Science Quiz 2.1
- 1.
A patient is receiving an antacid that contains aluminum salts. The nurse will inform the patient to watch for which possible adverse effect?
- A.
Diarrhea
- B.
Constipation
- C.
Intestinal flatulence
- D.
Abdominal cramping
Correct Answer
B. ConstipationExplanation
Aluminum-based antacids have a constipating effect as well as an acid-neutralizing capacity. The other options are incorrect.Rate this question:
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- 2.
When reviewing the health history of a patient who will be receiving antacids, the nurse recalls that antacids containing magnesium should be used cautiously in which conditions?
- A.
Peptic ulcer disease
- B.
Renal failure
- C.
Hypertension
- D.
Heart failure
Correct Answer
B. Renal failureExplanation
Both calcium- and magnesium-based antacids are more likely to accumulate to toxic levels in patients with renal disease and are commonly avoided in this patient group. The other options are incorrect.Rate this question:
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- 3.
When giving H2 antagonists, the nurse recognizes that these drugs may inhibit the absorption of other drugs, which require an acidic gastrointestinal environment for gastric absorption, such as which drug?
- A.
Ibuprofen (Motrin)
- B.
Ranitidine (Zantac)
- C.
Tetracycline (Doryx)
- D.
Ketoconazole (Nizoral)
Correct Answer
D. Ketoconazole (Nizoral)Explanation
All H2 receptor antagonists may inhibit the absorption of certain drugs such as ketoconazole, which require an acidic gastrointestinal environment for gastric absorption. The other options are incorrect.Rate this question:
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- 4.
A patient who has been taking cimetidine (Tagamet) for hyperacidity calls the clinic to say that the medication has not been effective. The nurse reviews his history and notes that which factor may be influencing the effectiveness of this drug?
- A.
He takes the cimetidine with meals.
- B.
He smokes two packs of cigarettes a day.
- C.
He avoids caffeine and alcohol.
- D.
He takes an antacid 1 hour before or after the cimetidine dose.
Correct Answer
B. He smokes two packs of cigarettes a day.Explanation
Smoking may impair the absorption of H2 antagonists. The other factors are correct interventions for this medication.Rate this question:
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- 5.
A patient is taking omeprazole (Prilosec) for the treatment of gastroesophageal reflux disease (GERD). Which statement will the nurse include in the teaching plan about this medication?
- A.
“Take this medication once a day after breakfast.”
- B.
“You will be on this medication for only 2 weeks for treatment of the reflux disease.”
- C.
“The medication may be dissolved in a liquid for better absorption.”
- D.
“The entire capsule should be taken whole, not crushed, chewed, or opened.”
Correct Answer
D. “The entire capsule should be taken whole, not crushed, chewed, or opened.”Explanation
Omeprazole should be taken before meals, and an entire capsule should be taken whole, not crushed, chewed, opened, or dissolved in liquid when treating GERD, this medication is used on a long-term basis to maintain healing.Rate this question:
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- 6.
The nurse notes that a patient has excessive and painful gas. The nurse checks the patient’s medication orders and prepares to administer which drug for this problem?
- A.
Famotidine (Pepcid)
- B.
Aluminum hydroxide and magnesium hydroxide (Maalox or Mylanta)
- C.
Calcium carbonate (Tums)
- D.
Simethicone
Correct Answer
D. SimethiconeExplanation
Simethicone alters the elasticity of mucus-coated bubbles, causing them to break, and is an over-the-counter antiflatulent.Rate this question:
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- 7.
A 75-year-old woman comes into the clinic with the complaint of indigestion, stomach pain, and frequent belching. She tells the nurse that she has been taking sodium bicarbonate 5 or 6 times a day for the past 3 weeks. The nurse knows that which possible hazard exists with the use of sodium bicarbonate?
- A.
Constipation may occur with continuous use.
- B.
Metabolic acidosis may result from excessive use.
- C.
Metabolic alkalosis may result from excessive use.
- D.
It stimulates the stomach to secrete excess mucus.
Correct Answer
C. Metabolic alkalosis may result from excessive use.Explanation
Excessive use of sodium bicarbonate may lead to systemic alkalosis. The other options are not correct.Rate this question:
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- 8.
The physician has recommended 2 weeks of combination therapy with omeprazole and another drug for a patient diagnosed with a peptic ulcer caused by Helicobacter pylori. Which drug does the nurse expect will be the second drug ordered?
- A.
An antibiotic
- B.
A nonsteroidal antiinflammatory drug
- C.
An antacid
- D.
An antiemetic
Correct Answer
A. An antibioticExplanation
The antibiotic clarithromycin is active against H. pylori and is used in combination with omeprazole to eradicate the bacteria. First-line therapy against H. pylori includes a 10- to 14-day course of a proton pump inhibitor such as omeprazole plus the antibiotics clarithromycin and either amoxicillin or metronidazole or a combination of a proton pump inhibitor, bismuth subsalicylate, and the antibiotics tetracycline and metronidazole. Many different combinations are used.Rate this question:
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- 9.
A patient is asking advice about which over-the-counter antacid to choose. The nurse explains that calcium carbonate is not often used as an antacid because
- A.
Its use may result in kidney stones.
- B.
It causes decreased gastric acid production.
- C.
It often causes severe diarrhea.
- D.
It may result in fluid retention and edema.
Correct Answer
A. Its use may result in kidney stones.Explanation
Calcium carbonate is not often used because it may cause kidney stones; it also causes increased gastric acid production.Rate this question:
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- 10.
When the nurse is teaching a patient who is taking several medications, including twice-daily dosages of antacids, which instruction is correct?
- A.
The medications can be taken with the antacids.
- B.
The antacids should be taken at least 1 hour before or after the other medications.
- C.
The antacids should be taken at least 4 hours apart from the other medications.
- D.
The patient will not be able to take the antacid therapy at this time.
Correct Answer
B. The antacids should be taken at least 1 hour before or after the other medications.Explanation
It is recommended that antacids be given as ordered but not within 1 hour of other medications because of the effect of antacids on the absorption of oral medications.Rate this question:
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- 11.
During an admission assessment, the patient tells the nurse that he has been self-treating his heartburn for a year with over-the-counter antacids. The nurse is aware that this self-treatment may have which result?
- A.
No serious consequences
- B.
Prevention of more serious problems, such as an ulcer
- C.
Chronic constipation
- D.
Masked symptoms of serious underlying diseases
Correct Answer
D. Masked symptoms of serious underlying diseasesExplanation
Long-term self-medication with antacids may mask symptoms of serious underlying disease, such as bleeding ulcer or malignancy. Patients with ongoing symptoms should undergo regular medical evaluations, because additional medications or other interventions may be needed.Rate this question:
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- 12.
An elderly patient had gastric surgery a week ago, and he has been stable since the surgery. This evening, his daughter tells the nurse, “He seems to be more confused this afternoon. He’s never been like this. What could be the problem?” The nurse reviews the medication record and suspects that which drug could be the cause of the patient’s confusion?
- A.
Cimetidine (Tagamet)
- B.
Pantoprazole (Protonix)
- C.
Clarithromycin
- D.
Sucralfate (Carafate)
Correct Answer
A. Cimetidine (Tagamet)Explanation
Sometimes H2 receptor antagonists such as cimetidine may cause adverse effects related to the central nervous system in the elderly, including confusion and disorientation. The nurse should be alert for mental status changes when giving these drugs, especially if the changes are new to the patient.Rate this question:
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- 13.
The nurse is providing patient teaching about antacids. Which statements about antacids are true? Select all that apply.
- A.
Antacids prevent the overproduction of acid in the stomach.
- B.
Antacids neutralize acid in the stomach.
- C.
Antacids form a mucus barrier in the stomach.
- D.
Rebound hyperacidity may occur with calcium-based antacids.
- E.
Aluminum-based antacids cause diarrhea.
- F.
Magnesium-based antacids cause diarrhea.
Correct Answer(s)
B. Antacids neutralize acid in the stomach.
D. Rebound hyperacidity may occur with calcium-based antacids.
F. Magnesium-based antacids cause diarrhea.Explanation
Antacids neutralize acid in the stomach. Magnesium-based antacids cause diarrhea, and aluminum-based antacids cause constipation. Antacids generally should not be given with other drugs because antacids will alter their absorption. Calcium-based antacids often cause rebound hyperacidity.Rate this question:
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- 14.
The nurse is providing teaching to a patient who will be taking the laxative docusate (Bisocodyl). Which statement by the nurse is appropriate during this teaching session?
- A.
“The tablets may be crushed to improve action.”
- B.
“The tablets should be taken with water.”
- C.
“Do not take laxatives if you are experiencing vomiting or abdominal pain.”
- D.
“In a normal bowel pattern, a bowel movement occurs daily.”
Correct Answer
B. “The tablets should be taken with water.”Explanation
Docusate should be given with water only because interactions with milk and antacids may occur. All laxative tablets should be swallowed whole; a normal bowel pattern does not necessarily mean one bowel movement a day.Rate this question:
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- 15.
The nurse is giving oral mineral oil as an ordered laxative dose. The nurse will take measures to prevent which potential problem that may occur with mineral oil?
- A.
Fecal impaction
- B.
Constipation
- C.
Lipid pneumonia
- D.
Esophageal blockage
Correct Answer
C. Lipid pneumoniaExplanation
Lipid pneumonia may occur if the oral mineral oil is accidentally aspirated into the respiratory tract. The other options are not correct.Rate this question:
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- 16.
When administering a bulk-forming laxative, the nurse instructs the patient to drink the medication mixed in a full 8-ounce glass of water. Which statement best explains the rationale for this instruction?
- A.
There will be fewer systemic effects.
- B.
The water will help to reduce the bulk of the intestinal contents.
- C.
These laxatives may cause esophageal obstruction if taken with insufficient water.
- D.
The water acts as a lubricant to produce bowel movements.
Correct Answer
C. These laxatives may cause esophageal obstruction if taken with insufficient water.Explanation
Bulk-forming drugs increase water absorption, which results in greater total volume (bulk) of the intestinal contents. Bulk-forming laxatives tend to produce normal, formed stools. Their action is limited to the gastrointestinal tract, so there are few, if any, systemic effects. However, they should be taken with liberal amounts of water to prevent esophageal obstruction and fecal impaction.Rate this question:
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- 17.
A patient will be taking bismuth subsalicylate (Pepto-Bismol) to control his diarrhea. When reviewing the patient’s other ordered medications, the nurse recognizes that which medication will interact significantly with the Pepto-Bismol?
- A.
Digoxin (Lanoxin)
- B.
Antacids
- C.
Acetaminophen (Tylenol)
- D.
Tricyclic antidepressants
Correct Answer
A. Digoxin (Lanoxin)Explanation
Taking digoxin with an adsorbent such as bismuth subsalicylate may result in decreased absorption of the digoxin. The other options are not correct.Rate this question:
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- 18.
A patient is about to undergo a diagnostic bowel procedure. The nurse expects which drug to be used to induce total cleansing of the bowel?
- A.
Polyethylene glycol (GoLYTELY)
- B.
Docusate
- C.
Mineral oil
- D.
Milk of magnesia
Correct Answer
A. Polyethylene glycol (GoLYTELY)Explanation
Polyethylene glycol is a very potent laxative that induces total cleansing of the bowel and is most commonly used before diagnostic or surgical bowel procedures.Rate this question:
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- 19.
While recovering from surgery, a 74-year-old woman started taking a stimulant laxative, senna (Senokot), to relieve constipation caused by the pain medications. She tells the nurse that she likes how “regular” her bowel movements are now that she is taking the laxative. Which teaching principle is appropriate for this patient?
- A.
Use of a stimulant laxative will not affect the absorption of her other medications.
- B.
It is important to have a daily bowel movement to promote bowel health.
- C.
Long-term use of laxatives often results in decreased bowel tone and may lead to dependency.
- D.
She should switch to glycerin suppositories to continue having daily bowel movements.
Correct Answer
C. Long-term use of laxatives often results in decreased bowel tone and may lead to dependency.Explanation
Long-term use of laxatives or cathartics often results in decreased bowel tone and may lead to dependency. Patients should be taught that daily bowel movements are not necessary for bowel health.Rate this question:
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- 20.
The nurse knows that the major difference between diphenoxylate with atropine (Lomotil) and the over-the-counter drug loperamide (Imodium) is that
- A.
Lomotil acts faster.
- B.
Imodium does not cause physical dependence.
- C.
Lomotil is available as a parenteral form.
- D.
Imodium is a natural antidiarrheal drug.
Correct Answer
B. Imodium does not cause physical dependence.Explanation
Although the drug exhibits many characteristics of the opiate class, physical dependence on loperamide has not been reported. All antidiarrheal drugs are orally administered. The other options are not correct.Rate this question:
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- 21.
The patient asks advice about which type of laxative is safe to use while at home so as to prevent problems with constipation. The nurse explains that which class of laxative is considered safe to use on a long-term basis?
- A.
Emollient laxatives
- B.
Bulk-forming laxatives
- C.
Hyperosmotic laxatives
- D.
Stimulant laxatives
Correct Answer
B. Bulk-forming laxativesExplanation
Bulk-forming laxatives are the only laxatives recommended for long-term use. Stimulant laxatives are the most likely of all the laxative classes to cause dependence.Rate this question:
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- 22.
When administering mineral oil, the nurse recognizes that it can interfere with the absorption of which substance?
- A.
Vitamin A
- B.
Vitamin C
- C.
Iron
- D.
Potassium
Correct Answer
A. Vitamin AExplanation
Mineral oil can decrease the absorption of fat-soluble vitamins (A, D, E, and K). The other options are not correct.Rate this question:
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- 23.
The nurse is reviewing the mechanism of action of antidiarrheal drugs. Which type of antidiarrheal medication works by decreasing the intestinal muscle tone and peristalsis of the intestines?
- A.
Adsorbents such as Pepto-Bismol
- B.
Anticholinergics such as belladonna alkaloids
- C.
Intestinal flora modifiers such as Lactinex
- D.
Lubricants such as glycerin
Correct Answer
B. Anticholinergics such as belladonna alkaloidsExplanation
Anticholinergic drugs work to slow peristalsis by reducing the rhythmic contractions and the smooth muscle tone of the gastrointestinal tract.Rate this question:
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- 24.
The nurse is discussing the use of adsorbents such as bismuth subsalicylate (Pepto-Bismol) with a patient who has diarrhea. The nurse should warn the patient about which possible adverse effect?
- A.
Darkened stools
- B.
Urinary hesitancy
- C.
Drowsiness
- D.
Blurred vision
Correct Answer
A. Darkened stoolsExplanation
Darkened stools are one of the possible adverse effects of bismuth subsalicylate (see Table 51-2). The other adverse effects listed may occur with the use of anticholinergic drugs.Rate this question:
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- 25.
A patient who has been on antibiotic therapy for 2 weeks has developed persistent diarrhea. The nurse expects which medication to be ordered to treat this diarrhea?
- A.
Mineral oil
- B.
Adsorbents such as Pepto-Bismol
- C.
Anticholinergics such as belladonna alkaloids
- D.
Intestinal flora modifiers such as Lactinex
Correct Answer
D. Intestinal flora modifiers such as LactinexExplanation
Intestinal flora modifiers work by exogenously replenishing bacteria that may have been destroyed by antibiotic therapy, thus restoring the balance of normal flora and suppressing the growth of diarrhea-causing bacteria.Rate this question:
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- 26.
A patient will be taking bismuth subsalicylate (Pepto-Bismol) to control his diarrhea. When reviewing the patient’s other ordered medications, the nurse recognizes that which medication will interact significantly with the Pepto-Bismol?
- A.
Acetaminophen (Tylenol)
- B.
Thyroid replacement drugs
- C.
Warfarin (Coumadin)
- D.
Antidepressants
Correct Answer
C. Warfarin (Coumadin)Explanation
The oral anticoagulant warfarin is more likely to cause increased bleeding times or bruising when coadministered with adsorbents. This is thought to be because the adsorbents bind to vitamin K, which is needed to make certain clotting factors. Vitamin K is synthesized by the normal bacterial flora in the bowel.Rate this question:
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- 27.
A laxative has been ordered for a patient. The nurse checks the patient’s medical history, knowing that this medication is contraindicated with which condition?
- A.
High ammonia levels due to liver failure
- B.
Diverticulosis
- C.
Abdominal pain of unknown origin
- D.
Chronic constipation.
Correct Answer
C. Abdominal pain of unknown originExplanation
Laxatives should not be used, or should be used cautiously, in the presence of the following: acute surgical abdomen; appendicitis symptoms, such as abdominal pain, nausea, and vomiting; fecal impaction (mineral oil enemas excepted); intestinal obstruction; and undiagnosed abdominal pain. The other options are possible indications for laxatives.Rate this question:
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- 28.
A patient is severely constipated and needs immediate relief. The nurse knows that which type of laxative will provide the most rapid results?
- A.
Bulk-forming laxative, such as psyllium (Metamucil)
- B.
Stool softener, such as docusate salts (Colace)
- C.
Magnesium hydroxide (MOM)
- D.
Magnesium oxide tablets
Correct Answer
C. Magnesium hydroxide (MOM)Explanation
Saline laxatives such as magnesium hydroxide (MOM) produce a watery stool, usually within 3 to 6 hours of ingestion. Bulk-forming laxatives such as psyllium do not produce a bowel movement rapidly. Stool softeners such as docusate salts do not cause patients to defecate, they simply soften the stool to ease its passage. Magnesium oxide tablets are used as magnesium supplements, not as laxatives.Rate this question:
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- 29.
A patient is receiving lactulose (Chronulac) three times a day. The nurse knows that the patient is not constipated and is receiving this drug for which reason?
- A.
High ammonia levels due to liver failure
- B.
Preparation for bowel surgery
- C.
Abdominal pain of unknown origin
- D.
Chronic diarrhea
Correct Answer
A. High ammonia levels due to liver failureExplanation
Lactulose (Chronulac) is a synthetic derivative of the natural sugar lactose, which is not digested in the stomach or absorbed in the small bowel. Instead, it passes unchanged into the large intestine, where it is metabolized. Colonic bacteria digest lactulose to produce lactic acid, formic acid, and acetic acid, which create a hyperosmotic environment that draws water into the colon and produces a laxative effect. This drug-induced acidic environment also reduces blood ammonia levels by converting ammonia to ammonium. Ammonium is a water-soluble cation that is trapped in the intestines and cannot be reabsorbed into the systemic circulation. This effect has proved helpful in reducing elevated serum ammonia levels in patients with severe liver disease.Rate this question:
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- 30.
The nurse notes that a patient is taking tegaserod (Zelnorm) to treat irritable bowel syndrome (IBS). The nurse will monitor the patient for which adverse effect?
- A.
Chest pain
- B.
Dyspnea
- C.
Abdominal cramps
- D.
Chronic constipation
Correct Answer
A. Chest painExplanation
Tegaserod (Zelnorm) has been associated with serious adverse effects, including angina, heart attacks, and stroke. Abdominal cramps and chronic constipation are symptoms of irritable bowel disease. Dyspnea is not an adverse effect of tegaserod.Rate this question:
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- 31.
The nurse is considering the uses of oral laxatives. Which conditions are general contraindications to or cautions about the use of oral laxatives? Select all that apply.
- A.
Irritable bowel syndrome
- B.
Abdominal pain of unknown origin
- C.
Nausea and vomiting
- D.
Fecal impactions
- E.
Ingestion of toxic substances
- F.
Acute surgical abdomen
Correct Answer(s)
B. Abdominal pain of unknown origin
C. Nausea and vomiting
D. Fecal impactions
F. Acute surgical abdomenExplanation
Cautious use of laxatives is recommended in the presence of the following: acute surgical abdomen; appendicitis symptoms, such as abdominal pain, nausea, and vomiting; intestinal obstruction; and undiagnosed abdominal pain. Oral laxatives should not be used with fecal impactions; mineral oil enemas are indicated for fecal impactions. The other options are indications for laxative use.Rate this question:
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- 32.
A patient is receiving a tube feeding through a gastrostomy. The nurse expects that which type of drug will be used to promote gastric emptying for this patient?
- A.
Prokinetic drugs
- B.
Serotonin blockers
- C.
Anticholinergic drugs
- D.
Neuroleptic drugs
Correct Answer
A. Prokinetic drugsExplanation
Prokinetic drugs promote the movement of substances through the gastrointestinal tract and increase gastrointestinal motility.Rate this question:
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- 33.
A patient who has AIDS has lost weight and is easily fatigued because of his malnourished state. The nurse anticipates using which antinausea drug to stimulate his appetite?
- A.
Aprepitant (Emend), a substance P/NK1 receptor antagonist
- B.
Dronabinol (Marinol), a tetrahydrocannabinoid
- C.
Ondansetron (Zofran), a serotonin blocker
- D.
Metoclopramide (Reglan), a prokinetic drug
Correct Answer
B. Dronabinol (Marinol), a tetrahydrocannabinoidExplanation
Dronabinol is used for the treatment of nausea and vomiting associated with cancer chemotherapy, generally as a second-line drug after treatment with other antiemetics has failed. It is also used to stimulate appetite and weight gain in patients with AIDS and in patients undergoing chemotherapy. The drugs in the other options are used to reduce or prevent nausea and vomiting but are not used to stimulate appetite.Rate this question:
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- 34.
A patient on chemotherapy is using ondansetron (Zofran) for treatment of nausea. The nurse will instruct the patient to watch for which adverse effect of this drug?
- A.
Dizziness
- B.
Headache
- C.
Dry mouth
- D.
Blurred vision
Correct Answer
B. HeadacheExplanation
Headache is an adverse effect of the serotonin blockers. The other adverse effects listed may occur with anticholinergic drugs.Rate this question:
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- 35.
A patient who has severe nausea and vomiting following a case of food poisoning comes to the clinic. When reviewing his medication history, the nurse notes that he has an allergy to procainamide. The nurse would question an order for which antiemetic drug if ordered for this patient?
- A.
Metoclopramide (Reglan)
- B.
Promethazine (Phenergan)
- C.
Phosphorated carbohydrate solution (Emetrol)
- D.
Granisetron (Kytril)
Correct Answer
B. Promethazine (Phenergan)Explanation
The use of metoclopramide (Reglan) is contraindicated in patients with a hypersensitivity to procaine or procainamide. There are no known interactions with the drugs listed in the other options.Rate this question:
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- 36.
A mother calls the pediatrician’s office to report that her 18-month-old-child has eaten half of a bottle of baby aspirin. She says, “I have a bottle of syrup of ipecac. Should I give it to him? He seems fine right now. What do I do?” What is the nurse’s best response?
- A.
“Go ahead and give him the ipecac, then call 911.”
- B.
“Don’t give him the ipecac, but call the Poison Control number immediately for instructions.”
- C.
“Please come to the office right away so that we can check him.”
- D.
“Call 911 now and wait for them to come.”
Correct Answer
B. “Don’t give him the ipecac, but call the Poison Control number immediately for instructions.”Explanation
The American Academy of Pediatrics no longer recommends use of syrup of ipecac for home treatment for poisoning. Instructions state that if the poison has been ingested, first call the national poison control hotline at 800-222-1222. In all cases of poisoning, if the victim is conscious and alert, call the local poison control center. If the victim has collapsed or stopped breathing, call 911 for emergency transport to a hospital.Rate this question:
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- 37.
A patient is taking chemotherapy with a drug that has a high potential for causing nausea and vomiting. The nurse is preparing to administer an antiemetic drug. Which class of antiemetic drugs has proven most effective in preventing nausea and vomiting for patients receiving chemotherapy?
- A.
Prokinetic drugs
- B.
Serotonin blockers
- C.
Antihistamines
- D.
Anticholinergic drugs
Correct Answer
B. Serotonin blockersExplanation
Serotonin blockers have proven to be very effective in preventing chemotherapy-induced and postoperative nausea and vomiting.Rate this question:
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- 38.
A patient who has been newly diagnosed with vertigo will be taking an antihistamine antiemetic drug. The nurse will include which information when teaching the patient about this drug?
- A.
Doses may be skipped if she is feeling well.
- B.
The patient should avoid driving because of possible drowsiness.
- C.
The patient may experience transient taste problems.
- D.
It is safe to take it with a glass of wine in the evening to help settle her stomach.
Correct Answer
B. The patient should avoid driving because of possible drowsiness.Explanation
Drowsiness may occur because of central nervous system (CNS) depression, and patients should avoid driving or working with heavy machinery because of possible sedation. These drugs should not be taken with alcohol or other CNS depressants because of possible additive depressant effects. The medication should be taken as instructed and not skipped.Rate this question:
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- 39.
A patient with motion sickness is planning a cross-country car trip to attend a family reunion. He has a prescription for a scopolamine transdermal patch. The nurse should instruct the patient that the patch should be changed
- A.
Every day.
- B.
Every other day.
- C.
Every 3 days.
- D.
Only if it stops working.
Correct Answer
C. Every 3 days.Explanation
Scopolamine patches are 72-hour doses and should be changed every 3 days.Rate this question:
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- 40.
A woman who is in the first trimester of pregnancy has been experiencing severe morning sickness. She asks, “I’ve heard that ginger tablets may be a natural way to ease the nausea and vomiting. Is it okay to try them?” What is the nurse’s best response?
- A.
“They are a great natural remedy for nausea when you are pregnant.”
- B.
“Go ahead and try them, but stop taking them once the nausea is relieved.”
- C.
“Some health care providers do not recommend ginger during pregnancy. Let’s check with your doctor.”
- D.
“Wait until you are in your second trimester, then try them. They may be more effective then.”
Correct Answer
C. “Some health care providers do not recommend ginger during pregnancy. Let’s check with your doctor.”Explanation
There is some anecdotal evidence that ginger may have abortifacient properties, and for that reason some clinicians do not recommend its use during pregnancy.Rate this question:
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- 41.
A patient is on a chemotherapy regimen in an outpatient clinic and is receiving a drug that is known to be highly emetogenic. The nurse will implement which interventions regarding the pharmacologic management of nausea and vomiting? Select all that apply.
- A.
Giving antinausea drugs when beginning the chemotherapy infusion
- B.
Administering antinausea drugs 30 to 60 minutes before chemotherapy is started
- C.
For best therapeutic effects, medicating for nausea once the symptoms begin
- D.
Observing carefully for the adverse effects of restlessness and anxiety
- E.
Instructing the patient that the antinausea drugs may cause extreme drowsiness
- F.
Instructing the patient to rise slowly from a sitting or lying position because of possible orthostatic hypotension
Correct Answer(s)
B. Administering antinausea drugs 30 to 60 minutes before chemotherapy is started
E. Instructing the patient that the antinausea drugs may cause extreme drowsiness
F. Instructing the patient to rise slowly from a sitting or lying position because of possible orthostatic hypotensionExplanation
Antiemetics should be given before any chemotherapy drug is administered, often 30 to 60 minutes before treatment, but not immediately before chemotherapy is administered. Do not wait until the nausea begins. Most antiemetics cause drowsiness, and taking them with alcohol may increase central nervous system depression. Orthostatic hypotension is a possible adverse effect that may lead to injury.Rate this question:
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- 42.
An adult patient is about to receive intravenous (IV) ondanestron (Zofran) during a chemotherapy treatment. A dose of 0.15 mg/kg IV30 minutes before chemotherapy is ordered. The patient weighs 150 pounds. The medication is supplied in a vial marked 2 mg/mL for IV administration. How many milliliters will the nurse administer for this dose? Round answer to the nearest tenth.
Correct Answer(s)
5.1 mLExplanation
Convert pounds to kilograms: 150 2.2 = 68.18 kg
Calculate mg per dose: 0.15 mg/kg 68.18 kg = 10.23 = 10.23 mg dose
Calculate mL to be given:
2 mg : 1 mL :: 10.23 mg : x mL
(2 x) = (1 10.23); 2x = 10.23; x = 5.115 = 5.1 mLRate this question:
- 43.
The nurse is reviewing conditions caused by nutrient deficiencies. Conditions such as infantile rickets, tetany, and osteomalacia are caused by a deficiency in which vitamin or mineral?
- A.
Vitamin D
- B.
Vitamin K
- C.
Magnesium
- D.
Cyanocobalamin (vitamin B12)
Correct Answer
A. Vitamin DExplanation
Infantile rickets, tetany, and osteomalacia are all a result of long-term vitamin D deficiency. The other options are incorrect.Rate this question:
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- 44.
The nurse is preparing a plan of care for a patient undergoing therapy with vitamin A. Which nursing diagnosis is appropriate for this patient?
- A.
Risk for impaired skin integrity related to vitamin deficiency
- B.
Disturbed sensory perception (visual) related to night blindness caused by vitamin deficiency
- C.
Impaired physical mobility (muscle weakness) related to vitamin deficiency
- D.
Disturbed thought processes (confusion and psychosis) related to vitamin deficiency
Correct Answer
B. Disturbed sensory perception (visual) related to night blindness caused by vitamin deficiencyExplanation
Vitamin A deficiency causes night blindness, so disturbed sensory perception is an appropriate nursing diagnosis. The other nursing diagnoses are not appropriate for patients receiving vitamin A.Rate this question:
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- 45.
The nurse will monitor for which signs of toxicity when a patient is on vitamin D supplemental therapy?
- A.
Urticaria
- B.
Anorexia
- C.
Diarrhea
- D.
Tinnitus
Correct Answer
B. AnorexiaExplanation
Anorexia is a sign of vitamin D toxicity. The others listed are not.Rate this question:
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- 46.
When counseling a patient about calcium supplements, the nurse should include which dietary information?
- A.
Oral calcium supplements should be taken with meals.
- B.
Calcium products bind with tetracyclines and thus increase their effects.
- C.
Foods high in calcium include beef, egg yolks, and liver.
- D.
Foods high in calcium include dairy products and salmon.
Correct Answer
D. Foods high in calcium include dairy products and salmon.Explanation
Calcium products bind with tetracyclines, resulting in decreased effects of tetracyclines. Foods high in calcium include dairy products, fortified cereals, calcium-fortified orange juice, sardines, and salmon. Oral-dosage forms of calcium should be given 1 to 3 hours after meals.Rate this question:
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- 47.
The nurse is administering intravenous calcium and will administer it slowly to avoid which adverse effect?
- A.
Ototoxicity
- B.
Cardiac arrest
- C.
Nephrotoxicity
- D.
Respiratory arrest
Correct Answer
B. Cardiac arrestExplanation
Giving intravenous calcium too rapidly may precipitate cardiac irregularities or cardiac arrest; therefore, it must be administered slowly, as ordered, and within the manufacturer’s guidelines (e.g., usually less than 1 mL/min). The other options are not correct.Rate this question:
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- 48.
The nurse will prepare to give which preparation to a newborn upon arrival in the nursery after delivery?
- A.
Vitamin B3 (niacin)
- B.
Vitamin D (calciferol)
- C.
Vitamin A (Aquasol A)
- D.
Vitamin K (AquaMEPHYTON)
Correct Answer
D. Vitamin K (AquaMEPHYTON)Explanation
Deficiency in vitamin K can be seen in newborns because of malabsorption attributed to inadequate amounts of bile. AquaMEPHYTON is given as a single intramuscular dose for infants upon arrival in the nursery.Rate this question:
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- 49.
A patient with a history of alcohol abuse has been admitted for severe weakness and malnutrition. The nurse will prepare to administer which vitamin preparation to prevent Wernicke’s encephalopathy?
- A.
Vitamin B3 (niacin)
- B.
Vitamin B1 (thiamine)
- C.
Vitamin B2 (riboflavin)
- D.
Vitamin B6 (pyridoxine)
Correct Answer
B. Vitamin B1 (thiamine)Explanation
Thiamine is necessary for the treatment of a variety of thiamine deficiencies, including Wernicke’s encephalopathy.Rate this question:
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- 50.
Niacin is prescribed for a patient who has hyperlipidemia. The nurse checks the patient’s medical history, knowing this medication is contraindicated in which disorder?
- A.
Renal disease
- B.
Cardiac disease
- C.
Liver disease
- D.
Thyroid disease
Correct Answer
C. Liver diseaseExplanation
Niacin, unlike certain other B-complex vitamins, has additional contraindications besides drug allergy. They include liver disease, severe hypotension, arterial hemorrhage, and active peptic ulcer disease. The other options are not correct.Rate this question:
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Feb 21, 2012Quiz Edited by
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Feb 17, 2012Quiz Created by
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