Nokea
A nurse is administering glycopyrrolate to a client with a peptic ulcer. The nurse would assess the client for which of the following as a possible GI system adverse reaction?
- A. Diarrhea
- B. Dry mouth
- C. Constipation
- D. Nausea
- E. Dysphagia
Correct Answer: B,C,D,E
Rationale: A nurse administering glycopyrrolate to a client with a peptic ulcer should monitor the client for dry mouth, nausea, vomiting, constipation, and dysphagia.
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After administering a cholinergic blocking drug to a client, assessment of which of the following would lead the nurse to suspect that the client is experiencing a visual adverse reaction to the drug?
- A. Miosis
- B. Photophobia
- C. Mydriasis
- D. Diplopia
- E. Cycloplegia
Correct Answer: B,C,E
Rationale: Possible adverse effects include blurred vision, mydriasis, photophobia, cycloplegia, and increased ocular tension.
A client with an overactive bladder has been prescribed solifenacin by the physician. The client is also taking digoxin for the treatment of a cardiac condition. The nurse should monitor the client for an increase in which of the following resulting from the interaction of these two drugs?
- A. Increased neuromuscular blocking effect
- B. Increased effectiveness of digoxin
- C. Increased serum levels of digoxin
- D. Increased effectiveness of solifenacin
Correct Answer: C
Rationale: The nurse should monitor for increased serum levels of digoxin that occur due to the interaction of solifenacin and digoxin.
A nurse identifies a nursing diagnosis of Constipation related to the effects of the prescribed cholinergic blocking drug. Which of the following would the nurse expect to include in the client's plan of care?
- A. Encuring the intake of a diet high in fiber.
- B. Decreasing the dosage of the cholinergic blocking medication
- C. Increasing client's fluid intake to at least 2000 mL daily
- D. Withholding the drug until the client resumes usual bowel pattern
- E. Encouraging ambulation and exercise as appropriate
Correct Answer: A,C,E
Rationale: Appropriate interventions include encouraging a high-fiber diet, increasing fluid intake, and encouraging ambulation and exercise. It is not the nurse's decision to decrease the dosage. Withholding the drug until the client's bowel patterns return would be inappropriate.
A nurse is assigned to care for a client with biliary colic in a health care facility. The client has been prescribed atropine. The nurse reviews the client's medical record and determines that the client should not receive this drug because the client has a history of which of the following?
- A. Hepatic disease
- B. Benign prostatic hypertrophy
- C. Myocardial infarction
- D. Urinary retention
Correct Answer: C
Rationale: The nurse should know that the use of atropine is contraindicated in clients with myocardial infarction. Other contraindications include myasthenia gravis, tachyarrhythmia, and congestive heart failure (unless bradycardia is present).
A nurse is caring for a client admitted to the health care facility. The client is receiving a cholinergic blocking drug as treatment for bladder overactivity. Which intervention would be most appropriate for the nurse to include as part of the client's ongoing assessment?
- A. Assessment of the client's medical history
- B. Evaluation of symptoms related to the client's diagnosis
- C. Monitoring of the client's vital signs every 24 hours
- D. Observation for behavioral changes in the client
Correct Answer: B
Rationale: The nurse should evaluate the symptoms and complaints related to the client's diagnosis during the ongoing assessment of the treatment.