Pharmacology Exam #5

A client has been told that stimulation of their chemoreceptor trigger zone (CTZ) is responsible for their current symptoms. What nursing action indicates that the nurse is aware of the role of the CTZ?

Planning care to manage the client's nausea and vomiting

What electrolyte should be monitored taking furosemide?

Potassium (... & sodium)

An ED nurse is caring for a patient who is receiving furosemide for treatment of pulmonary edema. What will the nurse monitor to observe for adverse effects of the drug?

Potassium Levels

A client has been diagnosed with hypocalcemia. What should the nurse identify as outcomes if the disorder is not corrected?

-muscle spasms -laryngospasms -facial muscle twitching -numbness of the fingers and/or toes

A group of nursing students are analyzing the various categories of upper gastrointestinal system drugs. The instructor determines the session is successful when the students correctly choose which drug(s) as an example of a proton pump inhibitor?

-omeprazole -esomeprazole

An adult client has a fecal impaction. Which are effective medications a nurse can suggest to a prescriber for a fecal impaction?

-rectal suppository -enema

What symptoms can we see in Vitamin A toxicity?

-vision problems -headache -dry/itchy skin -elevated blood calcium

During a routine clinic visit, a client reports using an over-the-counter antidiarrheal agent for treatment of diarrhea. The nurse reviews the drug information with the client and determines the client grasps the importance of contacting the primary health care provider if the diarrhea is not resolved within which time frame?

48 hours

Why might a proton pump inhibit (PPI) be preferable to an a histamine2 receptor antagonists (H2RA) for the treatment of gastroesophageal reflux disease (GERD)?

-PPIs facilitate faster healing. -PPIs act for a longer period of time. -PPIs suppress acid more effectively.

A nurse, caring for a client diagnosed with hyperkalemia, should prioritize which nursing interventions?

-Removing sources of potassium from the diet. -Monitoring laboratory values of serum potassium daily. -Assessing for electrocardiographic changes.

I should sit or stand for 30 minutes after alendronate to prevent what?

-esophageal erosion -GI upset

A nurse is completing an assessment on a client diagnosed with adrenocortical excess. What are the expected clinical manifestations?

-heavy trunk -thin extremities -buffalo hump

Tell me therapeutic effect and educational information for sucralfate.

-protects the lining of the stomach. (Pt. edu: take 4x daily for 4-8 weeks)

The use of an antiemetic is not clinically safe for which client reporting nausea and vomiting?

A client seen in the emergency room for injuries associated with alcohol intoxication

Which is an example of a loop diuretic?

Furosemide (Lasix)

Which condition in a client's history can be a cause of adrenocortical insufficiency?

Histoplasmosis infection

Prevention of osteoporosis includes which of the following measures?

Maintaining adequate calcium and vitamin D intake.

A client began taking hydrochlorothiazide 1 week ago and is reporting occasional dizziness when standing up quickly from sitting or lying. What is the nurse's best action?

Teach the client about the blood pressure effects of the medication and relevant safety measures.

Which medication is prescribed for the treatment of iron toxicity?

deferoxamine

A male client develops diarrhea secondary to antibiotic therapy. He is to receive two tablets of diphenoxylate HCl with atropine sulfate (Lomotil) orally as needed for each loose stool. The nurse should inform him that he may experience:

dizziness

A client who has suffered a myocardial infarction is prescribed a laxative to help prevent straining during defecation. Which medication would the nurse expect to administer?

docusate

The nurse is planning the care of an older adult who has recently begun long-term hydrocortisone therapy. What nursing action best addresses the adverse effects of treatment?

ensuring that the clients immunizations stay current

A client reports diarrhea as being "fatty." The nurse suspects what possible cause?

enzyme deficiency

The nurse is providing education to a 72-year-old client who has been discharged home on a diuretic. What should the nurse include in the discharge instructions?

how to properly weight themselves at home

In the stomach lining, the parietal cells release _________ and the chief cells release __________ which both play a role in peptic ulcer disease.

hydrochloric acid, pepsinogen

How does histamine release contribute to ulcer formation?

stimulates gastric acid secretion

A nurse is caring for a client who reports experiencing headaches, diarrhea, and dry, pruritic skin. These reports support which possible cause of the symptomology?

toxic effects of vitamin A

A prescriber adds psyllium to the medication administration record for a client experiencing diarrhea. Which is the best rationale for the addition of psyllium?

It absorbs toxins and water, decreasing fluidity of stools.

An instructor is preparing a teaching plan for a class on the various pituitary hormones. Which hormone would the instructor include as being released by the posterior pituitary gland?

Oxytocin

The nurse is caring for a female client who has been recently been prescribed misoprostol. What change in the client's health status should the nurse communicate most promptly to the primary health care provider?

The client believes that they may be pregnant.

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

After administering desmopressin to a client with diabetes insipidus, which would the nurse identify as indicating drug effectiveness?

decreased reports of thirst

The nurse administers loperamide to a client. The nurse expects to decrease the client's number and liquidity of stool by what mechanism?

decreasing intestinal motility

A head injury has resulted in the hospitalization of a client. Nursing assessments confirm that the client is producing substantial amounts of dilute urine and is consuming large amounts of liquids. Considering the history and assessment findings support the possibility of what metabolic disorder?

diabetes insipidus (DI)

The nurse is caring for an older adult resident of long-term care who has fragile skin. The client experiences occasional skin tears despite careful repositioning and care. What component of the client's medication regimen should the nurse suspect?

hydrocortisone

What can happen if I push Furosemide too fast?

ototoxicity (can lead to tinnitus)

A client needing to evacuate the colon for endoscopy would likely be prescribed which medication solution?

polyethylene glycol electrolyte

The nurse administers ranitidine cautiously to clients with evidence of what condition?

pregnancy

After teaching a group of students about growth hormone agonists and antagonists, the instructor determines that additional teaching is needed when the students identify which agent as a growth hormone antagonist?

somatropin

Alendronate (Fosamax) is prescribed for a 67-year-old postmenopausal woman. In order to help prevent gastrointestinal distress, the nurse will advise the patient to:

stand or sit upright for at least 30 minutes after taking alendronate.

When considering the tendency of antiemetic agents to cross the placenta, which assessment question should the nurse initially ask every childbearing aged woman before initiating the therapy?

"Are you pregnant?"

A client has been prescribed furosemide. What medication education should the nurse provide this client?

-The medication will cause you to urinate larger amounts of urine than you are accustom to. -You should try to avoid excessive intake of salt. -Be aware that standing up quickly can cause you to be dizzy. -Notify your health care provider if you have more than a 3-pound weight change in one day.

What should I take for hypocalcemia?

-Vitamin D -Calcium

The nurse teaches the older adult client to best promote optimal gastrointestinal function by including what in the daily routine?

nutritious diet, adequate fluid intake, and exercise

A patient is recovering from discomfort from a peptic ulcer. The doctor has ordered to advance the patient's diet to solid foods. The patient's lunch tray arrives. Which food should the patient avoid eating?

orange

A client diagnosed with excessive parathyroid production is prone to develop:

osteopenia

Helicobacter pylori can live in the stomach's acidic conditions because it secretes ___________ which neutralizes the acid.

urease

My client is starting chemo, when should I give medication for nausea and vomiting?

30-60 minutes before starting infusion.

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

A nurse is caring for a patient with Addison disease. What therapy is recommended for this patient?

-Replacement of adrenocorticoids -Replacement of mineralocorticoids

A nurse is administering hydrocortisone cypionate (Cortef) to a child. What nursing intervention is essential?

monitor the patient's height and weight

A 73-year-old woman is experiencing recurrent constipation. The woman reports to the nurse that she experiences constipation despite the fact that she takes docusate on a daily basis and performs cleansing enemas several times weekly. How should the nurse best respond to this client's statements?

"Taking too many laxatives can make your bowels dependent on them, making you more susceptible to constipation."

A client is taking spironolactone (Aldactone) for edema. The nurse identifies the client's potassium level is 5.4 mEq/L. With this finding which question would be most appropriate for the nurse to ask?

"Do you use a salt substitute?"

A client is prescribed polyethylene glycol-electrolyte solution in preparation for a colonoscopy. The nurse would instruct the client to do which of the following?

"Drink 8 ounces every 10 minutes"

The nurse is providing education to a client who has been prescribed hydroxyzine. Which statement indicates that the client has understood the teaching?

"I may experience drowsiness with this medication."

You are providing discharge teaching to a patient taking Sucralfate (Carafate). Which statement by the patient demonstrates they understand how to take this medication?

"I will always take this medication on an empty stomach."

A client with heart failure is prescribed a loop diuretic. Which client statement indicates that teaching provided by the nurse about this medication was effective?

"I will change positions slowly if I feel dizzy."

What should the nurse tell a client who will begin taking rifaximin for traveler's diarrhea?

"If you notice any blood in your stool, do not take this medication any longer."

You're educating a group of patients at an outpatient clinic about peptic ulcer formation. Which statement is correct about how peptic ulcers form?

"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."

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."

The health care provider has prescribed sucralfate for a client with a gastric ulcer. The client asks how long he must take this medication. What is the nurse's best response to this client?

"You will need to take this medication for 4 to 8 weeks to ensure healing has occurred."

The nurse is caring for a client taking diphenoxylate with atropine. Which client statement(s) indicates to the nurse that the client is experiencing an adverse effect of the medication?

-"My mouth is so dry." -"I feel like my heart is racing." -"I can't get rid of this headache." -"I'm having a hard time emptying my bladder."

A client with osteoporosis is prescribed alendronate. Which information will the nurse include when teaching the client about this medication?

-"Take the medication with 6 to 8 ounces of water." -"Take the dose first thing in the morning on an empty stomach." -"Wait at least 30 minutes after taking the medication before eating or drinking." -"Report any new onset of esophageal burning or nausea to the health care provider."

A female client is to receive hydrocortisone. What adverse effects on reproduction would the nurse assess?

-Amenorrhea -Irregular menses

A client has been diagnosed with hypocalcemia. The nurse should prepare to educate the client on what likely treatment modules?

-Calcium -Vitamin D

Which of the following antacids may produce constipation and should be used cautiously in clients that have chronic constipation?

-Calcium carbonate (Mylanta) -Aluminum hydroxide (ALternaGEL)

Which clients are at risk for constipation?

-Client with a repair of a femur fracture -A pregnant women in her third trimester -Elderly clients with Alzheimer's disease -A client with chronic pain

When are bile-binding drugs useful in treating diarrhea?

-Crohn's disease -Ileectomy

A nurse is preparing to administer promethazine to a client. Which common side effects should the nurse teach the client about?

-Drowsiness -Dry mouth -Urinary retention

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:

-H. pylori -NSAIDS -E. Zollinger-Ellison Syndrome

Preventive measures can be taken for osteoporosis. Which of the following are considered preventive?

-Increasing calcium intake -Exercise -Medications

Lactulose (Chronulac, Cephulac) is prescribed for a client. The nurse knows that which of these statements regarding lactulose are correct?

-Lactulose is used to manage hepatic encephalopathy. -Lactulose can cause electrolyte imbalance. -Lactulose should produce two or three soft stools every day.

What can I use Hydroxyzine for?

-N/V -Motion sickness -Anti-anxiety -Reduce amount of narcotic for pain

Select all the medications a physician may order to treat a H. Pylori infection that is causing a peptic ulcer?

-PPI's -H2 Blockers -Bismuth subsalicylates (pepto-bismal) -antibiotics

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

Aspirin

I am giving a powerful diuretic called Mannitol. What is an important assessment?

Blood Pressure

A client is to undergo fertility treatment and is to receive an agent that induces ovulation because her ovaries are functioning. Which agent would this most likely be?

Chorionic gonadotropin

What is the best indicator of decreased nausea after administering ondansetron (Zofran) IV?

Client states, "I feel less nauseated."

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.

A male client is overweight and lives a sedentary lifestyle. He presents to the office with reports of acid regurgitation, especially at night. The nurse is aware that this client is displaying symptoms of what disorder?

Gastresophageal reflux disease

You are caring for a client who has just finished vomiting. Which of the following interventions is most appropriate?

Helping the patient rinse her mouth

An older adult client has a complex medical history that includes heart failure, type 1 diabetes, and diabetic nephropathy. The nurse has questioned a health care provider's prescription for oral spironolactone because the client's health problems would contribute to a high risk of which adverse reaction?

Hyperkalemia

A client demonstrating electrocardiography (EKG) changes and dysthymias would be expected to have which electrolyte imbalance?

Hypokalemia

What is a powerful diuretic that can be used for cerebral edema and other serious conditions?

Mannitol

A client with renal impairment is in need of a diuretic. Because of the renal problem, potassium-sparing diuretics are contraindicated but may be used if there is no other option. If they are used at all, what nursing intervention would be most important for this client?

Monitoring of serum electrolytes, creatinine, and BUN

A client diagnosed with HIV/AIDS has diarrhea that is not responding to antidiarrheal agents. Which medication will best assist in treating this client's diarrhea?

Octreotide acetate

A nurse is reviewing information about proton pump inhibitors. The nurse recognizes that which of the following is available as an over-the-counter agent?

Omeprazole

Which is an important assessment for the nurse to make before administering a laxative?

Question the client regarding the type and intensity of symptoms to provide a baseline evaluation.

A 54-year-old client, who is preparing to go on an ocean cruise, asks for a medication to relieve the symptoms of seasickness. What medication would a health care provider most likely prescribe?

Scopolamine

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:

Spiral shaped

An older client with hypertension reports frequent constipation. Which type of medication will the nurse ask the health care provider to prescribe for this client?

Stool softener

In which of the following scenarios would the nurse question the order for ondansetron (Zofran)?

Treatment of gastresophageal reflux

True or False? Dexlansoprazole is a proton pump inhibitor (PPI's)

True

True or False? Should water soluable vitamins be consumed daily.

True

True or False? Promethazine can cause drowsiness, dry up mucous membranes, blurry vision.

True (affects CNS)

True or False? Ascorbic acid (orange juice) enhances iron absorption.

True.

A client has a decreased calcium level. Which vitamin will assist in raising the client's calcium level?

Vitamin D

There are differences between fat-soluble and water-soluble vitamins. What is one of these differences?

Water-soluable vitamins should be consumed daily

The nurse is caring for a patient with primary adrenal insufficiency. What statement is appropriate for the nurse to make to this patient?

You will need hormonal replacement for life.

The nurse understands that which client is most likely to benefit from the administration of a combination of aprepitant and dexamethasone?

a client with advanced lung cancer who is receiving chemotherapy

The nurse is caring for a client who has anorexia nervosa and is being treated for chronic diarrhea. The nurse is aware that the client's diarrhea is due to what reason?

abuse of laxatives

The nurse should review which lab result before advising a client about taking the first dose of ibandronate (Boniva)?

calcium

A women in preterm labor is being administered magnesium sulfate. The client develops diminished reflexes and hypermagnesemia. What medication will be administered to this client?

calcium gluconate

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?

carbon dioxide

The health care provider (HCP) has determined that a client diagnosed with bacterial gastroenteritis following an overseas trip is a candidate for antibacterial drug therapy. The nurse knows that the HCP will select the appropriate drug based on which factor?

causative agent

A client is prescribed loperamide for diarrhea. Loperamide can be used for which type of diarrhea?

chronic diarrhea

The nurse administers mitotane (Lysodren) to the patient with Cushing's disease. What is the desired therapeutic effect?

decreased cortisol levels

The nurse is caring for a client who is receiving antacids to relieve gastrointestinal discomfort. Which nursing action is most appropriate?

give 1 hour before or 2 hours after other oral medications

The nurse is caring for a school-age child who is receiving long-term hydrocortisone therapy to treat adrenal insufficiency. When providing ongoing care for the child, what assessment should the nurse prioritize?

growth and development

A 75-year-old client is diagnosed with type 2 diabetes mellitus, hypertension, osteoporosis, and gastric ulcer disease. She is prescribed PPIs. The nurse is aware that long-term (greater than 1 year) administration of PPIs may increase the risk for which problem for this client?

hip fractures

A health care provider has prescribed a loop diuretic for a client with hypertension. The client also has diabetes mellitus. What condition should the nurse monitor for in this client after administering the prescribed drug?

increased blood glucose levels

What is the preferred route for administering promethazine?

intramuscular

The nurse is providing care to a client with hepatic encephalopathy. Which would the nurse anticipate administering to assist in lowering the client's blood ammonia level?

lactulose

The nurse knows that phosphates should be given only when hypercalcemia is accompanied by hypophosphatemia. Hypophosphatemia is assumed when the serum phosphorus is less than what level?

less than 3 mg/dL

Sara, age 6, is prescribed somatropin to stimulate growth. The nurse caring for Sara develops a teaching plan regarding medication administration. What adverse reaction would be most important to report?

limping when walking more than a block

The nurse is caring for a client with a severe head injury. An osmotic diuretic is prescribed. The nurse understands which drug is an osmotic diuretic?

mannitol

The nurse is caring for a client with increased intracranial pressure. Which diuretic would the nurse anticipate being prescribed for this client?

mannitol

What is a transdermal patch for motion sickness?

scopalamine ---> used in surgery for nausea (otoscope)

An older client has been prescribed omeprazole for the treatment of gastresophageal reflux disease (GERD). What explanation should the nurse provide when asked by the client why they are not being treated with famotidine?

"Proton pump inhibitors, like omeprazole, produce fewer adverse effects among the older population."

A nurse is teaching a client who has just been prescribed lansoprazole . What statement would indicate that the client correctly understands the action of this medication?

"The medication inhibits acid secretions."

Administering an antacid to a client taking which medications will decrease the absorption of the medication and result in a decreased drug effect?

Digoxin

A 94-year-old client is to begin taking psyllium hydrophilic mucilloid daily. What instructions should the nurse include in the discharge teaching?

Drink at least 8 ounces of fluid with the medication.

A patient with chronic peptic ulcer disease underwent a gastric resection 1 month ago and is reporting nausea, bloating, and diarrhea 30 minutes after eating. What condition is this patient most likely experiencing?

Dumping syndrome

A patient arrives to the clinic for evaluation of epigastric pain. The patient describes the pain to be relieved by food intake. In addition, the patient reports awaking in the middle of the night with a gnawing pain in the stomach. Based on the patient's description this appears to be what type of peptic ulcer?

Duodenal

True or False? I can give promethazine SUBQ

FALSE

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

A client is receiving hydrochlorothiazide. The nurse would expect to administer this drug by which route?

Oral

The nurse is scheduled to administer sucralfate 1 gram po four times daily to a pregnant client admitted with gastroesophageal reflux disease (GERD). What is the priority teaching that would be provided regarding this medication?

Take the medicine one hour before meals and at bedtime.

Which of the following statements about vitamins is true?

Taking large doses of vitamin A is potentially harmful

The nurse is assessing the patient on mitotane therapy. Which assessment finding requires action by the nurse?

The patient's blood pressure is 140/90 mm Hg sitting and 90/50 mm Hg standing.

The nurse notes that a client with night blindness is prescribed a vitamin A supplement. Which information will the nurse provide to the client when giving this medication?

This supplement is taken before meals.

What type of medication might be included in the medication therapy to treat a peptic ulcer by serving as a barrier to gastric secretions?

sucralfate

The nurse administers hydrocortisone cypionate (Cortef). What intervention is appropriate for this medication?

the nurse will monitor the patients blood glucose level

Which patient should not receive ketoconazole (Nizoral) as ordered for Cushing's disease?

the patient with elevated liver function tests

The nurse is assessing a child who is receiving growth hormone therapy. What would the nurse identify as suggesting glucose intolerance?

thirst