Nokea
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.
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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.
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 client is prescribed ranitidine. A review of the client's medication history reveals that she also takes warfarin for treatment of deep vein thrombosis. The nurse would monitor the client for which of the following?
- A. Decreased white blood cell count
- B. Increased risk of respiratory depression
- C. Increased risk for bleeding
- D. Decreased seizure threshold
Correct Answer: C
Rationale: Histamine-2 receptor antagonists when given with warfarin place the client at an increased risk for bleeding. A decreased white blood cell count occurs when histamine-2 receptor antagonists are given with carmustine. An increased risk of respiratory depression occurs when histamine-2 receptor antagonists are given with opioid analgesics. This class of drugs does not interact with any antiseizure medications.
A nurse follows a specific protocol when administering which of the following medications to prevent nausea induced by doxorubicin (Adriamycin) administration?
- A. Lansoprazole (Prevacid)
- B. Ondansetron (Zofran)
- C. Metoclopramide (Reglan)
- D. Promethazine (Phenergan)
- E. Granisetron (Kytril)
Correct Answer: B,E
Rationale: 5-HT3 receptor antagonists, like ondansetron (Zofran) and granisetron (Kytril), are used in the prevention of chemotherapy-induced nausea and vomiting.
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.