NURS 6521 Advanced Pharmacology – Week 7 – Quiz
NURS 6521 Advanced Pharmacology – Week 7 – Quiz
Attempt Score
34 out of 35 points
Time Elapsed
1 hour, 8 minutes out of 1 hour and 30 minutes
Instructions
Please answer each question below and click Submit when you have completed the Quiz.
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Question 1
1 out of 1 points
A woman with numerous chronic health problems has been diagnosed with a benign gastric ulcer has begun treatment with ranitidine (Zantac). Which of the following teaching points should the nurse provide to this patient?
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Response Feedback:
Smoking reverses the drug-induced inhibition of nocturnal gastric acid production and hinders ulcer healing. Cigarette smoking also is related closely to ulcer recurrence. Ranitidine should not be taken simultaneously with antacids and it does not eradicate H. pylori. It is not necessary to eat multiple small meals during the day. NURS 6521 Advanced Pharmacology – Week 7 – Quiz.
Question 2
1 out of 1 points
A teenage boy has undergone a diagnostic workup following several months of persistent, bloody diarrhea that appears to lack an infectious etiology. The boy has also experienced intermittent abdominal pain and has lost almost 15 pounds this year. Which of the following medications is most likely to treat this boy’s diagnosis?
Response Feedback:
This patient’s history and presentation are strongly suggestive of ulcerative colitis, a disease for which mesalamine is an approved treatment. Lubiprostone is used for the treatment of constipation and docusate is a stool softener. Bismuth subsalicylate is an antidiarrheal but is not effective in the management of ulcerative colitis.
Question 3
1 out of 1 points
A nurse is aware that diphenoxylate HCl with atropine sulfate is an effective adjunct in the treatment of diarrhea. For which of the following patients could the administration of this drug be potentially harmful? NURS 6521 Advanced Pharmacology – Week 7 – Quiz
Response Feedback:
Use of diphenoxylate HCl is contraindicated for diarrhea caused by GI organisms that penetrate the gastric mucosa (such as C. difficile) because the drug slows peristalsis and may aggravate and prolong the diarrhea. Diarrhea associated with stress, influenza, and tube feeding can be safely treated with the drug in most cases.
Question 4
1 out of 1 points
A nurse is planning care for a 59-year-old woman who is on ranitidine therapy. The nurse is concerned for the patient’s safety. Which of the following would be an appropriate nursing diagnosis?
Response Feedback:
The appropriate nursing diagnosis related to safety would be Risk for Injury related to drug-induced somnolence, dizziness, confusion, or hallucinations. Diarrhea related to adverse effects of drug therapy and Acute Pain related to adverse drug effects, headache are appropriate nursing diagnosis for a patient taking ranitidine, but are not related to safety. Potential Complication: Electrolyte Imbalance related to hypophosphatemia, secondary to drug therapy would be appropriate for a patient taking an aluminum hydroxide with magnesium hydroxide antacid (Maalox, Mylanta). NURS 6521 Advanced Pharmacology – Week 7 – Quiz.
Question 5
1 out of 1 points
It is determined that a patient, who is in a hepatic coma, needs a laxative. Lactulose is prescribed. Which of the following should the nurse monitor to assess the efficacy of the lactulose therapy?
Response Feedback:
Similar to the saline laxative magnesium hydroxide, lactulose pulls water into the colon. Unlike magnesium hydroxide, lactulose is a synthetic disaccharide of lactose. In the colon, bacteria metabolize lactulose into acids and carbon dioxide, increasing the oncotic pressure in the colon and drawing water into the stool. The acids formed also draw ammonia into the stool. Therefore, lactulose is used not only to treat constipation but also to decrease blood ammonia levels in patients in hepatic coma and those with hepatic encephalopathy. The other factors, although significant, would not indicate the efficacy of the lactulose therapy as accurately as blood ammonia levels. NURS 6521 Advanced Pharmacology – Week 7 – Quiz.
Question 6
0 out of 1 points
A nurse is providing discharge instructions to a patient who will be taking fludrocortisone at home. The nurse will encourage the patient to eat a diet that is
Response Feedback:
The patient should avoid foods that are high in sodium and eat foods that are high in potassium. The patient should eat foods rich in proteins because long-term fludrocortisone therapy promotes the deposition of liver glycogen and induces a negative nitrogen balance. NURS 6521 Advanced Pharmacology – Week 7 – Quiz. Iron-rich food is not typically shown to have therapeutic or adverse effects of fludrocortisone; therefore, it is more important to instruct the patient to avoid high-sodium foods and to eat potassium-rich ones.
Question 7
1 out of 1 points
A woman with an inflammatory skin disorder has begun taking prednisone in an effort to control the signs and symptoms of her disease. The nurse who is providing care for this patient should prioritize which of the following potential nursing diagnoses in the organization of the patient’s care?
Response Feedback:
Treatment with glucocorticoids such as prednisone is associated with numerous adverse effects, including the risk for excess fluid volume. Constipation and impaired gas exchange are not among the most common adverse effects and CNS effects are normally limited to anxiety, mood swings, and insomnia rather than acute confusion.
Question 8
1 out of 1 points
A 42-year-old man is being treated for a peptic ulcer with ranitidine (Zantac) taken PO at bedtime. Even though few adverse effects are associated with this drug, one common adverse effect that can be severe is
Response Feedback:
Even though ranitidine generally is well tolerated, headache is a common adverse effect that can be severe. The nurse will encourage the patient to adjust lights or temperature and avoid noise if headaches occur and to contact his physician if the headache becomes intolerable. Irritability, dry mouth, and heart palpitations are not associated with this drug. NURS 6521 Advanced Pharmacology – Week 7 – Quiz.
Question 9
1 out of 1 points
A 48-year-old woman who works as an office manager is prescribed metoclopramide (Reglan) for diabetic gastroparesis. The nurse will be sure to assess the patient for
Response Feedback:
Depression, from mild to severe, including suicidal ideation, has occurred in patients with and without a history of depression who take metoclopramide. Use caution in administering metoclopramide to patients with a history of depression. The nurse should assess the patient for signs of depression and monitor behavior as long as the patient is on the therapy. If the patient has been depressed or is depressed, metoclopramide therapy should be given only if the benefits of the drug outweigh the potential risks from depression. Tachycardia, hypotension, and anemia are not associated with metoclopramide.
Question 10
1 out of 1 points
A 60-year-old man has scheduled a follow-up appointment with his primary care provider stating that the omeprazole (Prilosec) which he was recently prescribed is ineffective. The patient states, “I take it as soon as I feel heartburn coming on, but it doesn’t seem to help at all.” How should the nurse best respond to this patient’s statement?
Response Feedback:
Optimal efficacy requires that omeprazole is taken daily, not just when the patient is symptomatic. A lack of immediate symptomatic relief does not necessarily indicate that the drug is ineffective.
Question 11
1 out of 1 points
A patient who takes aluminum hydroxide with magnesium hydroxide (Mylanta) frequently for upset stomach, heartburn, and sour stomach is seen regularly in the clinic. The nurse should assess which of the following?
Response Feedback:
The nurse should monitor the patient’s serum phosphate level because aluminum binds with phosphate. This can lower phosphate levels and cause an electrolyte imbalance. Blood glucose, urine specific gravity, and aspartate transaminase levels are not affected by this drug combination.
Question 12
1 out of 1 points
Following an endoscopy, a 66-year-old man has been diagnosed with a duodenal ulcer resulting from Helicobacter pylori infection. Which of the following medications will likely be used in an attempt to eradicate the patient’s H. pylori infection? (Select all that apply.)
Response Feedback:
Classic quadruple therapy for H. pylori eradication (bismuth, a PPI, 1,500 mg of metronidazole, and 1,500 mg of tetracycline) is highly effective and is frequently the regimen of choice. A newer sequential therapy (PPI plus amoxicillin followed by a PPI plus clarithromycin plus metronidazole) has been proposed and is expected to replace legacy therapy. Both regimens include PPIs and antibiotics and exclude aluminum hydroxide, ondansetron, and cisapride.
Question 13
1 out of 1 points NURS 6521 Advanced Pharmacology – Week 7 – Quiz
A 33-year-old woman has irritable bowel syndrome (IBS). The physician has prescribed simethicone (Mylicon) for her discomfort. Which of the following will the nurse monitor most closely during the patient’s drug therapy?
Response Feedback:
The nurse needs to closely monitor the patient for increased abdominal pain, nausea, fever, and vomiting. These symptoms are not indicative of excessive flatus, for which simethicone is prescribed, but indicate that the patient needs urgent medical attention for another condition. There is no risk for drug toxicity, anorexia, or increased urine output.
Question 14
1 out of 1 points
A 58-year-old man is prescribed dicyclomine (Bentyl) for irritable bowel syndrome. In which of the following conditions is dicyclomine therapy contraindicated?
Response Feedback:
Dicyclomine is contraindicated for patients with myasthenia gravis, glaucoma, GI tract obstruction, paralytic ileus, and toxic megacolon. The drug is not contraindicated for patients with hypertension, diabetes mellitus, and rheumatoid arthritis.
Question 15
1 out of 1 points
A 73-year-old woman has scheduled an appointment with her nurse practitioner to discuss her recurrent constipation. The woman states that she experiences constipation despite the fact that she takes docusate on a daily basis and performs cleansing enemas several times weekly. How should the nurse best respond to this patient’s statements?
Response Feedback:
Chronic use of laxatives may lead to dependency on the laxative to expel a bowel movement. This pattern is especially common among older adults. This phenomenon is more likely than a pathological condition. It would be inappropriate to suggest more (or different) laxatives.
Question 16
1 out of 1 points
A 29-year-old female patient has been prescribed orlistat (Xenical) for morbid obesity. The nurse is providing patient education concerning the drug. An important instruction to the patient would be to
Response Feedback:
The nurse should instruct the patient to omit the orlistat (Xenical) for any meal that does not contain fat. The nurse should also instruct the patient to limit dietary intake of fat to 30% of calories. This drug is a reversible lipase inhibitor. By inhibiting the action of lipase, it decreases the absorption of dietary fats. The patient would be advised to take a multivitamin that contains fat-soluble vitamins to prevent imbalances from drug therapy. The administration of orlistat and multivitamins should be separated by 2 hours. Dietary protein does not interfere with the action of orlistat.
Question 17
1 out of 1 points NURS 6521 Advanced Pharmacology – Week 7 – Quiz
An adult patient who has been diagnosed with a rectal tumor is scheduled to begin treatment with cisplatin. The nurse has conducted patient teaching about the possibility of nausea and vomiting. In order to reduce the patient’s risk of severe nausea, the nurse should
Response Feedback:
Antiemetics should be administered proactively rather than waiting until the patient’s nausea becomes unbearable. A combination approach is often effective. A low-residue diet is unnecessary and withholding food does not necessarily reduce nausea. NURS 6521 Advanced Pharmacology – Week 7 – Quiz
