Nokea
A nurse follows a specific protocol when administering which of the following medications to prevent nausea induced by doxorubicin (Adriamycin) administration?
- A. Lansoprazole (Prevacid)
- B. Ondansetron (Zofran)
- C. Metoclopramide (Reglan)
- D. Promethazine (Phenergan)
- E. Granisetron (Kytril)
Correct Answer: B,E
Rationale: 5-HT3 receptor antagonists, like ondansetron (Zofran) and granisetron (Kytril), are used in the prevention of chemotherapy-induced nausea and vomiting.
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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.
A nurse is teaching a client who is prescribed metoclopramide about signs and symptoms to report to the primary health care provider. The nurse determines that the teaching was successful when the client states which of the following?
- A. Difficulty swallowing
- B. Uncontrolled tongue movements
- C. Muscle laxity
- D. Shuffling gait
- E. Diarrhea
Correct Answer: A,B,D
Rationale: When taking metoclopramide, the client should immediately report any of the following signs: difficulty speaking or swallowing; mask-like face; shuffling gait; rigidity; tremors; uncontrolled movements of the mouth, face, or extremities; and uncontrolled chewing or unusual movements of the tongue. Diarrhea does not require the client to notify the health care provider.
A group of nursing students are reviewing information about upper gastrointestinal system drugs. The students demonstrate understanding of the material when they identify which of the following as a proton pump inhibitor?
- A. Nizatidine
- B. Omeprazole
- C. Esomeprazole
- D. Sucralfate
- E. Misoprostol
Correct Answer: B,C
Rationale: Omeprazole and esomeprazole are examples of proton pump inhibitors. Nizatidine is a histamine-2 receptor antagonist. Sucralfate and misoprostol are examples of miscellaneous acid reducers.
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 nurse educating a client on the antacid magnesium oxide (Mag-Ox) should warn the client of which of the following adverse reactions?
- A. Tremors
- B. Anorexia
- C. Diarrhea
- D. Dehydration
- E. Hypotension
Correct Answer: C,D,E
Rationale: Adverse reactions of magnesium oxide (Mag-Ox) include severe diarrhea, dehydration, and hypermagnesemia (nausea, vomiting, hypotension, and decreased respirations).