Nokea
A 30-year-old nonpregnant client is prescribed misoprostol. Which of the following should the nurse instruct the client as part of the teaching plan?
- A. Swallow the tablet 1 hour before eating.
- B. Administer the drug 1 hour before travel.
- C. Do not chew, open, or crush the tablet.
- D. Use a reliable contraceptive method.
Correct Answer: D
Rationale: The nurse should instruct the client to use a reliable contraceptive method to avoid pregnancy during the course of treatment as it can cause spontaneous abortion. The nurse should instruct the client taking proton pump inhibitors not to chew, open, or crush the tablet and to swallow the tablet whole at least 1 hour before eating. The nurse needs to inform the client taking a drug for motion sickness to administer it about 1 hour before travel.
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A nurse educating a client on the antacid aluminum hydroxide (ALternaGEL) should warn the client about which of the following adverse reactions?
- A. Alopecia
- B. Anorexia
- C. Diarrhea
- D. Tremors
- E. Bone pain
Correct Answer: B,D,E
Rationale: Adverse reactions of aluminum hydroxide (ALternaGEL) include constipation, intestinal impaction, anorexia, weakness, tremors, and bone pain.
A nurse is caring for an elderly client who has received cimetidine. Which of the following interventions should the nurse perform?
- A. Monitor the client for complaints of pain or sour taste.
- B. Monitor the client for concentrated urine and restlessness.
- C. Closely monitor the client for confusion and dizziness.
- D. Report symptoms of tardive dyskinesia to the primary health care provider.
Correct Answer: C
Rationale: The nurse should closely monitor the elderly client who has been administered cimetidine for confusion and dizziness. When the client is receiving an antiemetic, the nurse monitors the client frequently for continued complaints of pain, sour taste, spitting blood, or coffee-ground-colored emesis. When antacids are given to the client, the nurse should observe the client for concentrated urine and restlessness. When the client is administered prolonged doses of metoclopramide, the nurse reports any sign of tardive dyskinesia or extrapyramidal symptoms to the primary health care provider.
When describing the action of which drug would the nurse explain that it works to reduce gastric motility and decrease the amount of acid secreted by the stomach via blockade of cholinergic receptors?
- A. Omeprazole (Prilosec)
- B. Ranitidine (Zantac)
- C. Propantheline (Pro-Banthine)
- D. Sucralfate (Carafate)
- E. Glycopyrrolate (Robinul)
Correct Answer: C,E
Rationale: Propantheline (Pro-Banthine) and glycopyrrolate (Robinul) are anticholinergic drugs used to reduce gastric motility and decrease the amount of acid secreted by the stomach via blockade of cholinergic receptors.
A nurse is conducting a class for a community group. As part of the class, the nurse is explaining the use of syrup of ipecac. The nurse would emphasize that this drug is contraindicated in which of the following cases?
- A. The client is comatose or has altered mental status.
- B. The client has erosive esophagitis.
- C. The client is having seizures.
- D. The substance is a caustic or corrosive agent.
- E. The substance is a low-viscosity petroleum distillate.
Correct Answer: A,C,D,E
Rationale: The use of syrup of ipecac is contraindicated in the following cases: the client is comatose or has altered mental status, the client is having seizures, the substance is a caustic or corrosive agent, the substance is a low-viscosity petroleum distillate, or the substance is capable of also altered mental status or convulsions.
A nurse should monitor a client taking which of the following drugs for increased adverse effects and toxicity if omeprazole (Prilosec) therapy is initiated?
- A. Phenobarbital (Luminal)
- B. Digoxin (Lanoxin)
- C. Diazepam (Valium)
- D. Warfarin (Coumadin)
- E. Ketoconazole (Nizoral)
Correct Answer: B,C,D
Rationale: The initiation of proton pump inhibitors, like omeprazole (Prilosec), can result in increased adverse reactions and toxicities of warfarin (Coumadin), benzodiazepines (diazepam), digoxin (Lanoxin), phenytoin (Dilantin), and clarithromycin (Biaxin).