Nokea
A client is prescribed ranitidine. A review of the client's medication history reveals that she also takes warfarin for treatment of deep vein thrombosis. The nurse would monitor the client for which of the following?
- A. Decreased white blood cell count
- B. Increased risk of respiratory depression
- C. Increased risk for bleeding
- D. Decreased seizure threshold
Correct Answer: C
Rationale: Histamine-2 receptor antagonists when given with warfarin place the client at an increased risk for bleeding. A decreased white blood cell count occurs when histamine-2 receptor antagonists are given with carmustine. An increased risk of respiratory depression occurs when histamine-2 receptor antagonists are given with opioid analgesics. This class of drugs does not interact with any antiseizure medications.
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After teaching a group of nursing students about upper gastrointestinal system drugs, the instructor determines that the teaching was successful when the students identify which of the following as a gastrointestinal stimulant?
- A. Ranitidine (Zantac)
- B. Misoprostol (Cytotec)
- C. Omeprazole (Prilosec)
- D. Metoclopramide (Reglan)
Correct Answer: D
Rationale: Metoclopramide (Reglan) is classified as a gastrointestinal stimulant. Ranitidine is a histamine-2 receptor antagonist. Omeprazole is a proton pump inhibitor. Misoprostol is a miscellaneous acid reducer.
A nurse educating a client on the antacid calcium carbonate (Mylanta) should warn the client of which of the following adverse reactions?
- A. Rebound hyperacidity
- B. Anorexia
- C. Headache
- D. Dehydration
- E. Confusion
Correct Answer: A,C,E
Rationale: Adverse reactions of calcium carbonate (Mylanta) include rebound hyperacidity, metabolic alkalosis, hypercalcemia, vomiting, confusion, headache, renal calculi, and neurologic impairment.
A nurse is caring for a client brought to the health care facility for a drug overdose. In which of the following cases can the client be administered an emetic?
- A. Client's mental status is intact.
- B. Client has an existing condition of severe hypertension.
- C. Client has a medical history of convulsions.
- D. Client has an existing condition of hemorrhagic diathesis.
Correct Answer: A
Rationale: The client can be administered an emetic only if the client does not have an altered mental status or is not comatose. A client who is comatose has an increased risk of aspiration of stomach contents. Clients with an existing condition of severe hypertension, a medical history of convulsions, or an existing condition of hemorrhagic diathesis should not be given an emetic as these conditions may be exacerbated by vomiting.
A client is diagnosed with an infection with H. pylori. Which of the following drugs are commonly used in combination with certain antibiotics in the treatment of this infection?
- A. Metoclopramide (Reglan)
- B. Omeprazole (Prilosec)
- C. Ondansetron (Zofran)
- D. Lansoprazole (Prevacid)
- E. Promethazine (Phenergan)
Correct Answer: B,D
Rationale: The proton pump inhibitors, like omeprazole (Prilosec) and lansoprazole (Prevacid), are commonly used in combination with certain antibiotics in the treatment of H. pylori.
Which of the following antacids may produce constipation and should be used cautiously in clients who have chronic constipation?
- A. Calcium carbonate (Mylanta)
- B. Magnesium hydroxide (Milk of Magnesia)
- C. Magnesium oxide (Mag-Ox)
- D. Aluminum hydroxide (ALternaGEL)
- E. Sodium bicarbonate (Bell/ans)
Correct Answer: A,D
Rationale: The aluminum- and calcium-containing antacids may produce constipation. Magnesium- and sodium-containing antacids tend to have a laxative effect.