Nokea
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.
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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 caring for a client who is prescribed omeprazole for a duodenal ulcer. The client is also taking benzodiazepines for the management of a seizure disorder. The nurse would assess the client for which of the following?
- A. Decreased absorption of the proton pump inhibitor
- B. Risk for toxic level of benzodiazepines
- C. Increased risk of respiratory depression
- D. Increased risk of bleeding
Correct Answer: B
Rationale: When the proton pump inhibitor is administered with benzodiazepines, there will be a risk for a toxic level of benzodiazepines. When the client is administered sucralfate with the proton pump inhibitor, there will be a decrease in absorption of the proton pump inhibitor. When the client is administered an antacid with opioid analgesics, there will be an increased risk of respiratory depression. There will be an increased risk of bleeding when the client is taking oral anticoagulants with the proton pump inhibitor.
At a yearly physical examination, a client asks the nurse if it would be okay to take ginger to aid with digestion. Before telling the client it is okay to take ginger, which medical conditions should the nurse make sure the client does not have?
- A. Hypertension
- B. Kidney stones
- C. Vitamin B12 deficiency
- D. Gallstones
- E. Tayer disease
Correct Answer: A,D
Rationale: Ginger should be used cautiously in clients with hypertension or gallstones and during pregnancy and lactation.
A client with a nasogastric tube is prescribed therapy to prevent ulcer development. Which of the following would be the best option for the drug?
- A. Tablet that can be crushed
- B. Liquid formulation
- C. Intravenous administration
- D. Intramuscular injection
Correct Answer: B
Rationale: The nurse should request the liquid form when administration is in a tube to decrease the chance of a clogged NG tube. Although it is appropriate to crush the tablet and mix it with apple juice, there is still a risk for clogging. Intravenous or intramuscular administration would be inappropriate. The IV route is typically preferred if the patient has an existing IV line, because these drugs are irritating, and IM injections need to be given deep into the muscular tissue to minimize harm.
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.