Test 2 GI Study Guide.
Factor influencing Peptic Ulcer Disease (PUD)
A patient is receiving instructions regarding the use of caffeine. The nurse shares that caffeine
should be used with caution if which of these conditions is present? A history of peptic ulcers
A glucocorticoid is prescribed for a patient. The nurse checks the patient’s medical history
knowing that glucocorticoid therapy is contraindicated in which disorder? Peptic ulcer disease
The nurse is preparing to administer a first dose of clopidogrel (Plavix) to a patient. As part of the
history, the nurse learns that the patient has a previous history of peptic ulcers, diabetes,
hyperlipidemia, and hypertension. The nurse understands that which of these conditions
warrants caution with clopidogrel treatment? Peptic ulcer disease
atropine (Lomotil) indications/side effects/adverse effects
A patient who is taking diphenoxylate with atropine (Lomotil) to treat diarrhea asks the nurse
why it contains atropine. The nurse will explain that atropine is added, in part, to: decrease
abdominal cramping.
The nurse is caring for an older adult who is receiving diphenoxylate with atropine (Lomotil) to
treat severe diarrhea. The nurse will monitor this patient closely for which effect? Respiratory
depression
Constipation management
A patient is taking linaclotide (Linzess) to treat irritable bowel syndrome (IBS). The nurse will
monitor this patient for which adverse effect? Abdominal pain
Lactulose (Enulose) indications, MOA
A patient is receiving lactulose (Enulose) three times a day. The nurse knows that the patient is
not constipated and is receiving this drug for which reason? High ammonia levels due to liver
failure
Antiemetics indications, MOA. Zofran, reglan, Thorazine, Phenergan,
scopolamine.
A patient is receiving a tube feeding through a gastrostomy. The nurse expects that which type of
drug will be used to promote gastric emptying for this patient? Prokinetic drugs, such as
metoclopramide (Reglan)
Dronabinol (Marinol) indications
A patient who has AIDS has lost weight and is easily fatigued because of his malnourished state.
The nurse anticipates an order for which antinausea drug to stimulate his appetite? Dronabinol
(Marinol), a tetrahydrocannabinoid
Teaching for indigestion
A patient who has been receiving continuous enteral nutrition has had several large, watery
stools. The nurse will contact the provider to discuss which intervention? Slowing the rate of
infusion
PNS, vs SNP effects on GI system
Functions of each organ of the GI system and different parts of the small intestine.
GERD, PUD, Vomiting, diarrhea, and constipation pathophysiology
Nursing Dx for GI dysfunctions: diarrhea, constipation, vomiting.
Loperamide, Lomotil indications and side effects/adverse effects
A patient asks the nurse about using loperamide (Imodium) to treat infectious diarrhea. Which
response will the nurse give? “Loperamide can be used to treat diarrheal symptoms but may also
slow the exit of the infectious organisms from the GI tract.”
A patient asks the nurse about the difference between diphenoxylate with atropine (Lomotil) and
the over-the-counter drug loperamide (Imodium). Which response by the nurse is correct?
“Imodium does not cause physical dependence.”
Traveler's diarrhea etiology and treatment
A patient asks the nurse the best way to prevent traveler’s diarrhea. The nurse will provide which
recommendation to the patient? “Drink bottled water and eat only well-cooked meats.”
After traveling to Mexico, a man develops diarrhea 1 day after coming back to the U.S. Which of
the following is the most likely etiology of his s/s? E. coli is most common etiology of
traveler's diarrhea
CNS control of vomit
Chemoreceptor trigger zone (CTZ) located in the fourth ventricle of the brain
Digestion phases, enzymes action and MOA
2 to 3 calculation questions for GI system
Study Guide exam 3 CV and Resp.
Dextromethorphan contraindications
Cough and cold products are also used for substance abuse. Which of the following contains the
two most commonly misused cough and cold products? Dextromethorphan and
promethazine-codeine
A patient asks the nurse about using dextromethorphan for cough. Which of the following is
FALSE regarding dextromethorphan? It is classified as an antihistamine
Nasal decongestants teaching
The nurse is teaching a patient how to use phenylephrine HCl (Neo-Synephrine)
nasal spray to treat congestion from a viral upper respiratory infection. What
instruction will the nurse give the patient? Stop using the medication after 3
days.
A patient is admitted to the hospital after developing pneumonia. During the
admission assessment, the patient reports having used a topical nasal
decongestant spray for the past few weeks but thinks the nasal congestion is
getting worse. The nurse will: tell the patient the congestion will eventually clear
up after stopping the spray.
The patient who has nasal congestion asks the nurse to recommend a
decongestant medication. The nurse performs a medication history and learns
that the patient takes a beta blocker to treat hypertension. Which of the
over-the-counter products below would be most appropriate to recommend?
Phenylephrine nasal (Neo-Synephrine Nasal)
The patient has been ordered to receive pseudoephedrine (Sudafed) to treat
nasal congestion. The nurse performing an admission assessment learns that the
patient has diabetes mellitus. What action is appropriate for the nurse to take?
Hold the medication and contact the provider.
When administering nasal spray, which instruction by the nurse is appropriate?
“You will need to blow your nose before I give this medication.”
A gardener needs a decongestant because of seasonal allergy problems and asks
the nurse whether he should take an oral form or a nasal spray. Which of these
is a benefit of orally administered decongestants? Lack of rebound congestion
The nurse will instruct patients about a possible systemic effect that may occur
if excessive amounts of topically applied adrenergic nasal decongestants are used.
Which systemic effect may occur? Palpitations
A patient has been advised to add a nasal spray (an adrenergic decongestant) to
treat a cold. The nurse will include which instruction? “Limit use of this spray to
3 to 5 days.”
Guaifenesin teaching
A patient who has a nonproductive cough will begin taking guaifenesin to help with
secretions. When teaching this patient about the medication, the nurse will
provide which instruction? “Drink extra water while taking the medication.”
A patient is taking guaifenesin (Humibid) as part of treatment for a sinus
infection. Which instruction will the nurse include during patient teaching?
Increase fluid intake to help loosen and liquefy secretions.
A patient with a tracheostomy has difficulty removing excessive, thick mucus
from the respiratory tract. The nurse expects that which drug will be ordered to
aid in the removal of mucus? Guaifenesin (Mucinex)
Antihistamines with few anticholinergic effects that may be used for
narrow angle glaucoma patients
A patient who has narrow-angle glaucoma asks the nurse to recommend a
medication to alleviate cold symptoms such as nasal congestion and runny nose.
The nurse will suggest the patient talk to the provider about which medication
that is available as a nasal spray? Azelastine (Astelin)
Diphenhydramine indications, side effects, adverse effects
A patient who has seasonal allergies with a runny nose during the daytime reports
increasing nighttime symptoms of coughing and sneezing that are interfering with
sleep. The provider recommends diphenhydramine (Benadryl) at bedtime. What
information will the nurse include when teaching the patient about this
medication? “You should be able to sleep better when you take this medication.”
The parents of a 3-year-old child tell the nurse that they are planning to give
their child diphenhydramine (Benadryl) on a flight to visit the child’s grandparents
to help the child sleep during the flight. What will the nurse tell the parents
about giving this drug? Diphenhydramine may have the opposite effect and could
cause agitation
A patient asks the nurse about taking over-the-counter sleeping aids. The nurse
will tell the patient that the active ingredient in these products is often a(n):
antihistamine.
side effects and indications for cromolyn sodium
A patient who is using inhaled cromolyn sodium (Intal) daily calls the clinic to
report experiencing cough and a bad taste. The nurse will instruct the patient to
perform which action? Drink water before and after using the inhaler.
Inhaled glucocorticoid medications indications, side effects, adverse
effects
A patient who uses an inhaled glucocorticoid medication reports having a sore
tongue. The nurse notes white spots on the patient’s tongue and oral mucous
membranes. After notifying the provider, the nurse will remind the patient to
perform which action? Rinse the mouth thoroughly with water after each use.
A patient who has asthma will begin taking an inhaled corticosteroid medication to
be used with a spacer. The patient asks why the spacer is necessary. The nurse
will explain that the spacer: is used to enhance the delivery of medications when
using a metered-dose inhaler.
When educating a patient recently placed on inhaled corticosteroids, the nurse
will discuss which potential adverse effects? Oral candidiasis and dry mouth
The nurse is providing instructions to a patient who has a new prescription for a
corticosteroid metered-dose inhaler. Which statement by the patient indicates
that further instruction is needed? (Select all that apply.) “I will gargle after
using the inhaler and then swallow.”
“I will use this inhaler for asthma attacks.”
Albuterol (Proventil) used for asthma symptoms, teaching, adverse
reactions for prolonged use. Different presentations of the medication,
which one is more effective and why?
The nurse administers albuterol to a patient who has asthma. The albuterol acts by stimulating
beta2-adrenergic receptors to cause bronchodilation. The nurse understands that albuterol is a
beta-adrenergic: agonist.
The nurse is caring for a patient who has asthma. The provider has ordered an albuterol
metered-dose inhaler (MDI), 2 puffs q4 to 6h PRN wheezing. The patient’s last dose was 4 hours
ago. What is the nurse’s next action? Auscultate the patient’s lung sounds.
The nurse is caring for a patient recently diagnosed with mild emphysema and provides teaching
about the disease and medications for treatment. Which statement by the patient indicates
understanding of the medication regimen? “I should use albuterol when my symptoms worsen.”
A patient will be discharged home with albuterol (Proventil) to use for asthma symptoms. What
information will the nurse include when teaching this patient about this medication? Overuse of
this medication can result in airway narrowing and bronchospasm.
A provider has prescribed ipratropium bromide/albuterol sulfate (Combivent) for a patient who
has chronic obstructive pulmonary disease (COPD). The nurse explains that this combination
product is prescribed primarily for which reason? To increase forced expiratory volume, an
indicator of symptom improvement
A patient will begin using an albuterol metered-dose inhaler to treat asthma
symptoms. The patient asks the nurse about the difference between using an oral
form of albuterol and the inhaled form. The nurse will explain that the inhaled
form of albuterol: has a more immediate onset than the oral form.
Ipratropium bromide (Atrovent), albuterol (Proventil), and an inhaled
glucocorticoid medication (steroid) to treat chronic bronchitis. In which
order and why these medications should be used?
A patient will begin using ipratropium bromide (Atrovent), albuterol (Proventil),
and an inhaled glucocorticoid medication (steroid) to treat chronic bronchitis.
When teaching this patient about disease and medication management, the nurse
will instruct the patient to administer these medications in which order?
Albuterol, ipratropium bromide, steroid
Benzonatate HCl (Tessalon Perles), Dextromethorphan hydrobromide
(Benylin DM), Guaifenesin and codeine, Promethazine with
dextromethorphan. Choices for one question. (I don’t know the question).
A patient with a persistent nonproductive cough asks about a medication that will
help with her cough but not cause sedation. The nurse will encourage the patient
to discuss which medication with the provider? Benzonatate HCl (Tessalon Perles)
PFTs. Review VC, RV, TV, FEV1, TLC, IRV, ERV (was explained in lecture)
Tiotropium MOA, indications
The nurse is caring for a patient diagnosed with COPD who has been prescribed tiotropium
(Spiriva). Which statement will the nurse include in the education? Tiotropium works by relaxing
and dilating the bronchioles.
Antihistamine of choice for asthma patients
The nurse is caring for a patient who is hospitalized for an asthma exacerbation.
The patient reports taking diphenhydramine at home at night to help with
symptoms of allergic rhinitis and cough. The nurse will contact the patient’s
provider to request an order for which medication? Cetirizine (Zyrtec)
How to assess for anticholinergic effects?
The nurse is caring for a patient who is receiving diphenhydramine. The nurse
notes that the patient has not voided for 12 hours. What action will the nurse
take? Evaluate the bladder to check for distension.
Theophylline indications, side effects, adverse effects, interactions,
contraindications (application questions)
The nurse is teaching a patient who will begin taking oral theophylline (Theo-Dur)
when discharged home from the hospital. What information will the nurse include
when teaching the patient about this drug? Avoid caffeine while taking this
medication.
The nurse is caring for a patient who is receiving intravenous theophylline. The
patient complains of headache and nausea. The nurse will contact the provider to:
obtain an order for a serum theophylline level.
A patient who has been taking theophylline at home reports having palpitations
and jitteriness. Which of the following could interact with theophylline to
increase side effects such as these? Ephedra
Smoker patient on Theophylline, dose adjustment??
The nurse is caring for a patient who will begin taking theophylline at home.
During the assessment, the nurse learns that the patient smokes. The nurse
expects that the patient will eventually require which of the following? A larger
than typical dose of theophylline.
montelukast (Singulair) indications, side effects, adverse effects
The nurse provides teaching for a patient who will begin taking montelukast
sodium (Singulair). Which statement by the patient indicates a need for further
teaching? “I will use this as needed for acute symptoms.”
The nurse is performing a medication history on a patient who reports long-term use of
montelukast (Singulair) and an albuterol metered-dose inhaler (Proventil). The nurse will contact
the provider to discuss an order for which laboratory tests? Liver function tests and serum
glucose
The prescriber has changed the patient’s medication regimen to include the leukotriene receptor
antagonist (LTRA) montelukast (Singulair) to treat asthma. The nurse will emphasize which point
about this medication? It needs to be taken every day on a continuous schedule, even if
symptoms improve.
Treatment of choice for hypercholesterolemia and mixed dyslipidemia
combination. (Choose a combo, two meds for effective therapy).
A patient will begin taking the protease inhibitor combination Kaletra (lopinavir/ritonavir). What
information will the nurse include when teaching the patient about dietary changes? Consume a
low-cholesterol diet.
A female patient has serum lipid levels performed, which reveal a total cholesterol of 285 mg/dL,
triglycerides of 188 mg/dL, a low-density lipoprotein (LDL) of 175 mg/dL, and a high-density
lipoprotein (HDL) of 40 mg/dL. The patient’s blood pressure is 138/72 mm Hg. The patient is
currently not receiving any prescription medications. Which of the following would be the most
appropriate medication (or medications) to be started at this time? Atorvastatin (Lipitor)
A patient will begin taking simvastatin (Zocor) to decrease serum cholesterol. When teaching the
patient about this medication, the nurse will counsel the patient to take which action? Take the
medication in the evening for best effect.
A patient with high cholesterol is ordered to take atorvastatin (Lipitor). What information will be
included in the patient teaching? (Select all that apply.)
The medicine should be taken with a full glass of water.
The patient should watch for body aches or gastrointestinal upset as side effects.
The patient should have liver function tests frequently.
Disseminated intravascular coagulation (DIC) therapy of choice, why?
A nursing student asks why the anticoagulant heparin is given to patients who have disseminated
intravascular coagulation (DIC) and are at risk for excessive bleeding. The nurse will explain that
heparin is used in this case for which reason? To decrease the risk of venous thrombosis
NTG administration all routes, which ones increase absorption of the
medication? Indications, side effects
A patient who has stable angina pectoris is given nitroglycerin to use as needed. In addition to
pharmacotherapy, the nurse will give the patient which instruction? Avoid extremes in weather.
The nurse is teaching a patient about the use of a transdermal nitroglycerin patch. Which
statement by the patient indicates understanding of the teaching? “I should rotate sites when
changing the patch to prevent skin irritation.”
The nurse is teaching a patient about sublingual nitroglycerin administration. What information
will the nurse include when teaching this patient? Take the first tablet while sitting or lying down
A patient who just started using transdermal nitroglycerin reports having headaches. The nurse
will counsel the patient to perform which action? Take acetaminophen as needed.
A patient asks the nurse why nitroglycerin is given sublingually. The nurse will explain that
nitroglycerin is administered by this route for which reason? To increase the rate of absorption
Cholestyramine (Questran) to treat hyperlipidemia. Teaching
A patient begins taking cholestyramine (Questran) to treat hyperlipidemia. The patient reports
abdominal discomfort and constipation. The nurse will provide which instruction to the patient?
Increase fluid intake and slowly increase fiber intake.
A patient has been taking cholestyramine (Questran) to treat hyperlipidemia. The patient reports
abdominal cramping and constipation. The patient’s serum low-density lipoprotein (LDL) has
decreased from 170 to 110 mg/dL, and triglycerides have not changed from 150 mg/dL since
beginning the medication. The provider changes the medication to colesevelam HCl (Welchol).
The patient asks the nurse why the medication was changed, and the nurse will explain that
colesevelam HCl is ordered for which reason? It has fewer side effects.
(Niacin) for Tx of dyslipidemia, adverse reactions, what to do?
A patient begins taking nicotinic acid (Niacin) and reports dizziness and flushing of the skin. The
nurse will perform which action? Recommend that the patient take a baby aspirin with their
niacin dose.
Thrombolytic therapy: indications, contraindications, what medications
belong to this category? MOA.
A patient is receiving a thrombolytic medication. The patient calls the nurse to report having
bloody diarrhea. The nurse will anticipate administering which medication?
Aminocaproic acid (Amicar)
A patient experiences a blood clot in one leg, and the provider has ordered a thrombolytic
medication. The patient learns that the medication is expensive and asks the nurse if it is
necessary. Which response by the nurse is correct? “The drug will decrease the likelihood of
permanent tissue damage.”
Which of the following thrombolytics carries a higher risk for anaphylaxis? Streptokinase
(Streptase)
A patient is receiving a thrombolytic medication. The patient calls the nurse to report having
bloody diarrhea. The nurse will anticipate administering which medication? Aminocaproic acid
(Amicar)
The nurse is assessing a patient prior to administering thrombolytic therapy. Which is an
important assessment for this patient? Assessing which medications are taken for
discomfort/pain
The nurse is caring for a postoperative patient who is receiving alteplase tPA (Activase) after
developing a blood clot. The nurse notes a heart rate of 110 beats per minute and a blood
pressure of 90/60 mm Hg. The nurse will perform which action? Assess the surgical dressing for
bleeding.
CAD pathophysiology, risk factors
A patient has a serum cholesterol level of 270 mg/dL. The patient asks the nurse what
this level means. Which response by the nurse is correct? “You have a high cholesterol
which places you at risk for coronary artery disease.”
Heparin antidote
A patient has been receiving intravenous heparin. When laboratory tests are drawn, the nurse
has difficulty stopping bleeding at the puncture site. The patient has bloody stools and is
reporting abdominal pain. The nurse notes elevated partial thromboplastin time (PTT) and
activated PPT (aPTT). Which action will the nurse perform? Obtain an order for protamine sulfate.
Statins adverse reactions to report immediately to HCP.
A patient has been taking atorvastatin (Lipitor) for several months to treat hyperlipidemia. The
patient reports severe muscle weakness and tenderness. The nurse will counsel the patient to do
which of the following? contact the provider to report these symptoms.
The nurse provides teaching to a patient who will begin taking simvastatin (Zocor) to treat
hyperlipidemia. Which statement by the patient indicates understanding of the teaching? “I will
need an annual eye examination while taking this medication.”
Spironolactone (Aldactone) indications, side effects
A patient who has HF receives digoxin (Lanoxin) and an angiotensin-converting enzyme (ACE)
inhibitor. The patient will begin taking spironolactone (Aldactone). The patient asks why the new
drug is necessary. The nurse will tell the patient that spironolactone will be given for which
reason? To provide cardioprotective effects
A patient has begun taking spironolactone (Aldactone) in addition to a thiazide diuretic. With the
addition of the spironolactone, the nurse will counsel this patient to do which of the following?
report decreased urine output to the provider.
A patient has been taking spironolactone (Aldactone) to treat heart failure. The nurse will
monitor for which of the following electrolyte abnormalities? hyperkalemia
Signs and symptoms (S/S) of digoxin toxicity
The nurse is preparing to administer digoxin to a patient who has HF. The patient reports nausea,
vomiting, and visual halos around objects. The nurse notes a respiratory rate of 18 breaths per
minute, a heart rate of 58 beats per minute, and a blood pressure of 120/78 mm Hg. What will
the nurse do next? Hold the dose and notify the provider of possible digoxin toxicity.
The nurse performs a medication history and learns that the patient takes a loop diuretic and
digoxin (Lanoxin). The nurse will question the patient to ensure that the patient is also taking
which medication? Potassium
The nurse is preparing to administer digoxin to a patient who has a serum digoxin level of 2.5
ng/mL. The patient takes 0.25 mg of digoxin per day. What action will the nurse take? Do not
administer the digoxin and notify the provider of toxic digoxin levels.
A patient has congestive HF and has been taking digoxin (Lanoxin) for 9 years. The patient is
admitted with signs and symptoms of digoxin toxicity. Which signs and symptoms are associated
with digoxin toxicity? (Select all that apply.) Vomiting, Yellow haloes in the visual field, Diarrhea
The nurse is preparing to administer doses of hydrochlorothiazide (HydroDIURIL) and digoxin
(Lanoxin) to a patient who has heart failure. The patient reports having blurred vision. The nurse
notes a heart rate of 60 beats per minute and a blood pressure of 140/78 mm Hg. Which action
will the nurse take? Hold the digoxin and notify the provider.
The nurse is caring for a patient who is taking hydrochlorothiazide (HydroDIURIL) and digoxin
(Lanoxin). Which potential electrolyte imbalance will the nurse monitor for in this patient?
Hypokalemia
Atrial fibrillation is taking digoxin, what other medication should be
administered and why?
A patient who has atrial fibrillation is taking digoxin. The nurse expects which medication to be
given concurrently to treat this condition? Warfarin (Coumadin)
Verapamil (Calan) a calcium channel blocker, indications, if given to a
patient with angina, what effects on CV system the patient gets?
A patient who has been taking nitroglycerin for angina has developed variant angina, and the
provider has added verapamil (Calan) to the patient’s regimen. The nurse will explain that
verapamil is given for which purpose? To relax coronary arteries
ACE inhibitors, indications side effects
The nurse is preparing to care for a Native American patient who has hypertension. The nurse
understands that which antihypertensive medication would be most effective in this patient?
Captopril (Capoten)
A patient who has recently begun taking captopril (Capoten) to treat hypertension calls a clinic to
report a persistent cough that started right after starting the captopril. The nurse will perform
which action? Schedule an appointment with the provider to evaluate the cough and discuss
changing to an angiotensin II receptor blocker (ARB).
The nurse is preparing to administer an ACE inhibitor to a patient who has hypertension. The
patient started the ACE inhibitor the day prior. The nurse notes peripheral edema and swelling of
the patient’s lips. The patient has a blood pressure of 160/80 mm Hg and a heart rate of 76 beats
per minute. What is the nurse’s next action? Hold the dose and notify the provider of a
hypersensitivity reaction
The nurse is caring for a patient who will begin taking lisinopril (Zestril) for hypertension. The
nurse reviews the patient’s laboratory test results and notes increased BUN and creatinine.
Which action will the nurse take? Contact the provider to discuss changing to fosinopril
(Monopril).
A patient with severe liver disease is receiving the angiotensin-converting enzyme (ACE) inhibitor,
captopril (Capoten). The nurse is aware that the advantage of this drug for this patient is which
characteristic? Captopril does not need to be metabolized by the liver before becoming active
because it is not a prodrug
A patient with type 2 diabetes mellitus has been found to have trace proteinuria. The prescriber
writes an order for an angiotensin-converting enzyme (ACE) inhibitor. What is the main reason for
prescribing this class of drug for this patient? Renal protective effects
The nurse is reviewing the orders for a patient and notes a new order for an
angiotensin-converting enzyme (ACE) inhibitor. The nurse checks the current medication orders,
knowing that this drug class may have a serious interaction with what other drug class?
Nonsteroidal anti-inflammatory drugs
Which drug classes are considered first-line treatment for heart failure? (Select all that apply.)
Angiotensin-converting enzyme (ACE) inhibitors
Angiotensin II receptor blockers (ARBs)
Beta blockers
Plavix, aspirin, ticagrelor, warfarin, and Lovenox all in the same question
about the appropriate medication of choice, so you need to know
indications and MOA for all those meds to be used for management of
patient who had a MI.
A patient who has recently had a myocardial infarction (MI) will begin taking clopidogrel (Plavix)
to prevent a second MI. Which medication will the nurse expect the provider to order as
adjunctive therapy for this patient? Aspirin
The nurse is preparing to administer a first dose of clopidogrel (Plavix) to a patient. As part of
the history, the nurse learns that the patient has a previous history of peptic ulcers, diabetes,
hyperlipidemia, and hypertension. The nurse understands that which of these conditions
warrants caution with clopidogrel treatment? Peptic ulcer disease
What medication should be given to a patient taking warfarin and has an
elevated international normalized ratio (INR)?
A patient who is taking warfarin has an international normalized ratio (INR) of 5.5. The nurse will
anticipate giving which of the following? oral vitamin K.
Coumadin side effects (application)
The nurse performs a medication history on a patient who will begin targeted therapy for cancer
with gefitinib (Iressa). The nurse learns that the patient is taking carbamazepine, a histamine2
blocker, and warfarin. The nurse will anticipate that the provider will make which change to the
medication regimen? decrease the warfarin dose.
The nurse is caring for a patient who is receiving warfarin (Coumadin) and notes bruising and
petechiae on the patient’s extremities. The nurse will request an order for which laboratory test?
International normalized ratio (INR)
The nurse is teaching a patient who will begin taking warfarin (Coumadin) for atrial fibrillation.
Which statement by the patient indicates understanding of the teaching? “I will tell my dentist
that I am taking this medication.”
The nurse is assessing a patient who takes warfarin (Coumadin). The nurse notes a heart rate of
92 beats per minute and a blood pressure of 88/78 mm Hg. To evaluate the reason for these vital
signs, the nurse will assess which of the following? gums, nose, and skin.
A patient is admitted to the hospital, and the provider orders gemfibrozil (Lopid) 600 mg twice
daily, 30 minutes prior to meals. The nurse learns that the patient takes warfarin (Coumadin)
once daily. The nurse will contact the provider to discuss: ordering frequent INR levels.
A patient who takes warfarin (Coumadin) and digoxin (Lanoxin) develops hypothyroidism and will
begin taking levothyroxine (Synthroid). The nurse anticipates which potential adjustments in
dosing for this patient? Increased digoxin and decreased warfarin
A patient has been taking warfarin (Coumadin), which is highly protein-bound. The patient will
begin taking gemfibrozil, which is also highly protein-bound. The nurse will observe the patient
closely for: increased effects of warfarin.
Furosemide (Lasix) indications, MOA, side effects
The nurse is caring for a patient who develops marked edema and a low urine output as a result
of heart failure. Which medication will the nurse expect the provider to order for this patient?
Furosemide (Lasix)
The nurse is caring for a patient who is receiving furosemide (Lasix) and an aminoglycoside
antibiotic. The nurse will be most concerned if the patient reports which symptom? Tinnitus
The nurse is teaching a patient who will begin taking furosemide. The nurse learns that the
patient has just begun a 2-week course of a steroid medication. What will the nurse recommend?
Obtain an order for a potassium supplement.
Remember: Propranolol (Inderal), is a non-cardio selective beta blocker so,
it should not be used on asthmatic patients.
The nurse is performing an assessment on a patient who will begin taking propranolol (Inderal) to
treat hypertension. The nurse learns that the patient has a history of asthma and diabetes. The
nurse will take which action? Contact the provider to discuss another type of antihypertensive
medication.
A patient who has asthma is diagnosed with hypertension. The nurse understands that which
drug will be the safest to give this patient? Metoprolol (Lopressor)
Heart terminology (matching question), preload, afterload, SV, CO,
contractility, ejection fraction.
Preload is the initial stretching of the muscle cells prior to contraction. It is related
to ventricular filling.
Afterload is the force or load against which the heart has to contract to eject the
blood
Stroke Volume (SV) Is the amount of blood pumped out of the heart with each contraction.
Cardiac Output Is Heart rate X stroke volume = mL of blood pumped by heart per minute
Contractility is the intrinsic strength of the cardiac muscle independent of preload,
but a change in preload will affect the force of contraction
Ejection Fraction is The percentage of blood that is pumped out of the ventricles in one
heartbeat.
A patient who takes digoxin to treat HF will begin taking a vasodilator. The patient asks the
nurse why this new drug has been ordered. The nurse will explain that the vasodilator is used
to: decrease ventricular stretching.
Final exam Spring 22 Study Guide.
Chronic, acute, somatic, cancer, neuropathic, all classifications of pain. Be
able to identify in case scenarios, and to treat each type of pain, which
medication should be used.
The nurse assumes care of a patient who had surgery that morning. The provider has ordered
hydrocodone (Lortab) every 4 hours for mild to moderate pain and morphine sulfate for
moderate to severe pain. The nurse reviews the patient’s record and notes the patient has
received two doses of hydrocodone 4 hours apart for a pain level of 7 to 8 on a scale of 1 to 10
and has reported a decrease in pain to a level of 6 to 7 after 30 minutes. It has been 4 hours since
the last dose, and the patient reports a pain level of 7. What will the nurse do? Administer
morphine.
A patient is taking ibuprofen 400 mg every 4 hours to treat moderate arthritis pain and reports
that it is less effective than before. What action will the nurse take? Counsel the patient to
discuss a change in dose or changing to a prescription NSAID with the provider.
The nurse is caring for a postpartum woman who is refusing opioid analgesics but is rating her
pain as a 7 or 8 on a 10-point pain scale. The nurse will contact the provider to request an order
for which analgesic medication? Ketorolac (Toradol)
The nurse is evaluating a patient 2 hours after giving a dose of 30 mg of codeine with
acetaminophen for postoperative pain following abdominal surgery. The patient reports a pain
level of 7 on a scale of 1 to 10. The patient is not satisfied with their current level of pain relief.
The nurse notes a heart rate of 110 beats per minute, a respiratory rate of 28 breaths per minute,
and a blood pressure of 180/90 mm Hg. Which action will the nurse take? Request an order for
oxycodone with acetaminophen (Percocet).
Indications, side effects, adverse effects, and contraindications of
analgesics and anti-inflammatory meds.
A 16-year-old field hockey player fell and twisted her ankle during a game. The nurse will expect
to administer which type of analgesic? Nonopioid analgesics, such as indomethacin (Indocin)
A patient will be discharged with a 1-week supply of an opioid analgesic for pain management
after abdominal surgery. The nurse will include which information in the teaching plan? How to
prevent constipation
A 57-year-old woman being treated for end-stage breast cancer has been using a transdermal
opioid analgesic as part of the management of pain. Lately, she has been experiencing
breakthrough pain. The nurse expects this type of pain to be managed by which of these
interventions? Administering an immediate-release opioid
The nurse is assessing a patient for contraindications to drug therapy with acetaminophen
(Tylenol). Which patient should not receive acetaminophen? A patient with a history of liver
disease
A patient arrives at the urgent care center complaining of leg pain after a fall when rock climbing.
The radiographs show no broken bones, but he has a large bruise on his thigh. The patient says he
drives a truck and does not want to take anything strong because he needs to stay awake. Which
statement by the nurse is most appropriate? “You can take acetaminophen, also known as
Tylenol, for pain, but no more than 3000 mg/day.”
A patient is suffering from tendonitis of the knee. The nurse is reviewing the patient’s medication
administration record and recognizes that which adjuvant medication is most appropriate for this
type of pain? Corticosteroid
How to manage overdose, how to identify overdose of narcotic meds.
A 78-year-old patient is in the recovery room after having a lengthy surgery on his hip. As he is
gradually awakening, he requests pain medication. Within 10 minutes after receiving a dose of
morphine sulfate, he is very lethargic and his respirations are shallow, with a rate of 7
breaths/minute. The nurse prepares for which priority action at this time? Administration of
naloxone (Narcan)
The nurse is assessing a patient who has been admitted to the emergency department for a
possible opioid overdose. Which assessment finding is characteristic of an opioid drug
overdose? Respiration rate of 6 breaths/min
A patient is brought to the emergency department for treatment of a suspected overdose. The
patient was found with an empty prescription bottle of a barbiturate by his bedside. He is
lethargic and barely breathing. The nurse would expect which immediate intervention?
Implementing measures to maintain the airway and support respirations
A 38-year-old man has come into the urgent care center with severe hip pain after falling from
a ladder at work. He says he has taken several pain pills over the past few hours but cannot
remember how many he has taken. He hands the nurse an empty bottle of acetaminophen
(Tylenol). The nurse is aware that the most serious toxic effect of acute acetaminophen
overdose is which condition? Hepatic necrosis
How to manage neuropathic pain?
A patient is taking gabapentin (Neurontin), and the nurse notes that there is no history of
seizures on his medical record. What is the best possible rationale for this medication order? The
medication is used for the treatment of neuropathic pain.
Opioid addiction, tolerance, toxicity, abstinence syndrome.
A patient has been treated for lung cancer for 3 years. Over the past few months, the patient
has noticed that the opioid analgesic is not helping as much as it had previously and more
medication is needed for the same pain relief. The nurse is aware that this patient is
experiencing which of these? Opioid tolerance
Antibiotics allergy. Which one to choose for identified allergy for another
ATB
A patient with a long-term intravenous catheter is going home. The nurse knows that if the
patient is allergic to seafood, which antiseptic agent is contraindicated? Povidone-iodine
(Betadine)
You need to study all nursing concerns when administering ATB Tx
The nurse is providing teaching to a patient taking an oral tetracycline antibiotic. Which
statement by the nurse is correct? “Avoid direct sunlight and tanning beds while on this
medication.”
A nurse is teaching a client about taking tetracycline to treat a Gl infection due to Helicobacter
pylori. Which of the following statements should the nurse identify as an indication that the
client understands the instructions? "I will let my doctor know if I start having diarrhea."
The nurse is caring for a 7-year-old patient who will receive oral antibiotics. Which antibiotic
order will the nurse question for this patient?
Tetracycline (Sumycin)
When reviewing the medication orders for a patient who is taking penicillin, the nurse notes that
the patient is also taking the oral anticoagulant warfarin (Coumadin). What possible effect may
occur as the result of an interaction between these drugs? The penicillin will cause an enhanced
anticoagulant effect of the warfarin.
Critical thinking questions about nursing interventions for complications of
ATB Tx
The nurse caring for a patient who will receive penicillin to treat an infection asks the patient
about previous drug reactions. The patient reports having had a rash when taking amoxicillin
(Amoxil). The nurse will contact the provider to: Discuss using erythromycin (E-Mycin) instead of
penicillin.
A 4-year-old child is receiving amoxicillin (Amoxil) to treat otitis media and is in the clinic
for a well-child checkup on the last day of antibiotic therapy. The provider orders varicella
(Varivax); measles–mumps–rubella (MMR); inactivated polio (IPV); and diphtheria, tetanus,
and acellular pertussis (DTaP) vaccines to be given. Which action by the nurse is correct?
Administer the vaccines as ordered.
Remember Antibiotic-associated diarrhea is a common adverse effect of
antibiotics.
The nurse is monitoring a patient who has been on antibiotic therapy for 2 weeks. Today the
patient tells the nurse that he has had watery diarrhea since the day before and is having
abdominal cramps. His oral temperature is 101° F (38.3° C). Based on these findings, which
conclusion will the nurse draw? The patient needs to be tested for Clostridium difficile infection.
Cephalosporines indications, differentiate all 4 generations
When reviewing the allergy history of a patient, the nurse notes that the patient is allergic to
penicillin. Based on this finding, the nurse would question an order for which class of antibiotics?
Cephalosporins
The nurse is reviewing the culture results of a patient with an infection, and notes that the
culture indicates a gram-positive organism. Which generation of cephalosporin is most
appropriate for this type of infection? First-generation
The nurse is preparing to administer the first dose of intravenous ceftriaxone (Rocephin) to a
patient. When reviewing the patient’s chart, the nurse notes that the patient previously
experienced a rash when taking amoxicillin. What is the nurse’s next action? Administer the drug
and observe closely for hypersensitivity reactions.
The nurse is providing teaching to a patient who will begin taking a cephalosporin to treat an
infection. Which statement by the patient indicates a need for further teaching? “I may stop
taking the medication if my symptoms clear up.”
Empiric, prophylactic, definitive ATB Tx
A patient will be having oral surgery and has received an antibiotic to take for 1 week before the
surgery. The nurse knows that this is an example of which type of therapy? Prophylactic
Resistance to ATB, superinfections. Know concepts, how to identify
Which actions can contribute to bacterial resistance to antibiotics? (Select all that apply.)
Frequent use of antibiotics
Skipping doses
Treating viral infections with antibiotics
A patient is being treated with isoniazid (INH), rifampin, and pyrazinamide in phase I of treatment
for tuberculosis. The organism develops resistance to isoniazid. Which drug will the nurse
anticipate the provider will order to replace the isoniazid? Ethambutol (Myambutol)
The nurse caring for a patient who has tuberculosis and who is taking isoniazid, rifampin, and
streptomycin reviews the medical record and notes the patient’s sputum cultures reveal
resistance to streptomycin. The nurse will anticipate that the provider will take which action?
Change the streptomycin to kanamycin.
The nurse is preparing to give a dose of a cephalosporin medication to a patient who has been
receiving the antibiotic for 2 weeks. The nurse notes ulcers on the patient’s tongue and buccal
mucosa. Which action will the nurse take? Report a possible superinfection side effect of the
cephalosporin.
Antiseptics vs disinfectants.
The nurse is preparing to use an antiseptic. Which statement is correct regarding how antiseptics
differ from disinfectants? Disinfectants are used only on nonliving objects to destroy organisms.
Study Indications of ATB according to the type of infections, e.g., a UTI,
which classification of ATB can be used, MRSA, etc.…
A patient has a urinary tract infection. The nurse knows that which class of drugs is especially
useful for such infections? Sulfonamides
A patient who has been hospitalized for 2 weeks has developed a pressure ulcer that contains
multidrug-resistant Staphylococcus aureus (MRSA). Which drug would the nurse expect to be
chosen for therapy Vancomycin (Vancocin)
The nurse is reviewing laboratory results for a patient and notes that the patient has positive
results for nasal colonization by methicillin-resistant Staphylococcus aureus (MRSA). The nurse
anticipates an order for which medication? Mupirocin (Bactroban)
A female patient who is taking trimethoprim–sulfamethoxazole (TMP–SMZ) (Bactrim, Septra) to
treat a urinary tract infection reports vaginal itching and discharge. The nurse will perform which
action? . Report a possible superinfection to the provider.
Review ATB toxicity manifestations. Vancomycin toxicity level
The nurse assumes care for a patient who is currently receiving a dose of intravenous vancomycin
(Vancocin) infusing at 20 mg/min. The nurse notes red blotches on the patient’s face, neck, and
chest and assesses a blood pressure of 80/55 mm Hg. Which action will the nurse take? Slow the
infusion to 10 mg/min and observe the patient closely.
The nurse is administering a vancomycin (Vancocin) infusion. Which measure is appropriate for
the nurse to implement in order to reduce complications that may occur with this drug’s
administration? Infusing the drug over at least 1 hour
The nurse checks the patient’s laboratory work prior to administering a dose of vancomycin
(Vancocin) and finds that the trough vancomycin level is 24 mcg/mL. What will the nurse do next?
Hold the drug, and notify the prescriber.
The nurse is caring for a patient who is receiving an intravenous antibiotic. The nurse notes that
the provider has ordered serum drug peak and trough levels. The nurse understands that these
tests are necessary for which type of drugs? Drugs with a narrow therapeutic index
Identify prototype antivirals, antifungals, antimalarial, antitubercular, and
anthelminthics, by name and indications.
When monitoring patients on antitubercular drug therapy, the nurse knows that which drug may
cause a decrease in visual acuity? Ethambutol (Myambutol)
The nurse is counseling a woman who will be starting rifampin (Rifadin) as part of antitubercular
therapy. The patient is currently taking oral contraceptives. Which statement is true regarding
rifampin therapy for this patient? Oral contraceptives are less effective while the patient is taking
rifampin
Which person should be treated with prophylactic antitubercular medication? A patient with
latent TB as evidence by a positive tuberculin skin test
The nurse is caring for a patient who is diagnosed with tuberculosis. The patient tells the nurse
that the provider plans to order a prophylactic antitubercular drug for family members and asks
which drug will be ordered. The nurse will expect the provider to order which drug? Isoniazid
(INH)
Complications, contraindications, and adverse effects of antitubercular
drugs.
The nurse is discussing adverse effects of antitubercular drugs with a patient who has active
tuberculosis. Which potential adverse effect of antitubercular drug therapy should the patient
report to the prescriber? Numbness and tingling of extremities
The nurse will assess the patient for which potential contraindication to antitubercular therapy?
Hepatic impairment
A patient has been taking antitubercular therapy for 3 months. The nurse will assess for what
findings that indicate a therapeutic response to the drug therapy? There is a decrease in
symptoms of tuberculosis along with improved chest radiographs and sputum cultures.
A patient newly diagnosed with tuberculosis (TB) has been taking antitubercular drugs for 1 week
calls the clinic and is very upset. He says, “My urine is dark orange! What’s wrong with me?”
Which response by the nurse is correct? “This is an expected side effect of the medicine. Let’s
review what to expect.”
The nurse is providing patient teaching for a patient who is starting antitubercular drug therapy.
Which of these statements should be included? (Select all that apply.)
“Take the medications at the same time every day.”
“Avoid alcoholic beverages while on this therapy.”
“If you experience a burning or tingling in your fingers or toes, report it to your prescriber
immediately.”
“Oral contraceptives may not work while you are taking these drugs, so you will have to use
another form of birth control.”
Amphotericin B adverse effects
During an intravenous (IV) infusion of amphotericin B, a patient develops tingling and numbness
in his toes and fingers. What will the nurse do first? Discontinue the infusion immediately.
The nurse is preparing an infusion of amphotericin B for a patient who has a severe fungal
infection. Which intervention is appropriate regarding the potential adverse effects of
amphotericin B? Before beginning the infusion, administering an antipyretic and an antiemetic
drug
The nurse is administering one of the lipid formulations of amphotericin B. When giving this drug,
which concept is important to remember? The lipid formulations are associated with fewer
adverse effects than the older drugs.
During therapy with amphotericin B, the nurse will monitor the patient for known adverse effects
that would be reflected by which laboratory result? Serum potassium level of 2.7 mEq/L
The nurse is administering an amphotericin B infusion. Which actions by the nurse are
appropriate? (Select all that apply.)
Discontinuing the drug immediately if the patient develops tingling and numbness in the
extremities
Using an infusion pump for IV therapy
Monitoring the IV site for signs of phlebitis and infiltration
Administering premedication for fever and nausea
The nurse is teaching a nursing student about the antifungal drug amphotericin B. Which
statement by the student indicates a need for further teaching? “Amphotericin B may be given
intravenously or by mouth.”
Praziquantel (Biltricide), Pyrantel (Pin-X), Metronidazole (Flagyl),
Ivermectin (Stromectol), Atovaquone (Mepron), hydroxychloroquine
(Plaquenil); indications. Know exactly what infections can be treated with
these drugs.
A patient has an infestation with flukes (trematodes). The nurse anticipates the use of which drug
to treat this infestation? Praziquantel (Biltricide)
A patient with late-stage HIV infection also has Pneumocystis jirovecii pneumonia. The nurse
anticipates treatment with which medication for this pneumonia? Atovaquone (Mepron)
A child is diagnosed with pinworms. Which anthelmintic drug will the provider likely order for
this child? Pyrantel pamoate (Pin Rid)
A young adult female is prescribed metronidazole (Flagyl) to treat trichomoniasis. Which of the
following is FALSE regarding metronidazole? Metronidazole is not appropriate for this patient
because it is only indicated for bacterial infections.
A patient presents to the clinic with pediculosis (head lice). Which of the following will most likely
be prescribed? ivermectin (Nix)
Antimalarial drug therapy potential adverse reactions
A patient is taking chloroquine (Aralen) to treat acute malaria. Which statement by the patient
indicates understanding of this medication? “I should report visual changes immediately.”
A patient is experiencing the exoerythrocytic phase of malaria. The nurse expects which drug to
be used for this patient? Primaquine
A patient who is being treated for malaria has started therapy with quinine and tetracycline. He
asks the nurse why he is on an antibiotic when malaria is caused by a parasite. Which response
by the nurse is correct? “The two drugs are more effective against malaria when given together.”
A woman is traveling to a country where she will be at high risk for malarial infection. What will
the nurse teach her regarding prophylactic therapy with hydroxychloroquine (Plaquenil)? The
drug is usually started 1 to 2 weeks before traveling to endemic areas and is continued for 4
weeks after leaving the area.
The nurse is reviewing antimalarial drug therapy with a patient and instructs the patient to watch
for and report which potential adverse reactions? Visual disturbances
A patient is receiving hydroxychloroquine therapy but tells the nurse that she has never traveled
out of her city. The nurse knows that a possible reason for this drug therapy is which condition?
Systemic lupus erythematosus
Hydroxychloroquine (Plaquenil) is prescribed as part of malaria prophylaxis for a patient who will
be traveling. The nurse will discuss which potential adverse effects with the patient? (Select all
that apply.)
Diarrhea
Dizziness
Rash
Headache
Gout treatment, specific meds
A patient with gout has been treated with allopurinol (Zyloprim) for 2 months. The nurse will
monitor laboratory results for which therapeutic effect? Decreased uric acid levels
Which antigout medication is considered first-line to treat chronic tophaceous gout?
Allopurinol (Zyloprim)
The nurse is teaching a patient who is taking colchicine for the treatment of gout. Which
instruction will the nurse include during the teaching session? “Call your doctor if you have
increased joint pain or blood in the urine.”
The nurse notes in a patient’s medication history that the patient is taking allopurinol (Zyloprim).
Based on this finding, the nurse interprets that the patient has which disorder? Gout
The nurse is teaching a patient about taking colchicine to treat gout. What information will the
nurse include when teaching this patient about this drug? Increase fluid intake.
The nurse is assessing a patient who has gout who will begin taking allopurinol (Zyloprim). The
nurse reviews the patient’s medical record and will be concerned about which of the following
findings? History of kidney stones
The nurse is caring for a patient who is receiving a third dose of high-dose cyclophosphamide
(Cytoxan). The nurse notes hematuria. The nurse will notify the provider and will perform
which action? Question the patient about fluid intake.
Cytotec indications (not as an abortion drug).
A patient has used enteric aspirin for several years as treatment for osteoarthritis. However,
the symptoms are now worse and she is given a prescription for a nonsteroidal
anti-inflammatory drug and misoprostol (Cytotec). The patient asks the nurse, “Why am I
now taking two pills for arthritis?” What is the nurse’s best response? “Cytotec may help to
prevent gastric ulcers that may occur in patients taking NSAIDs.”
Anti-inflammatory indications, side effects, adverse effects,
contraindications.
The nurse is reviewing the therapeutic effects of nonsteroidal anti-inflammatory drugs (NSAIDs),
which include which effect? Antipyretic
A patient is taking the nonsteroidal anti-inflammatory drug indomethacin (Indocin) as treatment
for pericarditis. The nurse will teach the patient to watch for which adverse effect? Nausea and
vomiting
A patient with gout has been treated with allopurinol (Zyloprim) for 2 months. The nurse will
monitor laboratory results for which therapeutic effect? Decreased uric acid levels
A patient who has a history of coronary artery disease has been instructed to take one 81-mg
aspirin tablet a day. The patient asks about the purpose of this aspirin. Which response by the
nurse is correct? “It will help to prevent clot formation.”
During assessment of a patient with osteoarthritis pain, the nurse knows that which condition is
a contraindication to the use of nonsteroidal anti-inflammatory drugs (NSAIDs)? Renal disease
The nurse is reviewing the history of a patient who has a new order for a nonsteroidal
anti-inflammatory drug (NSAID) to treat tendonitis. Which conditions are contraindications to the
use of NSAIDs? (Select all that apply.)
Vitamin K deficiency
Peptic ulcer disease
Documented aspirin allergy
H2 receptor blockers indications, MOA, interactions, adverse effects
The nurse is reviewing the medication orders for a patient who will be taking an H2 antagonist.
Which drug may have an interaction if taken along with the H2 antagonist? Ketoconazole
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? Cimetidine (Tagamet)
A patient who has been taking cimetidine (Tagamet) for hyperacidity calls the clinic to say that
the medication has not been effective. The nurse reviews his history and notes that which factor
may be influencing the effectiveness of this drug? He smokes two packs of cigarettes a day.
A patient has been taking famotidine (Pepcid) 20 mg bid to treat an ulcer but continues to
have pain. The provider has ordered lansoprazole (Prevacid) 15 mg per day. The patient asks
why the new drug is necessary, since it is more expensive. The nurse will explain that
lansoprazole: is more potent than famotidine.
Antiacids adverse effects (acid-base imbalance, stones formation),
interactions
A patient is receiving an aluminum-containing antacid. The nurse will inform the patient to watch
for which possible adverse effect? Constipation
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?
Renal failure
A patient is asking advice about which over-the-counter antacid is considered the most safe to
use for heartburn. The nurse explains that the reason that calcium antacids are not used as
frequently as other antacids is for which of these reasons? Their use may result in kidney stones.
The nurse is providing patient teaching about antacids. Which statements about antacids are
accurate? (Select all that apply.)
Antacids neutralize acid in the stomach.
Rebound hyperacidity may occur with calcium-based antacids.
Magnesium-based antacids cause diarrhea.
A woman who is pregnant tells the nurse she has frequent heartburn in spite of eating small
meals slowly; avoiding greasy, gas-forming foods; and remaining upright for 30 minutes after
eating. The nurse will recommend which over-the-counter product? Magnesium and aluminum
containing antacids
Peptic ulcer (PUD) caused by Helicobacter pylori Tx (3 meds)
A patient will be taking a 2-week course of combination therapy with omeprazole (Prilosec) and
another drug for a peptic ulcer caused by Helicobacter pylori. The nurse expects a drug from
which class to be ordered with the omeprazole? Antibiotic
A patient with a peptic ulcer has been diagnosed with H. pylori. The provider has ordered
lansoprazole (Prevacid), clarithromycin (Biaxin), and metronidazole (Flagyl). The patient asks the
nurse why two antibiotics are needed. The nurse will explain that two antibiotics: combat
bacterial resistance
Proton pump inhibitor as long-term therapy potential adverse effects,
indications
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? Masked symptoms of serious
underlying diseases
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? Long-term use of these drugs may
contribute to osteoporosis.
A patient in the intensive care unit has a nasogastric tube and is also receiving a proton pump
inhibitor (PPI). The nurse recognizes that the purpose of the PPI is which effect? Prevent stress
ulcers
Laxatives, classification, and adverse effects
The nurse is giving oral mineral oil as an ordered laxative dose. The nurse will take measures to
prevent which potential problem that may occur with mineral oil? Lipid pneumonia
When administering a bulk-forming laxative, the nurse instructs the patient to drink the
medication mixed in a full 8-ounce glass of water. Which statement best explains the rationale for
this instruction? These laxatives may cause esophageal obstruction if taken with insufficient
water.
A patient is about to undergo a diagnostic bowel procedure. The nurse expects which drug to be
used to induce total cleansing of the bowel? Polyethylene glycol 3350 (GoLYTELY)
While recovering from surgery, an elderly woman started taking a stimulant laxative, senna
(Senokot), to relieve constipation caused by the pain medications. Two weeks later, at her
follow-up appointment, she tells the nurse that she likes how “regular” her bowel movements
are now that she is taking the laxative. Which teaching principle is appropriate for this patient?
Long-term use of laxatives often results in decreased bowel tone and may lead to dependency.
A patient wants to prevent problems with constipation and asks the nurse for advice about which
type of laxative is safe to use for this purpose. Which class of laxative is considered safe to use on
a long-term basis? Bulk-forming laxatives
A laxative has been ordered for a patient. The nurse checks the patient’s medical history and
would be concerned if which condition is present? Abdominal pain of unknown origin
A patient is severely constipated and needs immediate relief. The nurse knows that which class of
laxative will provide the most rapid results? Magnesium hydroxide (MOM)
A pregnant woman reports having constipation and has tried dietary changes without success.
What will the nurse recommend? A bulk-forming laxative like psyllium (Metamucil)
The nurse is caring for a newly admitted patient who will receive digoxin to treat a cardiac
dysrhythmia. The patient takes hydrochlorothiazide (HydroDIURIL) and reports regular use of
over-the-counter laxatives. Before administering the first dose of digoxin, the nurse will review
the patient’s electrolytes with careful attention to the levels of which electrolytes? Potassium and
magnesium
The nurse is reviewing the uses of oral laxatives. Which conditions are general contraindications
to or cautions about the use of oral laxatives? (Select all that apply.)
Undiagnosed abdominal pain
Nausea and vomiting
Fecal impaction
Acute surgical abdomen
Pepto-Bismol side effects
The nurse is discussing the use of adsorbents such as bismuth subsalicylate (Pepto-Bismol)
with a patient who has diarrhea. The nurse will warn the patient about which possible adverse
effects? Dark stools and blue gums
A patient will be taking bismuth subsalicylate (Pepto-Bismol) to control diarrhea. When
reviewing the patient’s other ordered medications, the nurse recognizes that which medication
or medication class will interact significantly with the Pepto-Bismol? Hypoglycemic drugs
A patient will be taking bismuth subsalicylate (Pepto-Bismol) to control diarrhea. When
reviewing the patient’s other ordered medications, the nurse recognizes that which medication
will interact significantly with the Pepto-Bismol? Warfarin (Coumadin), an anticoagulant
Vicodin adverse effects (SATA)
The opioid Vicodin (acetaminophen/hydrocodone) is prescribed for a patient who has had
surgery. The nurse informs the patient that which common adverse effects can occur with this
medication? (Select all that apply.)
Constipation
Lightheadedness
Urinary retention
Itching
NOTES