Practice your knowledge (pharm t-3)

GOODLUCK BIATCH

Constipation

Antacids that contain aluminum salts may result in which adverse effect?

Renal failure

Antacids containing magnesium should be used cautiously in patients with which condition?

ketoconazole

H2 antagonists, such as cimetidine, may inhibit the absorption of drugs that require an acidic gastrointestinal environment. Which drug requires an acidic gastrointestinal environment?

The patient is smoking two packs of cigarettes a day.

A patient has been taking cimetidine for hyperacidity but says that the medication has not been effective. What is the patient doing that may be influencing the effectiveness of this drug?

The entire capsule should be taken whole and not crushed, chewed, or opened.

A patient is taking omeprazole (Losec®) for the treatment of gastroesophageal reflux disease. What important information should the nurse give the patient about this medication?

simethicone (Oval®)

Which drug is used for the management of conditions associated with excessive gas production?

Systemic alkalosis

A 75-year-old woman reports experiencing indigestion, stomach pain, and frequent belching. She tells the nurse that she has been taking sodium bicarbonate five or six times a day for the past 3 weeks. Which hazard does the nurse know can possibly result from excessive use of sodium bicarbonate?

. clarithromycin

A patient has been diagnosed with a peptic ulcer caused by Helicobacter pylori. The physician has recommended 2 weeks of combination therapy with omeprazole and an antibiotic. Which antibiotic will be chosen for this therapy?

Its use may result in kidney stones.

A patient asks why calcium carbonate is not often used as an antacid. What is the nurse's best explanation to the patient?

The antacids should be taken 1 to 2 hours before or after the other medications.

A patient is taking several medications, including twice-daily dosages of antacids. What important information about taking the antacids should the nurse give this patient?

Proton pump inhibitors

Which classification of medications is considered triple therapy for treatment of erosive esophagitis?

B ,D, F, G

Which are true statements about antacids? (Select all that apply.)

a. Antacids prevent the overproduction of acid in the stomach.

b. Antacids neutralize acid in the stomach.

c. Antacids form a mucous barrier in the stomach.

d. Rebound hyperacidity may occur with calcium-based antacids.

e. Aluminum-based antacids cause diarrhea.

f. Magnesium-based antacids cause diarrhea.

g. Stomach acidity is reduced by 90% if the pH is raised an entire point.

Bisacodyl should be given with water only.

A patient is on laxative therapy. What important information about this therapy should the nurse provide the patient?

A hyperosmotic laxative

What type of laxative is glycerin?

240 mL

When preparing the bulk-forming laxative methylcellulose for administration, the nurse will mix the medication with how much water to avoid possible obstruction?

digoxin

The nurse advises a patient to try bismuth subsalicylate (Pepto-Bismol®) to control diarrhea. Which medication will interact significantly with the Pepto-Bismol?

polyethylene glycol

Which drug is commonly used to induce total cleansing of the bowel before diagnostic or surgical bowel procedures?

Long-term use of laxatives often results in decreased bowel tone and may lead to dependency.

While recovering from surgery, a 74-year-old woman started taking senna (Senokot®) to relieve constipation caused by the pain medications. She is also taking digoxin and tetracycline. She tells the nurse that she likes how "regular" her bowel movements are now that she is taking the laxative. What important information should the nurse give to this patient?

Loperamide does not cause dependence.

What is a major difference between diphenoxylate with atropine (Lomotil®) and loperamide (Imodium®)?

Stimulant laxatives

Which type of laxatives is most likely to cause dependence if overused? a.Emollient laxatives

Vitamin A

Mineral oil can interfere with the absorption of which vitamin?

Anticholinergics

Which type of antidiarrheal medication works by decreasing the intestinal muscle tone and peristalsis of the intestines?

Darkened stools

A patient is taking an adsorbent, such as bismuth subsalicylate (Pepto-Bismol). What possible adverse effects should the nurse warn this patient about?

An intestinal flora modifier

. A patient who has been on antibiotic therapy for 2 weeks has developed persistent diarrhea. Which drug will likely be recommended for this patient?

C, D, G

Regarding the uses for laxatives, which conditions are general contraindications to the use of oral laxatives? (Select all that apply.)

a. High ammonia levels due to liver failure

b. The presence of parasites and intestinal worms

c. Abdominal pain of unknown origin

d. Nausea and vomiting

e. Pregnancy

f. Ingestion of toxic substances

g. Acute surgical abdomen

granisetron

The nurse has just completed the intravenous administration of a drug to a patient for the prevention of chemotherapy-induced nausea and vomiting. What antiemetic drug has the patient received?

Scopolamine hydrobromide

Which primary anticholinergic medication is used as an antiemetic?

Headache

A patient receiving chemotherapy is prescribed ondansetron (Zofran) for treatment of nausea. Which is an adverse effect of this antiemetic drug?

prochlorperazine

A patient is experiencing intractable hiccups. Which drug will the nurse expect to administer to this patient?

metoclopramide

Which antiemetic drug works by blocking dopamine in the chemoreceptor trigger zone, causing the zone to be desensitized to impulses received from the gastrointestinal tract?

Antiemetics are often administered 30 to 60 minutes before a chemotherapy drug is given.

Which statement is correct regarding the management of nausea and vomiting?

ondansetron

Which antiemetic drug is effective in preventing chemotherapy-induced and postoperative nausea and vomiting?

meclizine

patient with motion sickness is planning a cross-country car trip to attend a family reunion. What medication will the nurse tell the patient prevents motion sickness?

Chemotherapy treatment

Tetrahydrocannabinol (THC) is an antiemetic used for treatment of nausea and vomiting associated with which situation?

Because of possible drowsiness, the patient should avoid driving.

A patient who has been newly diagnosed with vertigo will be taking an antihistamine antiemetic drug. What is important for the nurse to emphasize when teaching the patient about this drug?

240ml

To avoid fecal impaction, psyllium (Metamucil®) should be administered with at least how many mL of fluid?

   It causes water absorption into the colon.

How does magnesium hydroxide (Phillips Milk of Magnesia®) alleviate constipation?

 Binds to diarrhea-causing bacteria for excretion

Bismuth subsalicylate (Pepto-Bismol®), as an adsorbent, has which mechanism of action?

Reducing ammonia levels

Related to its mechanism of action, what is an additive effect of lactulose?

Risk for injury related to thrombocytopenia

Which nursing diagnosis is appropriate for a patient receiving famotidine (Pepcid®)?

   A 32-year-old pregnant woman with a urinary tract infection

The nurse will question a prescription for misoprostol for which patient?

Neutralize gastric acid

The nurse will teach patients that antacids are effective in the treatment of hyperacidity because they do which of the following? \n \n \n Decrease stomach motility \n Antacids work by neutralizing gastric acid, which would cause an increase in pH. They do not affect gastric motility.

   Constipation

The nurse will monitor a patient taking an aluminum-containing antacid, such as aluminum hydroxide, for which adverse effect?

   Magnesium-containing antacids

or a patient with chronic renal failure, the nurse most likely will question a prescription for which type of antacid?

   Metabolic alkalosis

What condition will the nurse monitor for with a patient using sodium bicarbonate to treat gastric hyperacidity?

It competes with histamine for binding sites on the parietal cells.

What is the mechanism of action of famotidine?

smoking decreases the effects of this medication so i should look into cessation program

Which patient statement demonstrates a patient’s understanding of the nurse’s teaching in regard to the use of histamine2-receptor antagonists?

 It promotes motility in the small intestine.

Metoclopramide is useful in treating postoperative nausea and vomiting because of which of the following actions?

 ondansetron (Zofran®)

Which drug works by blocking serotonin receptors in the GI tract, vomiting center, and CTZ?

Glaucoma

Before administering the anticholinergic drug scopolamine, the nurse should carefully assess the patient for a history of which condition?

scopolamine

The nurse should teach a patient about which antiemetic commonly used to prevent motion sickness?

 Give 30 minutes before meals and at bedtime.

Which of the following directions applies to the administration of metoclopramide?

“I will apply the scopolamine patch to my right or left arm and rotate the sites of application.”

Which patient statement indicates the need for further teaching about antiemetic medications?

  different vomiting pathways are blocked.

When planning administration of antiemetic medications to a patient, the nurse is aware that combination therapy is preferred because:

 Deficient fluid volume related to nausea and vomiting

In developing a plan of care for a patient receiving an antihistamine antiemetic drug, which nursing diagnosis would be the highest priority nursing diagnosis?

\

“It causes mucus-coated gas bubbles to break into smaller ones.”

A 30-year-old man is taking simethicone for excessive flatus associated with diverticulitis. During a patient teaching session, which statement by the nurse explains the mechanism of action of simethicone?

ketoconazole

When evaluating the medication list of a patient who will be starting therapy with an H2 receptor antagonist, the nurse is aware that which drug may interact with it?

**Giving the drug on an empty stomach**

When administering sucralfate, which action by the nurse is most correct?

“Aluminum-based antacids are the best choice for you.”

A patient with a history of kidney problems is asking for advice about which antacid he should use. The nurse will make which recommendation?

Give the tetracycline, but delay the antacid for 1 to 2 hours.

A patient who is taking oral tetracycline complains of heartburn and requests an antacid. Which action by the nurse is correct?

A ,C

When the nurse is administering a PPI, which actions by the nurse are correct? (Select all that apply.)

a. Giving the PPI on an empty stomach

b. Giving the PPI with meals

c. Making sure the patient does not crush or chew the capsules

d. Instructing the patient to open the capsule and chew the contents for best absorption

e. Administering the PPI only when the patient reports heartburn

Pregnancy

The nurse is preparing to administer the first dose of misoprostol for a patient who has been diagnosed with a gastric ulcer. What condition would be a contraindication to this medication?

PEG 3350

A patient is being prepared for a colonoscopy. The nurse expects which laxative to be used as preparation for this procedure?

Possible obstruction

The nurse is administering oral methylcellulose and keeps in mind that a potential concern with this drug is which of the following?

A, B C E

A 45-year-old woman has been diagnosed with irritable bowel syndrome (IBS) and has numerous bowel movements each day. She has been prescribed loperamide. What are the actions of this drug? Select all that apply.

a. Reduces the daily fecal volume

b. Increases viscosity and bulk of the bowel movements

c. Reduces the loss of fluids and electrolytes associated with watery bowel movements

d. Cures the disease process by eliminating the infection causing IBS e. Reduces bowel incontinence and urgency

“Take this medication on an empty stomach.

When a nurse teaches a patient about taking bisacodyl tablets, which instruction is correct?

Lactobacillus acidophilus

A patient has been receiving long-term antibiotic therapy as part of treatment for an infected leg wound. He tells the nurse that he has had “spells of diarrhea” for the past week. Which medication is most appropriate for him at this time

Loperamide

A parent calls to ask about giving a medication for diarrhea to his 12-year-old child, who is recovering from the flu. The nurse expects the health care provider to recommend which medication?

A, C

A patient has been instructed to use an OTC form of the bulk-forming laxative methylcellulose to prevent constipation. The nurse will advise the patient of potential adverse effects, including which of the following? (Select all that apply.)

a. Fluid and electrolyte disturbances

b. Decreased absorption of vitamins

c. Gas formation

d. Darkened stools

e. Discolored urine

“I should be seeing improvement within a few days.”

A patient has been given a new prescription for loperamide hydrochloride (Imodium), and the nurse is providing education about this medication. Which statement by the patient indicates a need for further education?

30 minutes before the chemotherapy begins

A 33-year-old patient is in an outpatient cancer centre for his first round of chemotherapy. The nurse knows that which schedule is the most appropriate timing for the IV antiemetic drug?

Delayed gastric emptying

. When reviewing the various types of antinausea medications, the nurse recognizes that prokinetic drugs are also used for which disorder

“This drug may not help the more severe nausea symptoms associated with chemotherapy.”

A patient who has been receiving chemotherapy tells the nurse that he has been searching the Internet for antinausea remedies and that he found a reference to a product called aprepitant. He wants to know if this drug would help him. What would be the nurse’s best answer?

A, C, E

A patient is asking about using THC. Which statements about dried marihuana therapy are true? (Select all that apply.)

a. It is useful for nausea and vomiting as a result of cancer chemotherapy.

b. It is approved for the treatment of hyperemesis gravidarum.

c. It is useful to help stimulate the appetite in patients with nutritional wasting.

d. It may cause extrapyramidal symptoms.

e. It may cause drowsiness or euphoria.

“Apply the patch at least 4 hours before travelling.”

The nurse is providing patient teaching regarding scopolamine transdermal patches (Transderm-Scōp) to a patient who is planning an ocean cruise. Which instruction is most appropriate?

B C E

The nurse is reviewing the current medications for a patient who has a new prescription for aprepitant (Emend). Which of these medications may have an interaction with aprepitant? (Select all that apply.)

\
a. digoxin

b. warfarin

c. Oral contraceptives

d. Nonsteroidal anti-inflammatory drugs

e. Corticosteroids