Nokea
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).
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A nurse in a health care facility is caring for a client who is receiving an antiemetic to control vomiting related to chemotherapy. Which of the following nursing diagnoses should the care plan for this client include?
- A. Risk for Imbalanced Fluid Volume
- B. Disturbed Sensory Perception
- C. Impaired Physical Mobility
- D. Ineffective Tissue Perfusion
Correct Answer: A
Rationale: The care plan should include Risk for Imbalanced Fluid Volume for the client receiving an antiemetic due to the possible fluid losses associated with vomiting as well as the possible decrease in fluid intake. Disturbed sensory perception, impaired physical mobility, and ineffective tissue perfusion are not applicable.
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 client is receiving an antiemetic. The nurse identifies a nursing diagnosis of Imbalanced Nutrition: Less Than Body Requirements? Which of the following would the nurse include in the client's plan of care?
- A. Remove items with strong smells and odors.
- B. Use mouthwash or frequent oral rinses.
- C. Make the environment as pleasant as possible.
- D. Explain that the drug may change the color of the stool.
- E. Follow the medication with a small amount of water.
Correct Answer: A,B,C
Rationale: When caring for a client receiving an antiemetic with a nursing diagnosis of Imbalanced Nutrition: Less Than Body Requirements, the nurse makes the environment as pleasant as possible to enhance the client's appetite and removes items with strong smells and odors. The nurse gives the client mouthwash or frequent oral rinses to remove the disagreeable taste that accompanies vomiting. Stool color is unaffected. Liquid antacids could be followed with a small amount of water.
A nurse educating a client on the antacid aluminum hydroxide (ALternaGEL) should warn the client about which of the following adverse reactions?
- A. Alopecia
- B. Anorexia
- C. Diarrhea
- D. Tremors
- E. Bone pain
Correct Answer: B,D,E
Rationale: Adverse reactions of aluminum hydroxide (ALternaGEL) include constipation, intestinal impaction, anorexia, weakness, tremors, and bone pain.
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.