pharm questions ch 31-34

Which statement by the patient would indicate to the nurse that further teaching is needed about how the defense mechanisms of the stomach can be compromised to cause PUD?

"I need to be careful about drinking too much orange juice because it is acidic and can damage my stomach lining."

The nurse is teaching a patient who has been prescribed dronabinol (Marinol) for emetogenic chemotherapy. Which statement by the patient indicates a correct understanding of the nurse's instructions?

"I will have someone stay with me when I first start taking this drug."

A patient was asking the nurse to explain canker sores. What is the appropriate response by the nurse?

"The causes of canker sores are not known." "Sometimes canker sores are brought on by stress and trauma to the mouth."

The nurse teaching a patient about the antidiarrheal agent Lactobacillus acidophilus (Lactinex) knows that which statement by the patient indicates further teaching is needed?

"This drug Lactinex has a stimulating effect on my bowels."

A nurse preparing the drug Metamucil explains to the patient that oral, bulk-forming laxatives usually relieve constipation by which time frame?

"This drug works by absorbing water into the stool, causing a softer stool, and takes about 12 to 24 hours."

A nurse is preparing the drug granisetron prior to the patient receiving chemotherapy and explains to the patient that relief of nausea will occur when?

"When we administer granisetron 60 minutes before your chemotherapy, we anticipate that you will not have any nausea.

the nurse discussing with a patient different ways to deal with anticipatory nausea and vomiting included in the discussion which of the following statements?

"You can expect anticipatory nausea to become more severe as your chemotherapy treatments progress." "We can teach you nonpharmacologic management of your nausea that includes progressive muscle relaxation and self-hypnosis." "It is recommended that we use antiemetic therapy prior to chemotherapy so that the nausea does not occur."

The nurse educating a patient with painful oral lesions discusses the best approach to oral hygiene that includes which instruction?

"You could think about using normal saline, baking soda, or half-strength hydrogen peroxide rinses for these lesions."

A patient has a flight at 10 AM and wants to take a scopolamine patch (Transerm Scop) to prevent motion sickness. Which time is best for the nurse to instruct the patient to apply the patch?

6 AM

Stimulant laxatives have an onset of action of how many hours?

6 to 10

Which patient prescribed metoclopramide (Reglan) should not receive this medication?

A 50-year-old with epilepsy

Which antacid is not suitable for a patient with hypertension?

Aluminum hydroxide/magnesium hydroxide/simethicone (Mylanta)

Which principle guides care planning for a patient with recurrent nausea and vomiting?

Antiemetics are more effective when given before the onset of nausea.

Which class of drug requires a premedication assessment screening for glaucoma?

Antispasmodic agent

The nurse is reviewing the medication record for a patient diagnosed with xerostomia. Which medication order should the nurse question?

Atropine

A patient with mucositis is being treated with viscous lidocaine 2%. Which instruction should the nurse include in the patient's teaching plan?

Avoid eating for 30 minutes after taking the medication.

Which instruction does the nurse include when teaching a patient how to use chlorhexidine (Peridex) for the treatment of mucositis?

Avoid eating for at least 30 minutes after use to prevent systemic toxicity.

The nurse is preparing to administer trimethobenzamide (Tigan) intramuscularly to a surgical patient. Which nursing interventions does the nurse perform when administering this drug?

Avoid escape of solution along the route Monitor for burning on injection of the medication Do not administer if the patient is allergic to local anesthetics.

When does the nurse expect to administer antiemetics to a patient with chemotherapy-induced nausea and vomiting (CINV)?

Both before and after chemotherapy is given

Which type of laxative is best for a patient who is confined to bed and who regularly needs a laxative?

Bulk forming

Which type of laxative may be ordered to control diarrhea from intestine-irritating substances?

Bulk-forming laxatives

Which of these interventions help postoperative nausea and vomiting?

Checking patency of NG tube if one is present Limiting patient movement Ensuring adequate analgesia Administering antiemetics as ordered

The stomach functions to digest food by secreting pepsinogen from the secretory cells known as what?

Chief cells

A patient has been prescribed atropine for treatment of pylorospasm. Which condition of the patient would cause the nurse to question this order

Closed-angle glaucoma

Proton pump inhibitors and antibiotics are often used in combination to eradicate which common cause of PUD?

Helicobacter pylori

The nurse instructing a patient on how to reduce acid production in the stomach to prevent GERD indicated that which measures should be taken?

Decrease or stop smoking. Decrease the amount of coffee consumed. Decrease the amount of alcohol intake.

Patients using dronabinol (THC) (Marinol) for nausea and vomiting should be taught to report which of these symptoms?

Depression Paranoia Hallucinations

Which antidiarrheal agent is contraindicated for use in children younger than the age of 2 years?

Diphenoxylate (Lomotil)

A patient with oral candidiasis is being treated with clotrimazole (Mycelex) lozenges. Which instruction does the nurse include in the patient's teaching plan?

Do not eat or drink for at least 30 minutes after taking

The nurse is caring for a patient recovering from a myocardial infarction. Which drug does the nurse anticipate will be ordered for the patient to prevent straining during a bowel movement?

Docusate sodium (Colace)

Which common stomach disorders are treated with proton pump inhibitors?

Duodenal ulcers GERD Esophagitis Hypersecretory disorders

Trimethobenzamide (Tigan) is prescribed for a surgical patient. Which adverse effect might the nurse assess?

Dystonia

a patient is prescribed bisacodyl (Dulcolax), famotidine (Pepcid), metoprolol succinate (Toprol XL), chlorothiazide (Diuril), and chlorpheniramine maleate (Chlor Trimeton) as needed. Which medication must the nurse avoid administering at the same time as bisacodyl?

Famotidine

Which potential complication is associated with the continued use of saline cathartics?

Fluid and electrolyte imbalance

A patient with gastroesophageal reflux disease (GERD) for whom antacids have been prescribed asks the nurse how these drugs work. Which action of antacids should guide the nurse's response?

Gastric acid is neutralized.

A patient is taking aprepitant (Emend) for the prevention of acute chemotherapy-induced nausea and vomiting. Which adverse effect might the nurse assess?

Hiccups

A 21-year-old pregnant woman comes into the clinic complaining of extreme "morning sickness." She has not been able to keep down any food or drink for 2 days. The nurse understands which treatments are available?

Hospitalization with management of fluids and electrolytes by the IV route Antihistamines such as diphenhydramine Ginger (herb) to treat the nausea and vomiting

Which patient statement indicates that more information concerning the use of a scopolamine patch (Transerm Scop) is required?

I should apply the patch 4 hours before I may experience nausea.

Which change in the care plan is required when metoclopramide (Reglan) is ordered for a patient with diabetes mellitus?

Increase frequency of monitoring for hypoglycemia.

The nurse knows that thrush can occur in which of these patient populations

Infants Pregnant women Debilitated patients

A patient has a history of chronic diarrhea. Which drug does the nurse anticipate the healthcare provider will order for the patient?

Lactobacillus acidophilus (Lactinex)

Which type of laxative should not be administered to debilitated patients who are in a recumbent position most of the time?

Lubricant

A patient receiving palliative care is prescribed morphine for the management of bone cancer pain. Which medication might the healthcare provider order to treat the patient's constipation?

Methylnaltrexone bromide (Relistor)

A nurse caring for a patient with diabetes who was diagnosed with gastroparesis would expect which drug to work as a gastric stimulant?

Metoclopramide (Reglan)

A patient with a history of irritable bowel syndrome is prescribed psyllium (Metamucil). Which instruction does the nurse include in the patient's teaching plan?

Mix the drug with a full glass of water.

A patient has recently been diagnosed with xerostomia. Which medication does the nurse anticipate will be ordered for this patient?

MouthKote

The anticholinergic agents are used to prevent which type of nausea?

Nausea and vomiting in pregnancy

Which histamine-2 (H2) antagonist is only available for oral administration?

Nizatidine (Axid)

Which drug has been approved specifically for use in preventing and treating the mucositis that develops in leukemia or lymphoma patients undergoing chemotherapy before bone marrow transplantation?

Nystatin

Which type of laxative may cause electrolyte imbalance and dehydration?

Osmotic

A patient with lymphoma who is undergoing chemotherapy before bone marrow transplantation has developed mucositis. Which medication does the nurse anticipate the healthcare provider will order for this patient?

Palifermin (Kepivance)

A patient with a gastric ulcer has been prescribed misoprostol (Cytotec). Which condition diagnosed in the patient would cause the nurse to question this order?

Pregnancy

The several different classes of antiemetic drugs used include which of the following?

Serotonin antagonists Benzodiazepines Neurokinin-1 receptor antagonists Corticosteroids

A systemically acting antidiarrheal drug is ordered for a patient who has diarrhea associated with food poisoning. Which is the reason why the nurse should question this order?

Reducing gastrointestinal (GI) motility will allow the condition to worsen

For which conditions is esomeprazole (Nexium) typically prescribed?

Severe esophagitis Zollinger-Ellison syndrome Gastroesophageal reflux disease

The nurse was discussing the mechanism of action for pantoprazole with a patient diagnosed with GERD and realized further education was needed after the patient made which statement?

So this drug will coat the lining of my stomach so I do not get GERD symptoms."

A nurse is providing education to a patient who has complained about frequent bouts of constipation. Which statement by the patient indicates further teaching is needed?

Taking pain medications regularly will not affect my bowel habits.

The patient with an ileostomy is receiving loperamide (Imodium A-D) for treatment of diarrhea because of which effects?

This drug will inhibit peristalsis. This drug allows more time for the intestines to absorb excess water to cause a formed stool.

A patient has been prescribed bismuth subsalicylate (Pepto Bismol) for the treatment of diarrhea. Which adverse effect exhibited by the patient would cause the nurse to contact the healthcare provider?

Tinnitus

Which information does the nurse include when teaching a patient about oral care?

Toothpastes vary in abrasiveness and should be selected accordingly.

A patient is taking omeprazole (Prilosec) for the treatment of a duodenal ulcer. Which adverse effect can occur with this medication?

Vesicular rash

The nurse is reviewing instructions with a patient prescribed oral dicyclomine (Bentyl) for the treatment of a duodenal ulcer. Which time is best to administer dicyclomine (Bentyl)?

With food

Which time is best for a patient to take misoprostol (Cytotec) in order to minimize the incidence of diarrhea?

With meals

The nurse can expect that a patient who recently underwent chemotherapy will develop mucositis during which time frame?

Within 5 to 7 days of starting chemotherapy

A patient has been prescribed a laxative. Which situation or symptom exhibited by the patient would be a cause for the nurse to question this order?

abdominal pain

A patient is taking the oral contraceptive Ortho Tri Cyclen. The nurse instructs the patient to use an additional method of contraception if the patient is also taking which drug?

aprepitant (Emend)

The patient with chemotherapy-induced nausea and vomiting was receiving benzodiazepines because these drugs will work in which way?

by depressing the VC By reducing anxiety associated with chemotherapy-induced nausea and vomiting

Which therapy does the nurse instruct a patient to use to prevent plaque formation?

flossing between teeth

Which basic principle does the nurse consider when scheduling the administration of drugs used to treat patients with gastroesophageal reflux disease (GERD) or peptic ulcer disease (PUD)?

individualized scheduling is required to avoid drug interactions.

Which type of ulcer has misoprostol (Cytotec) been shown to effectively reduce?

nonsteroidal antiinflammatory drug (NSAID) induced

Which beverage should a patient diagnosed with canker sores avoid?

orange juice

The nurse discussing halitosis with a patient should include which of these causes?

smoking sinusitis candida

Which statement best describes the action of phenothiazines?

they are serotonin (5-HT3) antagonists that block receptors known to induce nausea and vomiting.

A patient has been prescribed mineral oil for the treatment of constipation. Which condition of the patient would cause the nurse to question this order?

vitamin D deficiency

The nurse is instructing a patient with canker sores about the use of benzocaine (Kank A). Which statement by the patient indicates a need for further instruction?

will apply this medication before eating.