Nokea
A client with a nasogastric tube is prescribed therapy to prevent ulcer development. Which of the following would be the best option for the drug?
- A. Tablet that can be crushed
- B. Liquid formulation
- C. Intravenous administration
- D. Intramuscular injection
Correct Answer: B
Rationale: The nurse should request the liquid form when administration is in a tube to decrease the chance of a clogged NG tube. Although it is appropriate to crush the tablet and mix it with apple juice, there is still a risk for clogging. Intravenous or intramuscular administration would be inappropriate. The IV route is typically preferred if the patient has an existing IV line, because these drugs are irritating, and IM injections need to be given deep into the muscular tissue to minimize harm.
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A client is receiving an antiemetic. The nurse identifies a nursing diagnosis of Imbalanced Nutrition: Less Than Body Requirements? Which of the following would the nurse include in the client's plan of care?
- A. Remove items with strong smells and odors.
- B. Use mouthwash or frequent oral rinses.
- C. Make the environment as pleasant as possible.
- D. Explain that the drug may change the color of the stool.
- E. Follow the medication with a small amount of water.
Correct Answer: A,B,C
Rationale: When caring for a client receiving an antiemetic with a nursing diagnosis of Imbalanced Nutrition: Less Than Body Requirements, the nurse makes the environment as pleasant as possible to enhance the client's appetite and removes items with strong smells and odors. The nurse gives the client mouthwash or frequent oral rinses to remove the disagreeable taste that accompanies vomiting. Stool color is unaffected. Liquid antacids could be followed with a small amount of water.
A nurse in a health care facility is caring for a client who is receiving an antiemetic to control vomiting related to chemotherapy. Which of the following nursing diagnoses should the care plan for this client include?
- A. Risk for Imbalanced Fluid Volume
- B. Disturbed Sensory Perception
- C. Impaired Physical Mobility
- D. Ineffective Tissue Perfusion
Correct Answer: A
Rationale: The care plan should include Risk for Imbalanced Fluid Volume for the client receiving an antiemetic due to the possible fluid losses associated with vomiting as well as the possible decrease in fluid intake. Disturbed sensory perception, impaired physical mobility, and ineffective tissue perfusion are not applicable.
The nurse should administer which of the following medications cautiously to clients with vitamin B12 deficiency as the prolonged use of these drugs decreases the body's ability to absorb vitamin B12?
- A. Metoclopramide (Reglan)
- B. Rabeprazole (AcipHex)
- C. Sucralfate (Carafate)
- D. Pantoprazole (Protonix)
- E. Promethazine (Phenergan)
Correct Answer: B,D
Rationale: The nurse should administer proton pump inhibitors, like rabeprazole (AcipHex) and pantoprazole (Protonix), cautiously to clients with vitamin B12 deficiency as the prolonged use of these drugs decreases the body's ability to absorb vitamin B12.
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.
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.