lecture 4 olympics

Question 1

An older pt with severe gastroesophageal reflux disease (GERD) has had only minimal relief using histamin2-receptor antogonist (H2RA). The patient is to begin taking omeprazole. What will the nurse teach this pt ?

Answer 1

Long-term therapy may be needed

Question 2

which organism or disorder is responsible for many cases of PUD

Answer 2

H. pylori

Question 3

Which common drug for nausea and vomiting is a 5-HT3 receptor against antagonist

Answer 3

ondansetron

Question 4

What is the purpose for the nurse administering metoclopramide (Reglan). IV postoperatively ?

Answer 4

Prevent postoperative nausea and vomiting

Question 5

A pt who has had a myocardial infarction is advised to avoid straining with defecation. Which medication would be prescribed to this pt?

Answer 5

Stool softners

Question 6

Which is the laxative of choice for an older pt who is in the end stage of Alzheimers disease and requires a daily laxative ?

Answer 6

Bulk forming

Question 7

The parent of a child with cerebral palsy reports that the child has pebble-like stools most of the time and seems uncomfortable if several days have passed between stools. The nurse will suggest that the parent discuss which medication with the child’s provider?

Answer 7

Polyethylene glycol

Question 8

Pt prescribed metoclopramide reports having difficulty sleeping, difficulty concentrating, tiredness, and feeling hopeless. What is your best action ?

Answer 8

Hold the drug and notify the prescriber

Question 9

Which treatment would be considered safe for an infant?

Answer 9

-Bulk forming laxatives
-Malt soup extract

Question 10

The recovery room nurse is preparing to assist with the care of several postoperative pts. Which pt would the nurse prioritize care for regarding the potential for postoperative nausea and vomiting?

Answer 10

A 50 yr old woman undergoing a total hysterectomy with general anesthesia

Question 11

What condition is occurring when pt experiences nausea immediately on entering the clinic to receive another course of chemotherapy?

Answer 11

Anticipatory nausea and vomiting

Question 12

Which drug therapy is aimed at reducing gastric acid secretions?

Answer 12

-H2 antagonists
-Proton pump inhibitors

Question 13

Pt newly diagnosed with PUD reports taking low-dose aspirin (ASA) for prevention of cardiovascular disease. The nurse learns that the pt drinks 2 to 3 cups of coffee each day and has a glass of wine with dinner 3 or 4 nights per week. The pt eats three meals a day. The nurse will counsel this pt to:

Answer 13

change the meal pattern to five or six smaller meals per day

Question 14

The nurse in a long term care facility is preparing to pass medications to the residents. To which of the following residents should the nurse administer an antidiarrheal ?

Answer 14

-An 80 yr old woman with diarrhea of sudden onset that has lasted 3 days
-A 92 yr old man with diarrhea secondary to inflammatory bowel disease
-A 70 yr old woman with a history chronic diarrhea from GI surgery

Question 15

What problems may a pt with nausea and vomiting be at risk for ?

Answer 15

-weight loss
-dehydration
-electrolyte imbalance

Question 16

Nurse receives an order to administer castor oil to a patient. Which action by the nurse is correct ?

Answer 16

Chill the medication and mix it with fruit juice

Question 17

The nurse is caring for an older adult pt after a right hip open reduction internal fixation (ORIF). The pt is taking an opioid every 6 hrs as needed for pain. The nurse discusses obtaining an order from the prescriber for which medication ?

Answer 17

Docusate sodium

Question 18

Why does the nurse monitor daily weights prior to the administration of antiemetic medications to chemotherapy pts?

Answer 18

Weight loss is a common adverse effect associated with chemotherapy, and dosages may need to be readjusted

Question 19

What is the mechanism of action of a stimulant laxative ?

Answer 19

Irritates the intestine directly, promoting peristalsis and evacuation

Question 20

Pt with renal disease is scheduled for colonoscopy. Before the procedure, the nurse will anticipate administering :

Answer 20

Polyethylene glycol and electrolytes

Question 21

Which factors contribute to the development of PUD?

Answer 21

-cigarette smoking
-genetics
-h. pylori

Question 22

Cimetidine (Tagamet) is an example of which class of drug ?

Answer 22

Histamine (H2) receptor antagonist

Question 23

When the nurse assesses bowel habits in a patient, which is the best example of normal bowel elimination ?

Answer 23

Regular bowel elimination pattern of soft stool

Question 24

Which medication is used in the treatment gastric reflux esophagitis and diabetic gastroparesis ?

Answer 24

Metoclopramide

Question 25

You are giving discharge instructions to a pt who will be taking an antacid for gastric problems. Which instructions should be provided to this pt ?

Answer 25

-Antacids must be taken between meals -Antacids should be taken at bedtime -Antacids serve as a gastric buffer -Antacids can cause diarrhea

Question 26

A pt is receiving morphine for pain control. What will the nurse emphasize about preventing constipation ?

Answer 26

Stool softeners are taken on a regular basis during opioid use.

Question 27

Which condition would cause the nurse to withhold a PRN order for magnesium hydroxide ?

Answer 27

chronic renal failure

Question 28

Which are potential worrisome adverse effects associated with proton pump inhibitor use in older patients

Answer 28

-medication interactions -osteoporosis -vitamin and mineral deficiencies

Question 29

A pts provider has recommended a bulk forming laxative for occasional constipation. Which statement by the patient indicates understanding of the teaching about this agent ?

Answer 29

" I should take each dose with a full glass of water"

Question 30

A pt who is taking NSAIDs to treat arthritis asks the nurse why misoprostol has also been prescribed. Which explanation by the nurse is accurate ?

Answer 30

NSAIDs often cause GI irritation that can result in peptic ulcers

Question 31

Which symptom is the pt with lactase deficiency most likely to exhibit?

Answer 31

Diarrhea

Question 32

Pt who takes non-steroidal anti-inflammatory drugs (NSAIDs) for arthritis asks a nurse what can be done to prevent ulcers. The nurse will recommend asking the provider about using which medication?

Answer 32

Proton pump inhibitors

Question 33

Which are classified as one of the five major categories or laxatives ?

Answer 33

-Bulk forming laxatives -Lubricant laxative -Stimulant laxative -Stool softeners

Question 34

The nurse is caring for 27 yr old pt taking a cannabinoid during chemotherapy. Which consideration will the nurse take into account?

Answer 34

Antihistamines may potentiate the effects

Question 35

A pt is diagnosed with Zollinger-Ellison syndrome. Which medication does the nurse expect the provider to order for this patient ?

Answer 35

Ranitidine

Question 36

A friend reports using loperamide for continual diarrhea for a week since returning home from a vacation outside the country. Which is the nurse's best response?

Answer 36

"I'd stop taking the Imodium and go in to see a health care provider immediately. You may have an infection in your intestinal tract"

Question 37

A pt has been taking psyllium two to three times daily for several days. The patient complains of stomach pain but has not had a stool. What will the nurse do?

Answer 37

Palpate the patient's abdomen and auscultate for bowel sounds.

Question 38

A postoperative appendectomy pt has a nasogastric tube and wonders why the previous nurse told him that he was receiving an IV "ulcer preventing" medication called ranitidine. The pt states that he has never had any stomach problems in his life. Which is the best response by the nurse?

Answer 38

"Because you are not eating after surgery, this medication will help reduce the hydrochloric acid your stomach is still secreting"

Question 39

Which instruction will the nurse include in the discharge teaching of a pt taking psyllium?

Answer 39

"Administer with a full glass of water"

Question 40

Which antiemetic drug class is reserved for pts with severe nausea and vomiting?

Answer 40

Cannabinoids

Question 41

The nurse would expect to administer which drug when treating hyperemesis gravidarum?

Answer 41

Metoclopramide

Question 42

Which drug for nausea and vomiting can cause decreased sweating and increased risk for overheating?

Answer 42

Prochlorperazine

Question 43

A pt is beginning the second round of high dose cisplatin. Severe, chemotherapy induced nausea and vomiting occurred following the first treatment, requiring 72 hours of continuous IV hydration. In addition to her chemotherapy regimen, which medication would be best to administer ?

Answer 43

Parental ondansetron 1 hour before chemotherapy, with oral ondansetron to continue for the next 4 days

Question 44

Which signs and symptoms are consistent with dehydration ?

Answer 44

-Increased hemoglobin and hematocrit -Mental confusion and excessive thirst -Nonelastic skin turgor and delayed capillary filling

Question 45

An older adult is admitted through the emergency department with complaints of nausea, abdominal tenderness, and continual stooling. On assessment, the nurse notes abdominal distention, smearing of stool on undergarments, and hypoactive bowel sounds LUQ and LLQ. The

Answer 45

An impaction

Question 46

A pt with PUD asks the nurse about the action of prokinetic medications. Which explanation by the nurse is accurate ?

Answer 46

It increases the lower esophageal sphincter muscle pressure and peristalsis

Question 47

Which explanation by the nurse is accurate to include when teaching a patient who is beginning therapy for gastroesophageal reflux disease (GERD) with metoclopramide?A

Answer 47

"peristalsis is increased, so food is digested more quickly"

Question 48

When metronidazole is a component of the H.pylori treatment regimen, the pt must be instructed to do what ?

Answer 48

Avoid any alcoholic beverages

Question 49

The nurse is caring for a pt receiving palliative care with opioid induced constipation. Laxative therapy has been unsuccessful. in treating this pt. Which PRN medication should the nurse provide to best alleviate this type of constipation?

Answer 49

Methylnaltrexone

Question 50

The nurse is assessing a pt taking lactulose to treat chronic constipation. Which adverse effect should the nurse immediately report to the health care provider?

Answer 50

Abdominal tenderness

Question 51

What specific problem can develop in a pt who has been prescribed both a 5-HT3 receptor antagonist and a phenothiazine ?

Answer 51

Cardiac dysrhytthmias.

Question 52

A 6 yr old child has frequent constipation. The nurse provides teaching after the parent ask the nurse why the provider recommended using laxatives only when needed. Which statement by the parent indicates a need for further teaching?

Answer 52

"Frequent use of laxatives can cause diverticulitis"

Question 53

A prepared childbirth nurse educator is discussing potential discomforts during pregnancy with a group of women. When relaying information about and vomiting, the nurse will include which statement(s).

Answer 53

-Vomiting during pregnancy is more common among primigravidas. -Nausea and vomiting during pregnancy can occur at any time of the day.

Question 54

The nurse is administering medication to various patients during morning medication pass. The patient at the lowest risk of having an adverse reaction is the patient receiving :

Answer 54

dexamethasone

Question 55

A patient reports taking an oral bisacodyl laxative for several year. The provider has suggested discontinuing the laxative, but the pt is unsure how to do this. The nurse will tell the patient to :

Answer 55

stop taking the laxative immediately and expected no stool for several days

Question 56

What is an advantage of using benzodiazepines as an an adjunctive treatment for nausea and vomiting associated with chemotherapy?

Answer 56

The antianxiety effect helps, in addition to reducing the frequency of nausea and vomiting.

Question 57

The nurse is preparing to administer medications and notes that a pt has sucralfate ordered qid. When is the best time to administer this medication?

Answer 57

1 hour before meals

Question 58

A pt taking metoclopramide for the last 6 months develops uncontrolled rhythmic movement of the face, lip smacking, and rapid or wormlike movements of the tongue. What is your best action?

Answer 58

Document the findings and contact the prescriber

Question 59

Which non pharmaceutical interventions can be used to reduce symptoms of gastroesophageal reflux disease?

Answer 59

Avoiding late-night meals, stopping smoking

Question 60

You are providing instruction to a pt about the use of a bulk-forming laxative for the treatment of constipation. Which statement should be included in the teaching plan for this pt?

Answer 60

"Take this drug with a full glass of water"

Question 61

You are caring for a pt who is taking a substance P/neurokinin1 (NK1) receptor antagonist. Which laboratory finding would suggest the pt is experiencing an adverse reaction to this class of drugs?

Answer 61

Decreased white blood cell count

Question 62

The nurse is planning to administer an antacid to a pt dx with PUD who will receive an H2 antagonist at 8:00 am. When is the most appropriate time for the nurse to provide the antacid to this pt?

Answer 62

2 hrs after the H2 antagonist

Question 63

A pt going on vacation asks the nurse what she can give her 3 yr old child who becomes car sick. Which response would be accurate?

Answer 63

-"position techniques such as placing the child facing forward and blocking out scenery through the side windows can be helpful" -"I would check with the pharmacist regarding over the counter products available for young children"

Question 64

Which drug would be most effective for an obstetric patient who is complaining of constipation as a result of her enlarging uterus and use of prenatal vitamins ?

Answer 64

Lubricant laxative

Question 65

A pt admitted to the hospital has a hx of peptic ulcer disease. The pt takes ranitidine and sucralfate. The pt tells the nurse that discomfort is usually controlled but that symptoms occasionally flare up. What will the nurse do ?

Answer 65

Counsel the pt to avoid beverages containing caffeine

Question 66

A pt who has gastroesophageal reflux disease (GERD) receives a prescription for a proton inhibitor (PPI) medication. What will the nurse include when teaching the patient about this drug?

Answer 66

"You should report any fever and cough to your provider"

Question 67

A pt is admitted with lower abdominal pain and nausea. The nurse performing the initial assessment notes that the pt abdominal is distended and firm, and hypoactive bowel sounds are present. The pt has not had a stool for 3 days. The nurse will contact the provider, who will:

Answer 67

perform diagnostic tests

Question 68

Which factors prevents breakdown of the body's normal defense barriers that protect against ulcer formation?

Answer 68

-Prostaglandins -Mucous cells

Question 69

Which statement made by a pt taking a H2-receptor blocker for peptic ulcer disease leads you to suspect the patient needs additional teaching regarding taking this class of drugs?

Answer 69

"I will take my daily dose of this drug first think in the morning"