week 12 sherpath Flashcards
In which time frame would a nurse expect omeprazole to reach its peak concentration?
0.5 hour
1 hour
2 hours
4 hours
2 hours
Which statement regarding the pharmacokinetic profile of esomeprazole is inaccurate?
“Esomeprazole is well absorbed after oral administration.”
“The drug is less than 50% protein bound.”
“Esomeprazole is extensively metabolized in the liver.”
“The drug undergoes excretion in the urine.”
“The drug is less than 50% protein bound.”
Which statements are true about the pharmacokinetics of omeprazole and esomeprazole?
Select all that apply.
Omeprazole is more protein bound than esomeprazole.
Esomeprazole is metabolized more slowly than omeprazole.
Esomeprazole is excreted in the urine, while omeprazole is excreted in the feces.
Esomeprazole is metabolized in the liver, while omeprazole undergoes biliary -metabolism.
Esomeprazole achieves a higher blood level and has longer-lasting effects compared with omeprazole.
Esomeprazole is metabolized more slowly than omeprazole.
Esomeprazole achieves a higher blood level and has longer-lasting effects compared with omeprazole.
Which dosage and administration protocol would a nurse follow with the administration of intravenous esomeprazole to Ms. Contreras?
If given as an injection, it will be given over 1 minute.
It may be given with other intravenous medications.
If given as an infusion, it will be administered over 10 to 30 minutes.
The freeze-dried powder will be reconstituted with 5 mL of dextrose 5% in water.
If given as an infusion, it will be administered over 10 to 30 minutes.
Which drug interaction and outcome does the nurse anticipate will occur in Ms. Contreras with administration of esomeprazole?
Digoxin: Increased digoxin exposure
Digoxin: Decreased digoxin exposure
Ibuprofen: Increased ibuprofen exposure
Ibuprofen: Decreased ibuprofen exposure
Digoxin: Increased digoxin exposure
Which patient parameters would a nurse ensure are assessed before a patient receives oral esomeprazole?
Select all that apply.
Medication history
Gastrointestinal (GI) history
Risk for and history of osteoporosis
Risk for and history of hypertension
Risk for and history of hypothyroidism
Medication history
Gastrointestinal (GI) history
Risk for and history of osteoporosis
Which teaching points would a nurse share with a 33-year-old female patient who has been prescribed omeprazole delayed-release capsules for Zollinger-Ellison syndrome?
Select all that apply.
“Take omeprazole at least 1 hour before a meal.”
“Do not crush, chew, split, or open the omeprazole capsule.”
“You may experience headache and diarrhea with omeprazole.”
“Avoid alcohol while receiving omeprazole because it will decrease the absorption of the drug.”
“Use contraception and alert your health care provider if you suspect you are pregnant while taking omeprazole.”
“Do not crush, chew, split, or open the omeprazole capsule.”
“You may experience headache and diarrhea with omeprazole.”
“Use contraception and alert your health care provider if you suspect you are pregnant while taking omeprazole.”
Which statement by the nursing student about the mechanism of action of proton pump inhibitors (PPIs) requires further intervention?
“PPIs inhibit active parietal cell acid secretion.”
“They inhibit ATPase that generates gastric acid.”
“They promote irreversible hydrogen or potassium ATPase inhibition.”
“PPIs work by blocking histamine2 receptors, which reduces gastric acid secretion.”
“PPIs work by blocking histamine2 receptors, which reduces gastric acid secretion.”
In which time frame would a patient expect to experience effects from esomeprazole?
1 hour
2 hours
4 hours
6 hours
1 hour
Which statement regarding the pharmacodynamic profile of omeprazole is accurate?
The onset of action of omeprazole is 2 hours.
Omeprazole’s duration of action is up to 24 hours.
The elimination half-life of omeprazole is 0.5 to 1 hour.
The elimination half-life of omeprazole is reduced in patients with liver dysfunction.
The elimination half-life of omeprazole is 0.5 to 1 hour.
Which medical conditions would a nurse recognize that oral esomeprazole may be used to treat?
Select all that apply.
Gastroesophageal reflux disease (GERD)
Crohn disease
Duodenal ulcers
Nonsteroidal antiinflammatory drug (NSAID)-induced ulcers
Zollinger-Ellison syndrome
Gastroesophageal reflux disease (GERD)
Duodenal ulcers
Nonsteroidal antiinflammatory drug (NSAID)-induced ulcers
Zollinger-Ellison syndrome
Which patients would a nurse determine require cautious use of or avoidance of esomeprazole?
Select all that apply.
A 70-year-old Asian patient with hypertension
A 73-year-old Caucasian patient with osteoporosis
A 29-year-old Hispanic patient who is breastfeeding
A 54-year-old Caucasian patient with alcoholic cirrhosis
A 38-year-old Hispanic patient with type 2 diabetes mellitus
A 70-year-old Asian patient with hypertension
A 73-year-old Caucasian patient with osteoporosis
A 29-year-old Hispanic patient who is breastfeeding
A 54-year-old Caucasian patient with alcoholic cirrhosis
Which outcome would a nurse anticipate from the drug interaction that may occur in a patient who is receiving diazepam and has been newly prescribed omeprazole?
Increase in serum concentration of diazepam
Decrease in serum concentration of diazepam
Increase in serum concentration of omeprazole
Decrease in serum concentration of omeprazole
Increase in serum concentration of diazepam
A patient who is receiving omeprazole has been prescribed clopidogrel following stent placement. Which outcome does a nurse alert the health care provider about resulting from the drug interaction?
Increase in activation of clopidogrel
Decrease in activation of clopidogrel
Increase in activation of omeprazole
Decrease in activation of omeprazole
Decrease in activation of clopidogrel
A 93-year-old patient with gastroesophageal reflux disease (GERD) is prescribed esomeprazole. The patient is immobile in a skilled nursing facility, is frail, and experienced a stroke a year ago. Which adverse effects of esomeprazole will the nurse be concerned about in this patient?
Select all that apply.
Diabetes
Dementia
Pneumonia
Osteoporosis
Thyroid dysfunction
Hip or vertebral fracture
Dementia
Pneumonia
Osteoporosis
Hip or vertebral fracture
Match the laxative with its associated drug class.
Osmotic
Stimulant
Selective Chloride Channel Activator
Emollient
Answer choices
Lubiprostone
Docusate sodium
Bisacodyl
Lactulose
Psyllium
Osmotic
Lactulose
Stimulant
Bisacodyl
Selective Chloride Channel Activator
Lactulose
Emollient
Bisacodyl
Which statement by the nursing student regarding the pharmacokinetic parameters of lubiprostone requires further intervention?
“Lubiprostone has low systemic availability with oral administration.”
“The drug is 94% protein bound with minimal distribution outside of the gastrointestinal (GI) tract.”
“Lubiprostone is quickly metabolized in the stomach and jejunum by the cytochrome P450 (CYP450) system.”
“The drug is excreted mostly in urine and some in feces.”
“Lubiprostone is quickly metabolized in the stomach and jejunum by the cytochrome P450 (CYP450) system.”
In which time frame would a nurse expect to note the effects of oral bisacodyl in a patient?
15 to 60 minutes
2 to 4 hours
6 to 12 hours
10 to 12 hours
6 to 12 hours
To which classification of antidiarrheal drugs does bismuth subsalicylate belong?
Opiates
Probiotics
Adsorbents
Anticholinergics
Adsorbents
Which statements regarding the pharmacodynamic parameters of loperamide are accurate?
Select all that apply.
The onset of action for loperamide is 1 hour.
The capsule formulation of loperamide has a time to peak concentration of 30 minutes.
The liquid formulation of loperamide has a time to peak concentration of 2.5 hours.
The duration of action of loperamide is 24 hours.
Loperamide’s elimination half-life ranges from 5 to 6 hours.
The onset of action for loperamide is 1 hour.
The liquid formulation of loperamide has a time to peak concentration of 2.5 hours.
The duration of action of loperamide is 24 hours.
Which patient parameters would a nurse ensure are assessed before administering bisacodyl to a 17-year-old female patient?
Select all that apply.
Blood urea nitrogen (BUN)/Serum creatinine (SCr)
Bowel patterns
Blood pressure (BP)
Liver function tests
History of eating disorders
Blood urea nitrogen (BUN)/Serum creatinine (SCr)
Bowel patterns
Blood pressure (BP)
History of eating disorders
A nurse determines that patients with which conditions can safely receive laxative therapy?
Select all that apply.
Dyslipidemia
Osteoarthritis
Hypothyroidism
Fecal impaction
Intestinal obstruction
Dyslipidemia
Osteoarthritis
Hypothyroidism
Which outcome would a nurse anticipate will occur as a result of a drug interaction in a patient who is taking psyllium and has been prescribed tetracycline for an infection?
Increased effects of psyllium
Decreased effects of psyllium
Increased absorption of tetracycline
Decreased absorption of tetracycline
Decreased absorption of tetracycline
Which patient statement about glycerin administration and effects requires further intervention?
“I can expect the laxative effect to occur in about 1 hour.”
“I should try to keep the suppository in for about 15 to 30 minutes.”
“The suppository does not need to melt for a bowel movement to occur.”
“I should insert one suppository into my rectum once or twice daily as needed for constipation.”
“I can expect the laxative effect to occur in about 1 hour.”
Which adverse effects would a nurse monitor for in a patient receiving lubiprostone for irritable bowel syndrome?
Select all that apply.
Hypertension
Severe diarrhea
Urinary tract infection (UTI)
Intestinal nerve damage
Upper respiratory tract infection
Severe diarrhea
Urinary tract infection (UTI)
Upper respiratory tract infection
Which side effects would the nurse alert Mr. Frank to be monitored for while receiving loperamide?
Select all that apply.
Tinnitus
Drowsiness
Dark stools
Urinary retention
Metallic taste and black tongue
Drowsiness
Urinary retention
Which patients would a nurse determine cannot safely receive treatment with loperamide without consultation with a health care provider?
Select all that apply.
A patient with gout
A patient with liver disease
A patient with ulcerative colitis
A patient who has misused opioids
A patient with type 2 diabetes mellitus
A patient with liver disease
A patient with ulcerative colitis
A patient who has misused opioids
Which outcome would a nurse anticipate would occur in a patient taking bismuth subsalicylate and aspirin as a result of a drug interaction?
Increased effect of bismuth subsalicylate
Decreased effect of bismuth subsalicylate
Increased risk for bleeding, bruising, and confusion
Decreased risk for bleeding, bruising, and confusion
Increased risk for bleeding, bruising, and confusion
Match the laxative with its associated mechanism of action.
Draws water into the intestine to relieve constipation
Softens and increases bulk of digested food
Increases water in stools to soften it so it is more comfortable to pass
Activates chloride channels to enhance intestinal fluid secretion
Answer choices
Psyllium
Lubiprostone
Mineral oil
Polyethylene glycol
Draws water into the intestine to relieve constipation
Polyethylene glycol
Softens and increases bulk of digested food
Psyllium
Increases water in stools to soften it so it is more comfortable to pass
Mineral oil
Activates chloride channels to enhance intestinal fluid secretion
Lubiprostone
Which statements regarding the pharmacodynamics of bismuth subsalicylate are accurate?
Select all that apply.
The onset of action for bismuth subsalicylate is 1 hour.
The duration of action of bismuth subsalicylate is 12 hours.
The time to peak concentration of bismuth subsalicylate is 2 hours.
The elimination half-life of bismuth is 24 hours.
The elimination half-life of salicylate is 2 to 5 hours.
The onset of action for bismuth subsalicylate is 1 hour.
The time to peak concentration of bismuth subsalicylate is 2 hours.
The elimination half-life of salicylate is 2 to 5 hours.
Which laxative absorbs fat-soluble vitamins, thereby reducing the body’s absorption of these vitamins from foods?
Psyllium
Bisacodyl
Mineral oil
Lubiprostone
Mineral oil
Which statement regarding the pharmacokinetic and pharmacodynamic parameters of psyllium is accurate?
Psyllium is excreted mostly in the urine.
Psyllium has an onset of action of 1 to 3 hours.
Psyllium reaches its peak concentration in 12 hours.
Psyllium is not absorbed after oral administration.
Psyllium is not absorbed after oral administration.
Which phrase describes how loperamide acts to exert antidiarrheal effects?
Destroys bacteria and toxins by lining the gastrointestinal (GI) tract
Replaces bacteria to promote normal bacterial flora in the GI tract
Slows GI motility, reduces electrolyte loss, and decreases fecal volume
Decreases GI contractions as well as reduces gastric secretions through drying effects
Slows GI motility, reduces electrolyte loss, and decreases fecal volume
Which statement regarding the pharmacokinetic parameters of bismuth subsalicylate is accurate?
Bismuth is extensively absorbed with oral administration.
Subsalicylate is minimally absorbed after oral administration.
Bismuth subsalicylate is metabolized in the liver to bismuth and salicylic acid.
The drug is excreted in the feces.
Bismuth subsalicylate is metabolized in the liver to bismuth and salicylic acid.
Which outcome does a nurse anticipate will occur as a result of a drug interaction in a patient who is taking the anticoagulant warfarin and bismuth subsalicylate?
Increased absorption of warfarin
Decreased absorption of warfarin
Increased absorption of bismuth subsalicylate
Decreased absorption of bismuth subsalicylate
Decreased absorption of warfarin
Which patient teaching points would the nurse share with a patient who is receiving psyllium powder?
Select all that apply.
Do not administer the powder without mixing it with water.
Drink the psyllium solution within 1 hour of mixing.
Drink one glass of water after administration of psyllium.
Mix the psyllium powder well with 8 to 10 oz of water.
Inhalation of the powder may cause runny nose, wheezing, and watery eyes.
Do not administer the powder without mixing it with water.
Drink one glass of water after administration of psyllium.
Mix the psyllium powder well with 8 to 10 oz of water.
Inhalation of the powder may cause runny nose, wheezing, and watery eyes.
Which statement by the patient in regard to bisacodyl plus senna administration requires further education?
“I can take this medication as long and as often as I need it.”
“I may experience diarrhea and cramping from taking this medication.”
“I should take the medication with plenty of water to help with absorption.”
“I should wait at least 1 hour after taking bisacodyl and senna to take my other medications.”
“I can take this medication as long and as often as I need it.”
A nurse is caring for a patient who appears to be dehydrated. It has been determined that the patient has been unintentionally overusing laxative therapy. Which patient parameters would be assessed in this patient?
Select all that apply.
Bowel sounds
Blood pressure
Thyroid function
Electrolytes
Fluid intake and output
Bowel sounds
Blood pressure
Electrolytes
Fluid intake and output
Which side effects would a nurse monitor for in a patient who is receiving lubiprostone?
Select all that apply.
Paralysis
Complete heart block
Severe diarrhea
Urinary tract infection (UTI)
Upper respiratory tract infection
Severe diarrhea
Urinary tract infection (UTI)
Upper respiratory tract infection
Which patient parameters would a nurse ensure are assessed before administering loperamide to a 71-year-old patient?
Select all that apply.
Glucose level
Blood pressure (BP)
Hydration status
Recent foods consumed
History of viral or bacterial infections, including Clostridium difficile
Hydration status
Recent foods consumed
History of viral or bacterial infections, including Clostridium difficile
Which effect would a nurse anticipate will occur if a patient takes hydrocodone, an opioid, while receiving loperamide?
Additive central nervous system (CNS) stimulant effects
Additive CNS depressant effects
Reduced efficacy of loperamide
Reduced efficacy of hydrocodone
Additive CNS depressant effects
Which patient teaching points would a nurse share with a patient who has been prescribed loperamide hydrochloride?
Select all that apply.
“Loperamide hydrochloride may increase your risk for bleeding.”
“Avoid alcohol while receiving loperamide hydrochloride because there is a risk for central nervous system (CNS) depression.”
“You can expect the tongue to turn black and the stools to darken while receiving loperamide hydrochloride.”
“Use caution when driving or performing tasks that require mental alertness while -receiving loperamide hydrochloride.”
“If diarrhea continues for more than 48 hours after initiation of loperamide hydrochloride, contact your health care provider.”
“Avoid alcohol while receiving loperamide hydrochloride because there is a risk for central nervous system (CNS) depression.”
“Use caution when driving or performing tasks that require mental alertness while -receiving loperamide hydrochloride.”
“If diarrhea continues for more than 48 hours after initiation of loperamide hydrochloride, contact your health care provider.”
Match the antiemetic with its drug class
Substance P/Neurokinin 1 Antagonists
Dopamine antagonists
Cannabinoids
Antihistamine
Answer choices
Dexamethasone
Dronabinol
Meclizine
Aprepitant
Ondansetron
Substance P/Neurokinin 1 Antagonists
Aprepitant
Dopamine antagonists
Ondansetron
Cannabinoids
Dronabinol
Antihistamine
Meclizine
In which time frame would a patient expect dronabinol to begin working?
5 to 15 minutes
30 to 60 minutes
2 to 3 hours
4 to 6 hours
30 to 60 minutes
Which statement regarding the pharmacokinetics of promethazine is accurate?
The drug is easily absorbed through the gastrointestinal (GI) tract.
Promethazine is minimally protein bound.
The drug does not undergo metabolism.
Promethazine undergoes biliary excretion.
The drug is easily absorbed through the gastrointestinal (GI) tract.
Which antiemetic exerts its effects by binding to acetylcholine receptors to block the nausea-inducing signal from communicating to the vomiting pathway?
Aprepitant
Scopolamine
Ondansetron
Promethazine
Scopolamine
Which length of time is the anticipated duration of action for meclizine’s effects?
1 hours
2 hours
6 hours
8 hours
6 hours
Which side effects would the nurse advise Ms. Smith to monitor for while receiving promethazine?
Select all that apply.
Shivering
Dizziness
Dry mouth
Blurry vision
Tachycardia
Dizziness
Dry mouth
Blurry vision
Tachycardia
Which patients would a nurse determine can safely receive treatment with scopolamine?
Select all that apply.
A patient with asthma
A patient with glaucoma
A patient with depression
A patient with breast cancer
A patient with myasthenia gravis
A patient with asthma
A patient with depression
A patient with breast cancer
A nurse is caring for a patient with breast cancer who is experiencing chemotherapy-induced nausea and vomiting. Which side effects and adverse effects would a nurse monitor for if the patient is receiving aprepitant?
Select all that apply.
Urticaria
Thrombocytopenia
Deep vein thrombosis
Extrapyramidal symptoms
Neuroleptic malignant syndrome
Urticaria
Thrombocytopenia
Deep vein thrombosis
Which patient parameters would a nurse evaluate in a patient receiving meclizine?
Select all that apply.
Heart rate
Gastric pH
Intake/Output
Bowel sounds
Blood pressure
Heart rate
Intake/Output
Bowel sounds
Blood pressure
Which antiemetic can a nurse anticipate having the longest duration of action?
Meclizine
Aprepitant
Dronabinol
Scopolamine
Scopolamine
Which antiemetic is excreted in urine, feces, and bile?
Meclizine
Dronabinol
Ondansetron
Promethazine
Dronabinol
Which statement regarding the pharmacodynamic parameters of intravenous (IV) ondansetron is accurate?
Its onset of action is 15 minutes.
It reaches its peak concentration in 30 minutes.
Its duration of action is 2 to 4 hours.
Its elimination half-life is 3 to 5 hours.
Its elimination half-life is 3 to 5 hours.
Which time frame can a nurse expect dexamethasone to reach its peak concentration?
5 to 10 minutes
15 to 30 minutes
45 to 60 minutes
1.5 to 2 hours
5 to 10 minutes
Which statement regarding the pharmacokinetic parameters of aprepitant is accurate?
The drug has an oral bioavailability of 25%.
Aprepitant is minimally protein bound (<5%).
The drug undergoes metabolism mostly by CYP3A4.
Excretion of aprepitant is predominantly in the feces.
The drug undergoes metabolism mostly by CYP3A4.
