Quizzam #3 (2/28/23)

A client diagnosed with peptic ulcer disease has begun taking sucralfate. The nurse should caution the client against the concurrent use of which classification of medications? A. Antacids B. NSAIDs C. Acetaminophen D. Probiotics

A

A client is prescribed a proton pump inhibitor to treat erosive gastritis. How soon will the client's symptoms be resolved? A. 1 to 2 weeks B. 6 weeks C. 10 weeks D. 12 weeks

A

A nurse is assessing a client who has administered ondansetron IV one hour ago. Which of the following findings should the nurse recognize as an adverse effect of the drug? A. Dizziness B. bradycardia C. tardive dyskinesia D. Dyspepsia

A. Dizziness

A nurse is preparing to administer phenylephrine to a client. The nurse should identify that which of the following manifestations is an adverse effect of this drug? A. headache B. Sleepiness C. Hypotension D. Constipation

A. Headache

A nurse should recognize that diphenoxylate/atropine should be used with caution for a client who has which of the following conditions? A. Inflammatory bowel disease B. Thrombophlebitis C. Agranulocytes D. Immunization with a live virus vaccine within the last 6 weeks

A. Inflammatory bowel disease

A client who has been prescribed an antihistamine for nausea should be monitored for which adverse effect of this classification of medication? A. Diarrhea B. Prolonged QRS complex C. Urinary retention D. Inverted T wave

C

A nurse is teaching a client about the use of antihistamines to treat allergic rhinitis. The nurse should explain that these drugs are effective because they perform which of the following actions? A. Decrease viscosity of nasal secretions B. Block H2 receptors C. Prevent histamine from binding to receptors D. Reduce nasal congestion

C. Prevent histamine from binding to receptors

A nurse is caring for a client who is taking codeine. The nurse should identify that which of the following assessments is priority to make? A. Blood pressure B. Apical heart rate C. Respirations D. LOC

C. Respirations

A nurse should recognize that using pseudoephedrine to treat allergic rhinitis requires cautious use with clients who have which of the following conditions? A. Peptic ulcer disease B. A seizure disorder C. Anemia D. Coronary artery disease

D. Coronary artery disease

A nurse is teaching a client who has a prescription for zileuton. Which of the following instructions should the nurse include? A. Check apical pulse before taking the drug B. Take the drug only as needed before exercising C. Rinse mouth after using the drug D. Have laboratory tests performed at regular intervals

D. Have laboratory tests performed at regular intervals

DC; Mucolytics

P: acetylcysteine TU: encourage productive cough (also acetaminophen overdose)

DC: Rescue Beta2 Adrenergic Agonists

P: albuterol TU: asthma, bronchospasm

A nurse is teaching a client about the adverse effects of pseudoephedrine. Which of the following should the nurse include? Restlessness Bradycardia Insomnia Muscle pain Anxiety

Restlessness Insomnia Anxiety

A nurse is caring for a male client who asked the nurse about taking alosetron for irritable bowel syndrome with diarrhea (IBS-D) lasting three months. Which of the following information should the nurse provide the client about alosetron? A. The drug is prescribed to female clients who have IBS-D lasting more than six months B. The drug is prescribed to clients who have chronic diarrhea lasting more than 12 months C. the drug is most beneficial for male clients who have inflammatory bowel disease D. the drug is most beneficial in treating clients who have constipation-predominant IBS (IBS-C)

. The drug is prescribed to female clients who have IBS-D lasting more than six months

A postoperative school-age pediatric client is experiencing nausea and vomiting. What is the antiemetic drug of choice in children? A. Promethazine B. Benzquinamide C. Buclizine D. Cyclizine

A

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? A. "This medication will only soften your stools over the next couple of days." B. "You'll usually have a bowel movement within 2 to 3 hours of taking this." C. "This medication will cause your bowels to contract more strongly than they normally do." D. "This drug will help you pass regular stools while you're in the hospital, but you should not take it for more than 5 days."

A

A pregnant client is experiencing morning sickness. Which should be considered as a first-line treatment for the management of morning sickness? A. Vitamin B6 B. Promethazine C. Vitamin E D. Diphenhydramine

A

The nurse is providing education to a client who has been prescribed diphenoxylate with atropine for diarrhea. What statement should the nurse include in teaching? A. "Once diarrhea slows down, stop using the drug." B. "Continue this medication until you have a solid stool." C. "After 3 days, stop the medication." D. "Call the health care provider and give an update within 7 days."

A

The nurse knows that antiemetics are most effective when administered A. before an emetogenic event occurs B. during an episode of nausea but before vomiting has occurred C. after the patient has experienced nausea and vomiting D. any time; timing of administration has no impact on drug effectiveness

A

The nurse would question an order for which of the following antiemetics for treatment of motion sickness-induced nausea? A. prochlorperazine B. dimenhydrinate C. meclizine D. scopolamine

A

What antiemetic is the most common first-line drug for the treatment of postoperative nausea and vomiting? A. Ondansetron B. Dronabinol C. Dimenhydrinate D. Hydroxyzine

A

Which client is at highest risk for alteration in bowel elimination? A. A client who is paralyzed from a spinal cord injury B. A client who has a diagnosis of type 2 diabetes C. A client who has hypertension D. A client who takes thyroid replacements

A

Which organism is most likely to cause gastroenteritis and vomiting among the students and staff at a local school? A. Norwalk-like virus (calicivirus) B. Clostridium difficile C. Vibrio vulnificus D. E. coli

A

A nurse is caring for a patient preparing to undergo a colonoscopy. Which of the following drugs do health care providers commonly use to enhance bowel cleansing? (Select all that apply.) A. polyethylene glycol-electrolyte solution B. bisacodyl C. psyllium D. docusate sodium

A and B. Health care providers commonly give polyethylene glycol-electrolyte solution and bisacodyl to evacuate the colon in preparation for a colonoscopy.

The FDA pediatric safety labeling changes, warning against the use of prescription opioid cough and cold medicines in children younger than 18 years, are based on available data and expert opinion that supports which of the following statements? (Select all that apply.) A. A cough should not be suppressed unless it is causing clinical consequences, such as consecutive nights of poor sleep and/or vomiting, rib fractures, or hypoxia. B. The safety labeling changes should protect children from unnecessary exposure to opioids. C. The risks for prescription opioid cough products typically outweigh the potential benefits in children of all ages. D. Addiction or abuse potential is a concern regarding the use of hydrocodone or codeine in children.

A, B, C, and D. The FDA label for the use of prescription opioid cough and cold medications in children younger than 18 years of age warns of all of the concerns in that population.

Because of the action of antihistamines on target tissues, these drugs are effective in producing which of the following actions? (Select all that apply.) A. inhibiting vascular permeability B. reducing pruritus C. minimizing edema formation D. preventing histamine release

A, B, and C. Antihistamines are effective in inhibiting vascular permeability, and they also reduce edema formation and pruritus associated with histamine release. They do not prevent histamine release or reduce the amount released.

The client diagnosed with peptic ulcer disease states, "I've never been a really anxious type of person, so I never thought I'd develop ulcers." The nurse has responded with health education addressing the etiology of peptic ulcer disease (PUD). What causative factors should the nurse cite? Select all that apply. A. Physiologic or psychological stress B. Diabetes mellitus C. Cigarette smoking D. Infections E. Nonsteroidal anti-inflammatory drugs

A, C, D, E

Adverse effects of cimetidine include which of the following? (Select all that apply.) A. headache B. constipation C. gynecomastia D. diarrhea E. confusion

A, C, D, and E. Common adverse effects of cimetidine include diarrhea, dizziness, drowsiness, headache, confusion, and gynecomastia.

Which of the following points should be included when teaching patients regarding measures to promote healthy bowel function? (Select all that apply.) A. increasing activity B. eating a low-residue diet C. maintaining adequate fluid intake D. establishing regular bowel habits

A, C, and D. A high-fiber, not a low-residue, diet is recommended to add bulk to stool and stimulate GI motility. Increasing exercise, maintaining adequate fluids, and establishing regular bowel habits will all help promote healthy bowel function.

A man who is using a steroid inhaler complains of anorexia and discomfort when he eats. The nurse reports this to the care provider, and the patient receives a diagnosis of oropharyngeal candidiasis. It is possible to decrease this adverse effect by which of the following actions? (Select all that apply.) A. reducing the dose B. administering the drug more frequently C. rinsing the mouth after use D. using a spacer device

A, C, and D. Local adverse effects with use of a steroid inhaler (oropharyngeal candidiasis, hoarseness) can be decreased by reducing the dose, administering the drug less often, rinsing the mouth after use, or using a spacer device. These measures decrease the amount of drug deposited in the oral cavity.

An adult resident of an assisted living facility has not responded appreciably to bulk-forming laxatives, so the health 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. A. Oral B. Intravenous C. Subcutaneous injection D. Suppository E. Intramuscular injection

A,D

When taking a patient's history, the nurse notes that the patient is taking warfarin and cimetidine concurrently. The nurse should anticipate which of the following? A. Warfarin effects would be increased. B. Cimetidine effects would be increased. C. Warfarin effects would be decreased. D. Cimetidine effects would be decreased.

A. A major disadvantage of cimetidine is that it inhibits the cytochrome P-450 drug-metabolizing system in the liver, decreasing hepatic metabolism of numerous other drugs, including warfarin, thereby increasing blood levels and risks of toxicity. Other histamine2 receptor antagonists, such as ranitidine, do not affect the cytochrome P-450 drug-metabolizing system; therefore, they do not interfere with the metabolism of other drugs. They are safer to use in clients who are on multiple medications, especially those who are known to be metabolized by the same cytochrome P-450 system and those with narrow therapeutic windows.

The nurse notes that a patient's serum theophylline level is 25 mcg/mL and that a scheduled dose of the medication is due. The nurse should do which of the following? A. Hold the scheduled dose, contact the health care provider, and assess the patient for signs of theophylline toxicity. B. Administer the dose as scheduled. C. Administer only half of the dose and repeat the theophylline level in 4 hours. D. Hold the dose until the next meal and administer at that time.

A. A serum theophylline level of 25 mcg/mL is at a toxic level. The nurse should hold the dose and notify the health care provider. Serious adverse effects frequently occur at this serum drug level, including anorexia, nausea, vomiting, agitation, nervousness, insomnia, tachycardia and other dysrhythmias, and tonic-clonic convulsions. Ventricular dysrhythmias or convulsions may be the first sign of toxicity.

In caring for a patient with nasal congestion, the nurse knows that adrenergic drugs are used as nasal decongestants to relieve symptoms by A. constricting arterioles and reducing blood flow to nasal mucosa B. stimulating air movement in the lungs C. stabilizing mast cells D. initiating the cough reflex

A. Adrenergic drugs relieve nasal congestion and swelling by constricting arterioles and reducing blood flow to nasal mucosa.

A nurse is teaching a client who has a prescription for albuterol via inhaler and fluticasone/salmeterol via inhaler who asthma management. For which of the following reasons should the nurse instruct the client to use the albuterol inhaler before using the fluticasone inhaler? A. Albuterol will increase the absorption of fluticasone B. Albuterol will decrease inflammation C. Albuterol will reduce nasal secretions D. Fluticasone will reduce the adverse effects of albuterol

A. Albuterol will increase the absorption of fluticasone

A nurse is caring for a client who is taking allopurinol to treat gout and has a new prescription for azathioprine to treat ulcerative colitis. For which of the following reason should the nurse clarify these prescriptions with the provider? A. Allopurinol delays the conversion of azathioprine and can lead to toxicity B. Azathioprine increases the effectiveness of allopurinol C. Allopurinol increases the metabolism of azathioprine and can require an increased dosage D. Azathioprine decreases the effectiveness of allopurinol

A. Allopurinol delays the conversion of azathioprine and can lead to toxicity

A nurse is teaching a client who is taking prednisone for chronic asthma. Which of the following instructions should the nurse include? A. Avoid taking non steroidal anti-inflammatory drugs B. Rinse your mouth after taking the medication to prevent a yeast infection C. Stop taking the medication if you become nauseous D. Change position slowly when standing up

A. Avoid taking non steroidal anti-inflammatory drugs

A common mucolytic used to liquefy mucus in the respiratory tract is A. acetylcysteine B. ipratropium C. dextromethorphan D. pseudoephedrine

A. Mucolytics are administered by inhalation to liquefy mucus in the respiratory tract. Sodium chloride solution and acetylcysteine are often used as mucolytics.

For which of the following reasons should a nurse instruct a client to avoid taking guaifenesin with combination over-the-counter cold products? A. Over-the-counter cold products can also contain guaifenesin B. Blood glucose levels are increased C. Rebound congestion is likely D. Drug tolerance is likely

A. Over-the-counter cold products can also contain guaifenisin

A woman begins using an albuterol inhaler and a beclomethasone inhaler for her asthma. She asks if it matters which inhaler she uses first. The best response by the nurse is which of the following? A. "You should use the albuterol inhaler first followed in 5 to 10 minutes by the beclomethasone inhaler." B. "You should use the beclomethasone inhaler first followed in 5 to 10 minutes by the albuterol inhaler." C. "The order in which you use the inhalers does not matter." D. "You should not use the inhalers one right after the other."

A. Prescribers often order beclomethasone, a steroid inhalant medication, concomitantly with one or more bronchodilators, such as albuterol, and clients may take these drugs with another anti-inflammatory drug, such as a leukotriene modifier or a mast cell stabilizer. It is necessary to use the inhaled bronchodilator first followed by the steroid inhalant medication. The bronchodilator increases the lumen of the bronchial tree, which subsequently increases the amount of steroid reaching the distal lung fields.

A nurse is monitoring plasma drug levels in a client who is taking theophylline. Which of the following findings should the nurse expect to see if the client's drug level indicates toxicity? A. Seizures B. Constipation C. Normal sinus rhythm D. Somnolence

A. Seizures

For which of the following reasons should a client attach a spacer to a metered-dose inhaler? A. To increase the amount of drug delivered to the lungs B. To increase the amount of drug delivered to the oropharynx C. To increase the amount of drug delivered on exhalation D. To increase the speed of drug delivery into the mouth

A. To increase the amount of drug delivered to the lungs

A nurse is teaching a client who has a new prescription for sulfasalazine. Which of the following statements should the nurse make? A. Use sunscreen and protective clothing while taking sulfasalazine to prevent sunburn B. The medication can stain your contact lenses green C. the medication can color your urine dark brown D. take an iron supplement when you take sulfasalazine to prevent anemia

A. Use sunscreen and protective clothing while taking sulfasalazine to prevent sunburn

A nurse is planning teaching for a client who has been prescribed loperamide to treat diarrhea. Which of the following statements should the nurse plan to include? A. avoid driving or activities requiring alertness B. if you miss a dose, double the next dose C. rinsing the mouth with alcohol-based mouthwash can reduce dryness D. having one glass of wine each night can improve medication effectiveness

A. avoid driving or activities requiring alertness

A nurse is teaching a client who has a new prescription for methotrexate. The nurse should instruct the client to Monitor for manifestations of which of the following conditions? A. gout B. constipation C. insomnia D. hirutism

A. gout

A nurse is caring for an older adult client who has renal impairment and a new prescription for cimetidine. The nurse should instruct the client to report which of the following manifestations? A. lethargy B. cellulitis C. dry mouth D. myalgia

A. lethargy

A nurse is caring for a client who is taking lubiprostone. The nurse should tell the client that lubiprostone can cause which of the following adverse drug reactions? A. nausea B. constipation C. urinary retention D. sore throat

A. nausea

A nurse is caring for a client who has a prescription for alosetron. The nurse should recognize that alosetron therapy is effected when the client reports which of the following? A. one formed stool per day B. urination w/o burning C. cessation of nausea or vomiting D. reduced GI reflux effects

A. one formed stool per day

A client is administered a phenothiazine for nausea and vomiting. What is the action of phenothiazine? A. Increases gastric motility B. Antagonizes dopamine receptors C. Blocks histamine receptors D. Antagonizes serotonin receptors

B

A critical care nurse is preparing to administer an intragastric drip of an antacid to a client through a nasogastric tube. How should the nurse most accurately titrate the dose and frequency? A. By assessing the pH of a 24-hour urine sample B. By aspirating stomach contents and measuring the pH C. By measuring the pH of urine after each void D. By swabbing the client's buccal mucosa and testing for pH daily

B

An adult client has presented to the emergency department (ED) after 36 hours of severe diarrhea that shows no sign of abating. The ED nurse should be aware that the use of diphenoxylate would be contraindicated in which circumstance? A. The client has a documented history of laxative abuse. B. The client's diarrhea is caused by the ingestion of toxins. C. The client's diarrhea is attributable to psychosocial stress. D. The client has an allergy to aspirin

B

The nurse is reviewing the history of a client who has been prescribed diphenoxylate. The nurse is aware that documentation of what disorder in the history requires that the drug be administered cautiously? A. Edema B. Hepatorenal disease C. Congestive heart failure D. Cardiovascular insufficiency

B

When administering 5-HT3 receptor antagonists before cancer chemotherapy, the nurse should also be prepared to administer which of the following adjunctive medications? A. promethazine B. dexamethasone C. dronabinol D. hydroxyzine

B

A 30-year-old female has been ordered dronabinol. Which of the following statements are true for dronabinol? (Select all that apply.) A. The drug is most effective when given every 2 hours. B. It is approved for nausea and vomiting related to chemotherapy in people with cancer. C. Adverse effects include drowsiness or euphoria. D. Insufficient research is available to support its use as a treatment for nausea and vomiting. E. It is approved as an appetite stimulant for anorexia in people with AIDS. F. The drug is used as a first-line treatment in women with hyperemesis gravidarum associated with pregnancy.

B, C, E

A nurse is caring for a client who has peptic ulcer disease. The nurse should monitor the client phosphorus level when administering which of the following drugs? A. Omeprazole B. Aluminum hydroxide C. sucralfate D. famotidine

B. Aluminum hydroxide

An appropriate nursing measure when treating a 5-year-old child with a 1-day onset of mild diarrhea involves encouraging which of the following? A. regular diet B. intake of clear liquids C. intake of milk products D. no fluids for 24 hours

B. Clear liquids and bland foods are appropriate in the diet of a young child who has diarrhea to replace fluid and electrolytes lost in the stool. Encouraging no fluids is very dangerous, especially in children, where the fluids lost through diarrhea must be replaced. Milk may actually worsen symptoms in those with lactose intolerance.

Cold remedies listed as "nondrowsy" or labeled as "daytime" formulas do not contain A. a nasal decongestant B. a first-generation antihistamine C. a pain reliever D. any of the above

B. Cold remedies referred to as "nondrowsy" or "daytime" formulas contain a nasal decongestant but do not contain an antihistamine. Those preparations referred to as "p.m." or "night" formulas contain a sedating antihistamine to promote sleep.

The nurse receives an order to administer diphenhydramine. This medication is recommended for use in which of the following? A. premature or full-term infants B. adults to prevent allergic reactions C. children with chickenpox D. children with a flulike infection

B. Diphenhydramine is indicated in adults to prevent or treat allergic reactions. Confusion (with impaired thinking, judgment, and memory), dizziness, hypotension, sedation, syncope, unsteady gait, and paradoxical central nervous system stimulation can occur with administration of diphenhydramine in older adults. These effects, especially sedation, lend themselves to misinterpretation as senility or mental depression. Older men with prostatic hypertrophy may have difficulty voiding while taking these drugs. The drug is not recommended for use in newborn infants (premature or full term) or children with chickenpox or a flu-like infection. When used in young children, doses should be small because of drug effects on the brain and nervous system.

A woman with diarrhea begins to complain of eye pain after administration of diphenoxylate with atropine. The nurse should do which of the following? A. Offer an over-the-counter analgesic such as acetaminophen. B. Discontinue the diphenoxylate with atropine and notify the provider. C. Tell the patient that this is a common side effect and will soon pass. D. Apply a cool compress to the eyes for relief of the discomfort.

B. Diphenoxylate contains atropine, which causes pupil dilation and closure of the filtration angle of the eye. In the presence of undiagnosed glaucoma, this drug could lead to increased intraocular pressure and eye pain. It is necessary to discontinue the drug and notify the client's provider of the eye pain immediately.

A nurse is teaching an adult client about diphenhydramine. The nurse should inform the client to expect which of the following adverse effects while taking this drug? A. muscle tremors B. Drowsiness C. Excitation D. Insomnia

B. Drowsiness

Legal restrictions apply to the purchase of pseudoephedrine (Sudafed) because of which of the following risks? A. Respiratory depression B. Drug abuse C. Drug tolerance D. Rebound congestion

B. Drug abuse

A patient has asked for an antihistamine to relieve symptoms of an upper respiratory infection. The nurse explains that studies have demonstrated that for treatment of the common cold, which of the following is true of antihistamines? A. are effective in relieving cold symptoms B. do not relieve symptoms and are not recommended C. should be compounded with other products to be effective D. relieve nonallergenic symptoms only

B. For treatment of the common cold, studies have demonstrated that antihistamines do not relieve symptoms and are not recommended.

A nurse is reviewing the medical record of a client who has a new prescription for ranitidine. The nurse should recognize that which of the following drugs interact with ranitidine? A. Phenobarbital sodium B. Ketoconazole C. lisinopril D. Hydrochlorothiazide

B. Ketoconazole

A laxative is contraindicated in a patient: A. with cancer taking daily narcotics for pain control B. complaining of abdominal pain and distention C. scheduled for a colonoscopy D. with limited mobility due to Parkinson's disease

B. Laxatives are contraindicated in the presence of undiagnosed abdominal pain and distention, which may indicate acute pathology such as an inflamed organ. In the case of appendicitis, laxatives are contraindicated because they may lead to rupture of the appendix, with contents spilling into the abdominal cavity causing life-threatening peritonitis. Laxatives are appropriate for the cancer client because narcotics are often prescribed and may lead to constipation. Laxatives are usually part of the preparation for a colonoscopy. Laxatives are often needed in clients with decreased activity such as those with Parkinson's disease to stimulate bowel function.

Which of the following mechanism of action is shown by over-the-counter drug magnesium hydroxide (milk of magnesia)? A. increased gastric secretions B. increased osmotic pressure in the intestinal lumen C. binding to diarrhea-causing bacteria for excretion D. decreased gastrointestinal motility

B. Magnesium hydroxide increases osmotic pressure in the intestinal lumen and causes water to be retained.

Montelukast is effective in relieving the inflammation and bronchoconstriction associated with acute asthmatic attacks through which principal action? A. stabilizing mast cells B. blocking leukotriene receptors C. binding to immunoglobulin E (IgE) D. decreasing prostaglandin synthesis

B. Montelukast is a leukotriene receptor antagonist. By blocking leukotrienes, it blocks bronchoconstriction and inflammation. Leukotriene-modifier drugs, such as montelukast, help prevent asthma attacks but are not helpful in relieving an acute attack.

A nurse should identify that dextromethorphan can have which of the following effects when combined with morphine? A. Reduced antitussive effect of dextromethorphan B. Potentiation of depression of CNS actions C. Increased renal reabsorption of the dextromethorphan D. Delayed analgesic effect of the opiod

B. Potentiation of depression of CNS actions

When teaching a patient about the proper use of metered-dose inhalers, which of the following statements should be included? A. "Make sure that you puff out air repeatedly after you inhale the medication." B. "After you inhale the medication, hold the breath for approximately 10 seconds and exhale slowly." C. "After you inhale the medication once, repeat until you obtain relief." D. "Rinse out your mouth before using the inhaler to decrease the development of a mouth infection."

B. Proper technique ensures that the drug is distributed into the lower airway. While pressing down on the inhaler, the client should take a slow, deep breath for 3 to 5 seconds, hold the breath for approximately 10 seconds, and exhale slowly.

A nurse is teaching a client about the use of an expectorant to treat a cough. The nurse should include that an expectorant has which of the following therapeutic effects? A. Suppresses the cough stimulus B. Reduces surface tension C. Reduces inflammation D. Dries mucous membranes

B. Reduces surface tension

A nurse is administering sulfasalazine to a client. Which of the following data should the nurse collect to help identify an adverse drug reaction? (select all that apply) A. LOC B. skin integrity C. temperature D. urine output E. CBC

B. Skin integrity C. Temperature E. CBC

A nurse is teaching a client about ipratropium. The nurse should include that this drug has which of the following adverse effects? A. Muscle tremors B. urinary retention C. Dry mouth D. Insomnia E. tachycardia

B. Urinary retention C. Dry mouth

A nurse is teaching a client about ipratropium. Which of the following instructions should the nurse include? A. Do not drink anything 30 min after using the drug B. Wait 5 min between using the drug and another inhaled drug C This drug is used to thin respiratory secretions D. Check pulse rate after inhaling the drug

B. Wait 5 min between using the drug and another inhaled drug

A nurse should recognize that sulfasalazine is contraindicated for clients who have which of the following conditions? A. pancreatitis B. aspirin sensitivity C. Bronchitis D. GERD

B. aspirin sensitivity

A nurse is providing teaching to a client who has a new prescription for omeprazole to treat a duodenal ulcer. Which of the following instructions should the nurse include? A. take the medication with foo B. swallow the capsule whole C. dissolve the tablets in water D. take the medication at bedtime

B. swallow the capsule whole

A client diagnosed with Crohn's disease is experiencing diarrhea during an exacerbation of symptoms. What medication will the nurse most likely administer? A. Bismuth salts B. Ciprofloxacin C. Cholestyramine D. Octreotide acetate

C

A client is undergoing a course of radiotherapy for the treatment of leukemia. Treatments in the past have caused the client severe nausea and vomiting. The oncology nurse should normally administer antiemetics on what schedule? A. Simultaneous with radiation treatment B. The night before a scheduled radiation treatment C. 30 to 60 minutes before the treatment D. 10 to 15 minutes before the treatment

C

A client is using psyllium hydrophilic mucilloid to promote evacuation of stool. What is the action of this medication? A. It reduces the surface tension of bowel contents. B. It irritates the intestinal mucosa, thus increasing intestinal motility. C. It increases mass and water content of the stool, promoting evacuation. D. It creates a barrier between the colon wall and feces.

C

A nurse is providing education to a 23-year-old female client who has been prescribed misoprostol. What instruction should the nurse include in the teaching? A. Supplement therapy with magnesium antacids. B. Report postmenopausal bleeding. C. Use effective contraceptive measures. D. Administer the drug one time per day.

C

How is constipation best defined? A. The passage of fewer than three stools in any 7-day period B. The passage of fewer than five stools in any 7-day period C. The infrequent and painful expulsion of hard, dry stools D. A subjective sensation of bowel fullness

C

The nurse is caring for a female client diagnosed with chronic severe diarrhea-predominant irritable bowel syndrome that has not responded to conventional therapy. Which medication should the nurse anticipate being prescribed? A. Rifaximin B. Nitazoxanide C. Alosetron D. Cholestyramine

C

A nurse should recognize that misoprostol is contra indicated for a client who has which of the following conditions? A. A seizure disorder B. Rheumatoid arthritis C. A positive pregnancy test D. heart failure

C. A positive pregnancy test

A nurse is caring for a client who is having difficulty mobilizing thick respiratory secretions. Which of the following drugs should the nurse expect to administer to the client? A. Ipratropium B. Beclomethasone C. Acetylcysteine D. Azelastine

C. Acetylcysteine

A nurse is teaching a client about using intranasal glucocorticoids. Which of the following instructions should the nurse give? A. Start at a low dose and gradually increase it B. Take the drug as needed for nasal congestion C. Allow at least 2 weeks for the full therapeutic effect D. Use the drug prior to exercise

C. Allow at least 2 weeks for the full therapeutic effect

A patient is started on Mylanta for peptic ulcer disease. It is important for the nurse to inform the patient about which of the following adverse effects? A. nausea B. vomiting C. diarrhea D. constipation

C. Calcium- and aluminum-based antacids have the adverse effect of constipation, whereas Mylanta, a magnesium-based antacid, has the adverse effect of diarrhea.

A nurse is teaching a client about the use of beclomethasone to treat asthma. The nurse should explain that the drug has which of the following therapeutic effects? A. Thins mucus B. Relaxes bronchial smooth muscle C. Decreases inflammation D. Increases the cough threshold

C. Decreases inflammation

The nurse working in the emergency department anticipates an order of a severe allergic reaction with anaphylaxis, knowing that the drug of choice for severe allergic reactions with anaphylaxis is which of the following? A. diphenhydramine B. cimetidine C. epinephrine D. loratadine

C. Epinephrine, rather than an antihistamine, is the drug of choice for treating severe anaphylaxis.

A hospitalized patient on antibiotic therapy begins to experience fever, abdominal pain, and diarrhea containing mucus, pus, and blood. The best nursing intervention in this situation is to do which of the following? A. Continue the antibiotic because the patient has signs of a gastrointestinal infection. B. Monitor the patient's vital signs and notify the provider if there is further deterioration. C. Withhold the antibiotic and notify the provider of the patient's condition. D. Encourage fluid intake because fever is a sign of dehydration

C. It is necessary to withhold the antibiotic and notify the provider immediately. Clients who are receiving antibiotic therapy may develop a serious complication called pseudomembranous colitis, or antibiotic-associated colitis due to suppression of normal flora in the colon with resultant proliferation of anaerobic Clostridium difficile organisms. This superinfection produces symptoms of fever, abdominal pain, and diarrhea containing blood, mucus, and pus. Treatment involves discontinuing the causative antibiotic and changing therapy to metronidazole or vancomycin.

The nurse would question the use of misoprostol (Cytotec) in which population? A. children under 5 years of age B. adults with concurrent use of antacid C. pregnant women at all stages of pregnancy D. older adults with concurrent use of cimetidine

C. Misoprostol is a synthetic form of prostaglandin E approved for concurrent use with nonsteroidal anti-inflammatory drugs (NSAIDs) to protect gastric mucosa from NSAID-induced erosion and ulceration. Misoprostol can cause abdominal cramps and miscarriage in pregnant women.

As the nurse caring for a patient with nasal congestion who is using the OTC decongestant oxymetazoline, the nurse counsels the patient that this medication should be used only for the time recommended on the package and no longer because excessive use may produce A. copious lower respiratory tract secretions B. ringing in the ears C. rebound nasal congestion D. a suppressed cough reflex

C. Oxymetazoline is only for short-term use because rebound nasal swelling can occur with excessive or extended use.

A man tells the nurse that he has bought the over-the-counter drug bismuth subsalicylate for the next episode of diarrhea. The nurse should assess for what allergy that would contraindicate use of bismuth subsalicylate? A. penicillin B. acetaminophen C. aspirin D. sulfa

C. People with an allergy to aspirin and aspirin products should not take bismuth subsalicylate because the drug contains aspirin.

A nurse is teaching a client about the use of mucolytic to treat a cough. The nurse should include that a mucolytic has which of the following therapeutic effects? A. Suppresses the cough stimulus B. Reduces inflammation C. Thins and loosens mucus D. Dries secretions

C. Thins and loosens mucus

A nurse is caring for a client who has a new prescription for alosetron To treat irritable bowel syndrome. The nurse should instruct the client to report which of the following adverse effects of the drug? A. headache B. drowsiness C. abdominal pain D. sore throat

C. abdominal pain

A nurse is planning teaching for a client who has been prescribed loperamide to treat diarrhea. Which of the following statements should the nurse plan to include? A. dissolve the powder thoroughly in 8 oz of water B. take with diphenhydramine to prevent extrapyramidal effects C. avoid activities that require alertness D. take 30 min before activities that trigger nausea

C. avoid activities that require alertness

A nurse is providing teaching to a client who has a new prescription for dimenhydrinate to prevent motion sickness. Which of the following instruction should the nurse include? (Select all that apply) A. sit upright for 30 min after taking the drug B. avoid antacids C. take the drug 30-60 min before activities that trigger nausea D. avoid activities that require alertness E. increase fluid and fiber intake

C. take the drug 30-60 min before activities that trigger nausea D. avoid activities that require alertness E. increase fluid and fiber intake

A nurse is providing teaching to a client who is about to start psyllium to treat Constipation. Which of the following instruction should the nurse include? (select all that apply) A. Expect results in 6-12 hr B. urinate every 4 hr C. take the drug with at least 8 oz of fluid D. avoid activities that require alertness E. Increase fluid and fiber intake

C. take the drug with at least 8 oz of fluid E. Increase fluid and fiber intake

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? A. Bismuth salts B. Ciprofloxacin C. Cholestyramine D. Octreotide acetate

D

A client is taking nonsteroidal anti-inflammatory agents for arthritis of the knees and hips. Which disease is a result of cellular destruction of the gastrointestinal tract from this medication? A. Esophageal cancer B. Bowel obstruction C. Liver cancer D. Peptic ulcer disease

D

A woman sends her partner to the store to purchase an over-the-counter product to resolve the vomiting she has experienced during a migraine. She has a history of diabetes mellitus and hypertension. She has an appointment with her health care provider in the morning. Which of the following drugs would be the best for the partner to purchase? A. promethazine B. phosphorated carbohydrate solution C. meclizine D. dimenhydrinate

D

An older adult client has received a third dose of diphenoxylate. In addition to monitoring the number and consistency of the client's stools, the nurse should prioritize what assessment? A. Neurologic status B. Oxygen saturation C. Nutritional status D. Fluid and electrolyte balance

D

An older adult client is administered dimenhydrinate. Which is the priority nursing intervention for this client? A. Encourage fluids with this client. B. Have the client void after administration. C. Maintain IV access. D. Protect from injury.

D

An older adult has regularly drunk mineral oil to treat occasional episodes of constipation. The nurse should encourage the client to explore other treatments because the use of oral mineral oil can result in which adverse effect? A. Edema from changes in intestinal solute content B. Paralytic ileus C. Rebound constipation D. Decreased absorption of drugs and vitamins

D

Which of the following oral medications is safe to use in a 60-year-old constipated patient with dysphagia? A. methylcellulose B. psyllium C. mineral oil D. docusate sodium

D. Bulk-forming laxatives such as methylcellulose and psyllium are contraindicated for clients with dysphagia because they may cause obstruction. Clients with dysphagia are also not good candidates for bulk-forming laxatives, because they may have decreased fluid intake secondary to their dysphagia. Mineral oil in oral formation is contraindicated for these clients because it may be aspirated leading to a lipid pneumonia. Docusate sodium is the safest choice for this client.

A 68-year-old man, well controlled on theophylline for 2 years, complains of insomnia, nervousness, nausea and vomiting, and tachycardia. He originally thought the nervousness was due to his recent smoking cessation. He had smoked one pack per day for 10 years. The nurse practitioner assesses the patient and tells him that he is likely experiencing theophylline toxicity. A serum theophylline level confirms the diagnosis. What is the best explanation for theophylline toxicity in this patient? A. Because of his age, the patient is likely having renal insufficiency. B. The patient is not taking the medication as prescribed. C. A concurrent medication is altering the metabolism of theophylline. D. The metabolism of theophylline has decreased with the recent smoking cessation.

D. Cigarette smokers usually need higher doses to maintain therapeutic blood levels because they metabolize theophylline rapidly. When clients stop smoking, metabolism of the drug decreases, and less drug is necessary to maintain therapeutic levels.

A nurse is teaching a client who is beginning fluticasone propionate/salmeterol therapy. Which of the following instructions should the nurse include? A. Take the drug as needed for acute asthma B. Follow a low sodium diet C. Use an alternate day dosing schedule D. Increase weight-bearing activity

D. Increase weight-bearing activity

A nurse is teaching a client about albuterol. The nurse should instruct the client to monitor for and report which of the following as an adverse effect of this drug? A. Fever B. Bruising C. Polyuria D. Palpitations

D. Palpitations

A nurse is teaching a client about the use of cromolyn sodium to prevent bronchospasm. The nurse should explain that the drug has which of the following therapeutic effects? A. Increases leukocyte activity B. Blocks muscarinic receptors C. Causes bronchodilation D. Reduces inflammation

D. Reduces inflammation

In explaining options for antihistamine medications to a patient, second-generation H1 antagonists differ from first-generation H1 antagonists in that they do which of the following? A. cause greater central nervous system sedation B. are available only by prescription C. are less expensive D. do not cross the blood-brain barrier

D. Second-generation H1 antagonists (also called selective or nonsedating agents) were developed mainly to produce less sedation than the first-generation drugs. They cause less central nervous system depression because they are selective for peripheral H1 receptors and do not cross the blood-brain barrier.

A nurse is caring for a client who takes phenytoin for a seizure disorder and has a new prescription for sucralfate to treat a duodenal ulcer. The nurse should instruct the client to take the drugs at least 2 hrs part for which of the following reasons? A. Phenytoin increases the metabolism of sucralfate B. Phenytoin reduces the effectiveness of sucralfate C. Sucralfate increases the risk for phenytoin toxicity D. Sucralfate interferes with the absorption of phenytoin

D. Sucralfate interferes with the absorption of phenytoin

Which fact regarding administration should the nurse include in patient teaching about the drug sucralfate? A. Take sucralfate concurrently with an antacid. B. Take sucralfate after meals. C. Take sucralfate before meals. D. Take sucralfate 2 hours before meals.

D. Sucralfate requires an acid pH for activation and should not be given with an antacid, histamine2 receptor antagonist, or proton pump inhibitor because it may bind other drugs and prevent their absorption. Sucralfate should be given 2 hours before or after other drugs and before meals.

A nurse is teaching a client about montelukast. Which of the following instructions should the nurse include? A. use a spacer to improve inhalation B. Take the drug at the onset of bronchospasm C. Rinse mouth to prevent an oral fungal infection D. Take the drug once a day in the evening

D. Take the drug once a day in the evening

Which of the following drugs has protocols that require clients to meet specific risk management criteria and sign a treatment agreement before the nurse can administer the drug? A. lubiprostone B. azathioprine C. sulfasalazine D. alosetron

D. alosetron

A nurse is caring for a client who has a new prescription for ranitidine to treat GERD. The nurse should instruct the client to wait at least one hour before taking ranitidine and which of the following over the counter drugs? A. Ginkgo biloba B. antidiarrheals C. St. johns wort D. antacids

D. antacids

A nurse is teaching a client who recently had a myocardial infarction and has a new prescription for docusate sodium. The nurse should inform the client that docusate sodium cause which of the following therapeutic effects? A. reduces inflammation B. reduces gastric acid C. prevents diarrhea D. prevents straining

D. prevents straining

DC: lubiprostone

DC: lubiprostone TU: IBS- C in women 18+

A nurse is planning care for a client who is receiving chemotherapy and has a new prescription for ondansetron. Which of the following actions should the nurse plan to take?(select all that apply) A. Infuse the drug 30 min prior to chemotherapy B. Administer the drug when the cloent reports nausea C. Infuse the drug slowly over 15 min D. Administer the drug immediately following chemo E. Repeat the dose four hr after chemotherapy

Infuse the drug 30 min prior to chemotherapy Infuse the drug slowly over 15 min Repeat the dose four hr after chemotherapy

DC: Alosetron

P: alosetron TU: women w/ IBS-D > 6 months

DC: Antacids

P: aluminum hydroxide TU: peptic ulcer disease/ GERD

DC: Immunosuppressants (IBS)

P: azathioprine TU: IBD

DC; Inhaled Glucocorticoids

P: beclomethasone TU: asthma

DC: stimulant laxative

P: bisacodyl TU: constipation

DC: Nonsedating antihistamines

P: cetirizine TU: allergies

DC: Histamine H2 antagonist

P: cimetidine TU: ulcers/hyperacidity

DC: Mast Cell Stabilizers

P: cromolyn TU: allergies, asthma

DC: antitussives

P: dextromethorphan TU: suppresses unproductive cough

DC: antihistamine (GI)

P: dimenhydrinate TU: motion sickness

DC: Sedating Antihistamines

P: diphenhydramine TU: allergies

DC: Opioids (diarrhea)

P: diphenoxylate/atropine TU: diarrhea

DC: stool softeners

P: docusate sodium TU: constipation

DC: Nasal Glucocorticoids

P: fluticasone TU: asthma

DC: Expectorant

P: guaifenesin TU: encourage productive cough

DC: Inhaled Anticholinergics

P: ipratropium TU: COPD

DC: Prokinetic

P: metoclopramide TU: gastroparesis

DC: Prostglandin E analog

P: misoprostol TU: ulcers

DC: Leukotriene Modifiers

P: montelukast TU: allergies, asthma

DC: Proton Pump Inhibitors (PPI)

P: omeprazole TU: ulcers/GERD

DC: serotonin agonists

P: ondansetron TU: nausea

DC: Sympathomimetics

P: phenylephrine TU: nasal decongestant

DC: Oral (IV) Glucocorticoids

P: prednisone TU: asthma

DC: Fiber

P: psyllium TU: constipation

DC: Maintenance Beta2 Adrenergic Agonists

P: salmeterol TU: asthma, bronchospasm

DC: mucosal protectants

P: sucralfate TU: ulcers

DC: amino salicylates

P: sulfasalazine TU: IBD

DC: Methylxanthines

P: theophylline TU: asthma