Nokea
A nurse is conducting a class for a community group. As part of the class, the nurse is explaining the use of syrup of ipecac. The nurse would emphasize that this drug is contraindicated in which of the following cases?
- A. The client is comatose or has altered mental status.
- B. The client has erosive esophagitis.
- C. The client is having seizures.
- D. The substance is a caustic or corrosive agent.
- E. The substance is a low-viscosity petroleum distillate.
Correct Answer: A,C,D,E
Rationale: The use of syrup of ipecac is contraindicated in the following cases: the client is comatose or has altered mental status, the client is having seizures, the substance is a caustic or corrosive agent, the substance is a low-viscosity petroleum distillate, or the substance is capable of also altered mental status or convulsions.
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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 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 nurse should monitor a client taking which of the following drugs for increased adverse effects and toxicity if omeprazole (Prilosec) therapy is initiated?
- A. Phenobarbital (Luminal)
- B. Digoxin (Lanoxin)
- C. Diazepam (Valium)
- D. Warfarin (Coumadin)
- E. Ketoconazole (Nizoral)
Correct Answer: B,C,D
Rationale: The initiation of proton pump inhibitors, like omeprazole (Prilosec), can result in increased adverse reactions and toxicities of warfarin (Coumadin), benzodiazepines (diazepam), digoxin (Lanoxin), phenytoin (Dilantin), and clarithromycin (Biaxin).
A client is taking ginger medicinally for motion sickness. The nurse would urge the client to use caution if the client has which medical condition?
- A. Gallstones
- B. Blood dyscrasia
- C. Parkinson's disease
- D. Severe liver disease
Correct Answer: A
Rationale: Ginger should be used with caution in clients with hypertension or gallstones and during pregnancy or lactation. Antiemetic prochlorperazine is contraindicated in clients with blood dyscrasia, Parkinson's disease, and severe liver disease.
After teaching a group of nursing students about upper gastrointestinal system drugs, the instructor determines that the teaching was successful when the students identify which of the following as a gastrointestinal stimulant?
- A. Ranitidine (Zantac)
- B. Misoprostol (Cytotec)
- C. Omeprazole (Prilosec)
- D. Metoclopramide (Reglan)
Correct Answer: D
Rationale: Metoclopramide (Reglan) is classified as a gastrointestinal stimulant. Ranitidine is a histamine-2 receptor antagonist. Omeprazole is a proton pump inhibitor. Misoprostol is a miscellaneous acid reducer.