Nokea
A client with peptic ulcer disease from chronic nonsteroidal anti-inflammatory drug (NSAID) use is prescribed misoprostol. The nurse would be correct in informing the client that this medication does which of the following?
- A. Decreases gas formation
- B. Increases the speed of gastric emptying
- C. Lines the stomach for protection
- D. Increases the lower esophageal sphincter pressure
Correct Answer: C
Rationale: Misoprostol (C) protects the stomach by increasing mucus production and reducing acid secretion, helping to heal NSAID-induced ulcers.
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A nurse is caring for a client who is admitted to the emergency department with an acetaminophen overdose. The primary action of N-acetylcysteine in the treatment of acetaminophen overdose is
- A. Inhibition of hepatic enzymes
- B. Binding to acetaminophen metabolites
- C. Enhancement of renal excretion
- D. Stimulation of hepatic regeneration
Correct Answer: B
Rationale: N-acetylcysteine replenishes glutathione, which binds to toxic acetaminophen metabolites, preventing liver damage. It does not inhibit enzymes, enhance renal excretion, or stimulate regeneration directly.
The nurse assesses a client receiving total parenteral nutrition (TPN) and fat emulsions. The nurse observes that the fat emulsion infusion is one hour behind schedule. The nurse should take which action?
- A. Adjust the infusion rate to make up the difference over the next hour, then revert the infusion rate back to the prescribed rate.
- B. Increase the infusion rate to ensure that the infusion finishes at the correct time.
- C. Ensure the fat emulsion infusion rate is infusing at the prescribed rate and maintain the rate at the prescribed rate.
- D. Stop the infusion and inform the primary health care provider (PHCP).
Correct Answer: C
Rationale: Fat emulsions must be infused at a steady, prescribed rate to prevent complications like fat overload syndrome. Adjusting or increasing the rate can be dangerous, and stopping the infusion is unnecessary unless there’s a specific issue.
The nurse is preparing a client for a scheduled colonoscopy. Which prescription should the nurse anticipate from the primary healthcare provider (PHCP) while the client is preparing for this procedure?
- A. Docusate
- B. Loperamide
- C. Polyethylene glycol 3350
- D. Famotidine
Correct Answer: C
Rationale: Polyethylene glycol 3350 is a bowel preparation agent used to clear the colon for a colonoscopy. Docusate softens stool but is insufficient for prep, loperamide slows motility, and famotidine reduces acid but is not for bowel prep.
The nurse is teaching a client about the newly prescribed medication, esomeprazole. Which statements, if made by the client, would require further teaching? Select all that apply.
- A. I should take this medication with meals.
- B. Long term use of this medication may increase my risk for osteoporosis.
- C. The medication will coat my ulcer so I can eat without pain.
- D. I will need frequent laboratory tests while taking this medication.
- E. I may need to take magnesium supplements while on this medication.
Correct Answer: A,C,D
Rationale: Esomeprazole should be taken before meals, not with them; it reduces acid but does not coat ulcers; and routine lab tests are not typically required. Osteoporosis risk and magnesium supplementation are valid concerns.
The nurse is screening individuals at risk for gastric cancer. It would be appropriate for the nurse to identify which of the following as a risk factor for gastric cancer?
- A. Irritable bowel syndrome
- B. Duodenal ulcer
- C. Chronic gastritis
- D. Sickle cell anemia
Correct Answer: C
Rationale: Chronic gastritis (C), often caused by H. pylori, is a known risk factor for gastric cancer. The other options are not directly associated.