hours to 1 day can be viral. Diarrhea for 7 days can be life threatening.

A client is to start receiving chemotherapy at 10:00 AM. The client has an order for intravenous metoclopramide. The nurse would expect to give the drug at which time?

9:30 AM Metoclopramide is given intravenously 30 minutes before chemotherapy.

A client is receiving sucralfate. The nurse understands that this drug would begin to act within which time frame?

30 minutes Sucralfate has an onset of action of 30 minutes and a duration of 5 hours.

The nurse is caring for a client with a hepatic impairment. The nurse knows that the dose of ondansetron should not exceed what amount?

8 mg

The 5-HT3 receptor blocker, palonosetron, is especially suited for administration to which client?

A 10 month old experiencing vomiting after chemotherapy Palonosetron is approved for use in children 1 month of age and older.

The nurse is assessing a client who reports constipation. The use of a medication to treat this problem is contraindicated if the client reports what symptom?

Abdominal pain and fever

All of the following are centrally acting antiemetics EXCEPT

Adsorbents

A nurse is caring for an elderly patient who has been administered cimetidine. Which intervention should the nurse perform?

Closely monitor the patient for confusion and dizziness.

The patient has called the office to see if using bismuth subsalicylate will work to treat simple diarrhea. The nurse knows this will be a safe and effective treatment for diarrhea unless the patient has:

Allergy to aspirin

The nurse is preparing to administer bismuth subsalicylate to a client. What assessment is most important to make before administration?

Allergy to aspirin Bismuth subsalicylate contains salicylate, and the client should be assessed for an aspirin allergy before administration.

Which of the following groups of antibiotics is notable for side effects such as nephrotoxocity and ototoxicity? Aminopenicillins Beta Lactams Aminoglycosides Tetracyclines Cephalosporins Anti-Pseudomonal Penicillins

Aminoglycosides Aminoglycosides are a class of antibiotic that inhibit the 30S subunit of the bacterial ribosome, leading to cell death or bactericidal activity. They are active against gram negative rods. Examples include gentamicin, neomycin and amikacin. Important side effects include nephrotoxicity and ototoxicity.

The nurse is reviewing a new prescription for promethazine. The nurse will immediately contact the health care provider if the prescription is for which client?

An 18-month-old child A black box warning alerts nurses that promethazine is contraindicated in children younger than 2 years of age because of the risk of potentially fatal respiratory depression.

The nurse cautions a client with what allergy to avoid the use of bismuth salts in the treatment of diarrhea?

Aspirin

Ranitidine (Zantac) is preferred over cimetidine (Tagamet) therapy in critically ill clients due to decreased risk of which adverse effect?

Drug-drug interactions

Which of the following best classifies penicillins, cephalosporins, and carbapenems? Mycolic Acid Synthesis Inhibitors RNA Synthesis Inhibitors Cell Wall Inhibitors Fluoroquinolones Protein Synthesis Inhibitors Sulfonamides

Cell Wall Inhibitors Cell wall inhibitors are antibiotics whose mechanism of action involves disruption of the bacterial cell wall, typically by preventing the peptidoglycan building blocks from being cross-linked together. Without an intact cell wall, bacteria cannot maintain normal metabolic functions and will either stop proliferating or die. Antibiotics under this category include the penicillins, cephalosporins, monobactams, carbapenems, and vancomycin.

Diphenoxylate with atropine sulfate resolves diarrhea by what mechanism of action?

Decreasing intestinal motility

A community health nurse is conducting a health promotion session with a group from a local seniors' center. The nurse has addressed the issue of laxative overuse in this population. The nurse should highlight what consequence of the overuse of laxatives?

Dependence

The nurse is caring for a client with diarrhea who has been prescribed diphenoxylate with atropine and is observing the client for which adverse effects of this drug?

Dizziness

A client reports to the nurse about needing to strain to defecate. The client adds that defecating is very painful. What laxative will the nurse suggest to the prescriber based on the painful defecation?

Docusate

The nurse is caring for a new mother who had to have an episiotomy during the birth of her baby. Two days after delivery the client is in need of a laxative. What will the nurse administer?

Docusate

Which statement best compares the use of phenothiazines in treatment as an antiemetic and an antipsychotic?

Dosing of phenothiazines is smaller for antiemetics than in antipsychotic use.

The nurse administers hydroxyzine to a client with nausea. After administration, the nurse should monitor for what adverse effect?

Dry mouth Anticholinergic effects, including dry mouth, can result from the use of hydroxyzine.

The nurse is preparing a teaching plan for a patient who is receiving sucralfate. Which would the nurse need to address? (Select all that apply.)

Eating a high fiber diet Ensuring safety precautions Taking the drug on an empty stomach Encouraging frequent mouth care Constipation is the most common adverse effect. A high fiber diet is needed to prevent constipation. Dizziness and vertigo can occur with this drug; safety precautions would be important. The drug should be taken on an empty stomach, 1 hour before or 2 hours after meals to ensure therapeutic effectiveness. Frequent mouth care is important in combating dry mouth, which is associated with this drug. Constipation is the most common adverse effect. Increased fluid intake is needed to promote bowel elimination. It also helps to combat dry mouth.

What is first-line therapy for infants and children 1 to 4 years of age with diarrhea?

Electrolyte replacement

A nurse is providing health education regarding the role of the accessory organs of the digestive system. What is the best explanation by the nurse of the action of bile released by the gallbladder?

Emulsification of fat

Which medication reduces the secretion of gastric acid by inhibition of the hydrogen-potassium adenosine triphosphate (ATPase) enzyme system of the gastric parietal cells? Select all that apply.

Esomeprazole Lansoprazole

The nurse is caring for a 19-month-old child who has been hospitalized with dehydration secondary to nausea and vomiting. The nurse is aware that promethazine will not be used for this client because it can cause what in children under the age of 2?

Fatal respiratory depression

A client is taking cimetidine for increased gastric pain and hypersecretion. Nurses should use caution when administering cimetidine to those with which condition?

Hepatic disease

The nurse should be aware that ranitidine achieves a therapeutic effect by which means?

Inhibiting the secretion of gastric acid

The vomiting reflex is stimulated by two centers in which structure of the brain?

Medulla

Which of the following groups of antibiotics best classifies aztreonam? Carbapenems (Imipenem & Meropenem) Aminoglycosides Cephalosporins Monobactams Penicillins Tetracyclines

Monobactams Monobactams are another class of beta-lactam cell wall inhibiting antibiotics, and the only relevant member of this class is aztreonam. Aztreonam only has coverage against gram negative bacteria, in contrast to many other beta-lactam antibiotics. It is useful for patients with penicillin allergies.

People taking phenothiazines need to be assessed for extrapyramidal symptoms. What effects are considered adverse effects of the phenothiazines?

dry mouth, drowsiness, dizziness, dystonia, photophobia, blurred vision, urinary retention, and urine discolored pink to red-brown

A client is diagnosed with peptic ulcer due to H. pylori. The nurse would anticipate administering which agent in conjunction with an antibiotic?

Omeprazole Omeprazole is a proton pump inhibitor which is used as part of combination therapy to treat H. pylori infections.

Medications are given post-operatively to prevent or treat severe nausea and vomiting associated with the surgery. What serotonin receptor antagonist would the nurse expect the surgeon to order?

Ondansetron

The nurse should administer which of the following medications cautiously to clients with vitamin B12 deficiency as the prolonged use of these drugs decreases the body's ability to absorb vitamin B12? Select all that apply:

Pantoprazole (Protonix) Rabeprazole (Aciphex) Pantoprazole (Protonix)

Which would an instructor include as an example of a phenothiazine used as an antiemetic?

Perphenazine

Which would an instructor include as an example of a phenothiazine used as an antiemetic?

Perphenazine Perphenazine is a phenothiazine antiemetic.

A client has been prescribed a phenothiazine for chemotherapy related nausea and vomiting. Which urinary side effect should the nurse include when educating the client on this medication?

Pink to red brown urine

The physician has prescribed an antiemetic for your 9-year-old patient to control nausea and vomiting. Which drug is the physician most likely to prescribe?

Promethazine Promethazine is often the drug of choice with children, and it has established oral, rectal, and parenteral doses.

Why is buclizine an effective antiemetic?

Promotes anticholinergic effects

An adult hospital client has been experiencing intractable nausea and vomiting for several hours, so the nurse has obtained a prescription for an antiemetic from the health care provider. The prescription reads: "Promethazine 25 mg subcutaneously every 6 hours PRN." The nurse should contact the health care provider to question what aspect of this prescription?

The route

A client is diagnosed with Helicobacter pylori infection. The health care provider will order amoxicillin and what other type of medication?

Proton pump inhibitors The treatment of choice for Helicobacter pylori infection is a PPI and clarithromycin plus either amoxicillin or metronidazole.

The nurse should know that lactulose achieves a therapeutic effect by which means?

Pulling water into the intestinal lumen by osmotic pressure

A female client presents to the health care provider's office with increasing stomach acidity. She self-administers calcium antacids. She notes that she seems to be having more issues with stomach acid, so she has been taking the calcium antacids more frequently. The nurse suspects that this may have caused what to occur in this client?

Rebound acidity

Ondansetron (Zofran) belongs to which pharmacological category of medications?

Selective 5-HT3 receptor antagonist

Where in the gastrointestinal (GI)tract does most of the absorption of nutrients occur?

Small intestines

The large intestine absorbs mostly water and which electrolyte?

Sodium

A client diagnosed with an H. pylori-associated ulcer has been prescribed treatment that includes two antimicrobials. What does the nurse identify as the reason for using multiple antimicrobials?

Two antimicrobials help prevent the emergence of drug-resistant H. pylori organisms.

A male client has been receiving promethazine for nausea that occurred following chemotherapy. Recently it has been discovered that this client has developed liver dysfunction. The nurse anticipates that the health care provider will do what to treat this client's nausea?

Use an alternative medication.

A client diagnosed with irritable bowel syndrome has been prescribed alosetron. The nurse should ensure that the client has been made aware of what potentially severe adverse effect?

bowel obstruction

A client reports the intention to use an over-the-counter bismuth product. The nurse should inform the client that there is a potential that the medication will cause what side effect?

dark stool

While reviewing the medication history of a client newly prescribed omeprazole, the nurse sees that the client is also taking warfarin. What potential interaction should the nurse account for when developing the plan of care for this client?

hemorrhage

Ranitidine and cimetidine are both H2RAs used in the treatment of peptic ulcer disease. Of the two, ranitidine is preferred in critically ill clients because it is less likely to:

interfere with the metabolism of other drugs.

A male client tells the nurse that he takes antacid tablets several times each day. Knowing that the brand of antacid he uses contains calcium carbonate, the nurse cautions the client that overuse could place him at risk for:

metabolic alkalosis.

A male client tells the nurse that he takes antacid tablets several times each day. Knowing that the brand of antacid he uses contains calcium carbonate, the nurse cautions the client that overuse could place him at risk for:

metabolic alkalosis. Overuse of antacids containing calcium carbonate can cause alkalosis and raise urine pH.

Which is a known trigger for nausea and/or vomiting? Select all that apply.

metabolic disorders neurologic disorders

An adult resident of an assisted living facility has not responded appreciably to bulk-forming laxatives, so the primary care provider has prescribed bisacodyl. The nurse who oversees the care at the facility should know that this drug may be administered by what route? Select all that apply.

orally or by suppository. Parenteral administration is not possible.

A 52-year-old man is suffering from a deficiency of exocrine pancreatic secretions and is prescribed pancrelipase (Pancrease MT). Before the medication therapy begins, the nurse will assess for allergies related to

pork. Pancrelipase is contraindicated in patients who are hypersensitive to pork protein or enzymes because the drug is derived from pork

A client is experiencing nausea and vomiting as a response to radiation therapy. Which antiemetic agent is a phenothiazine administered to control nausea and vomiting?

prochlorperazine

A client is experiencing nausea and vomiting as a response to radiation therapy. Which antiemetic agent is a phenothiazine administered to control nausea and vomiting?

prochlorperazine Prochlorperazine is a commonly used phenothiazine administered for nausea and vomiting related to radiation therapy.