Nokea
A nurse is caring for a client who has been prescribed aluminum carbonate gel (Basaljel) for the relief of an acute peptic ulcer. Which of the following interventions should the nurse perform to promote an optimal response to therapy?
- A. Administer the drug hourly for the first 2 weeks.
- B. Administer the drug early in the morning before breakfast.
- C. Administer the drug with 40 mL of apple juice.
- D. Administer the first dose by IV route and then orally.
Correct Answer: A
Rationale: The nurse should administer the drug hourly for the first 2 weeks when treating an acute peptic ulcer. The nurse instructs the client to administer the drug 1 to 2 hours after meals and at bedtime after the first 2 weeks. The nurse need not suggest to the client to administer the drug early to the morning before breakfast nor to administer it with apple juice. The drug is not given intravenously.
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A nurse should recognize that administering antacids to clients taking which of the following medications can result in decreased drug absorption and decreased drug effects?
- A. Simvastatin (Zocor)
- B. Isoniazid (Nydrazid)
- C. Digoxin (Lanoxin)
- D. Phenytoin (Dilantin)
- E. Enalapril (Vasotec)
Correct Answer: B,C,D
Rationale: Antacids decrease the absorption of digoxin, isoniazid, phenytoin, and chlorpromazine, leading to decreased effect of those drugs.
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).
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.
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 30-year-old nonpregnant client is prescribed misoprostol. Which of the following should the nurse instruct the client as part of the teaching plan?
- A. Swallow the tablet 1 hour before eating.
- B. Administer the drug 1 hour before travel.
- C. Do not chew, open, or crush the tablet.
- D. Use a reliable contraceptive method.
Correct Answer: D
Rationale: The nurse should instruct the client to use a reliable contraceptive method to avoid pregnancy during the course of treatment as it can cause spontaneous abortion. The nurse should instruct the client taking proton pump inhibitors not to chew, open, or crush the tablet and to swallow the tablet whole at least 1 hour before eating. The nurse needs to inform the client taking a drug for motion sickness to administer it about 1 hour before travel.