Nokea
A patient has excessive and painful gas. The nurse checks the patient's medication orders and prepares to administer which drug for this problem?
- A. Famotidine
- B. Aluminum hydroxide and magnesium hydroxide
- C. Calcium carbonate
- D. Simethicone
Correct Answer: D
Rationale: Simethicone alters the elasticity of mucus-coated bubbles, causing them to break, and is an over-the-counter antiflatulent.
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When reviewing the health history of a patient who will be receiving antacids, the nurse recalls that antacids containing magnesium need to be used cautiously in patients with which condition?
- A. Peptic ulcer disease
- B. Renal failure
- C. Hypertension
- D. Heart failure
Correct Answer: B
Rationale: Both calcium- and magnesium-based antacids are more likely to accumulate to toxic levels in patients with renal disease and are commonly avoided in this patient group.
The nurse is teaching a patient who will be taking a proton pump inhibitor as long-term therapy about potential adverse effects. Which statement is correct?
- A. Proton pump inhibitors can cause diarrhea.
- B. These drugs can cause nausea and anorexia.
- C. Proton pump inhibitors cause drowsiness.
- D. Long-term use of these drugs may contribute to osteoporosis.
Correct Answer: D
Rationale: New concerns have arisen over the potential for long-term users of proton pump inhibitors (PPIs) to develop osteoporosis. This is thought to be due to the inhibition of stomach acid, and it is speculated that PPIs speed up bone mineral loss.
An older adult patient had gastric surgery due to a gastrointestinal bleed 3 days ago, and he has been stable since the surgery. This evening, his daughter tells the nurse, 'He seems to be more confused this afternoon. He's never been like this.' What could be the problem? The nurse reviews the patient's medication record and suspects that which drug could be the cause of the patient's confusion?
- A. Cimetidine
- B. Pantoprazole
- C. Clarithromycin
- D. Sucralfate
Correct Answer: A
Rationale: Sometimes H2 receptor antagonists such as cimetidine may cause adverse effects related to the central nervous system in the older adult, including confusion and disorientation.
During an admission assessment, the patient tells the nurse that he has been self-treating his heartburn for 1 year with over-the-counter Prilosec OTC (omeprazole, a proton pump inhibitor). The nurse is aware that this self-treatment may have which result?
- A. No serious consequences
- B. Prevention of more serious problems, such as an ulcer
- C. Chronic constipation
- D. Masked symptoms of serious underlying diseases
Correct Answer: D
Rationale: Long-term self-medication with antacids may mask symptoms of serious underlying diseases, such as bleeding ulcer or malignancy. Patients with ongoing symptoms need to undergo regular medical evaluations, because additional medications or other interventions may be needed.
At 0900, the nurse is about to give morning medications, and the patient has asked for a dose of antacid for severe heartburn. Which schedule for the antacid and medications is correct?
- A. Give both the antacid and medications at 0900.
- B. Give the antacid at 0900, and then the medications at 0900.
- C. Give the medications at 0900, and then the antacid at 1900.
- D. Give the medications at 0900, and then the antacid at 0915.
Correct Answer: C
Rationale: Medications are not to be taken, unless prescribed, within 1 to 2 hours of taking an antacid because of the impact on the absorption of many medications in the stomach.