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Pharmacology for Nurses 3rd Edition Adams Holland Test Bank

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Pharmacology for Nurses 3rd Edition Adams Holland Test Bank

ISBN-13: 978-0135089811

ISBN-10: 0135089816

 

Description

Pharmacology for Nurses 3rd Edition Adams Holland Test Bank

ISBN-13: 978-0135089811

ISBN-10: 0135089816

 

 

 

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Free Nursing Test Questions:

Chapter 40

40.1 The nursing instructor teaches the student nurses about intrinsic factor.The instructor evaluates learning has occurred when the students make which response?

  1. “Intrinsic factor is necessary for absorption of vitamin B12.”
  2. “Intrinsic factor is secreted by the chief cells of the stomach.”
  3. “Intrinsic factor is necessary for absorption of vitamin B6.”
  4. “Intrinsic factor aids in the secretion of mucus to protect the stomach.”
    Answer: 1

Rationale:Parietal cells secrete intrinsic factor, which is essential for the absorption of vitamin B12. Chief cells secrete pepsinogen and rennin, not intrinsic factor. Intrinsic factor is necessary for the absorption of vitamin B12, not B6. Intrinsic factor does not aid in the secretion of mucus in the stomach.

Evaluation

Physiological Integrity

Application

Objective: 40-10

40.2 The physician has ordered bismuth (Pepto-Bismol) for the client with a peptic ulcer who is colonized with H. Pylori.The client asks the nurse why he is receiving this drug. What is the best response by the nurse? Select all that apply.

  1. “Bismuth (Pepto-Bismol) helps prevent the side effects of antibiotics.”
  2. “Bismuth (Pepto-Bismol) keeps bacteria from sticking in your stomach.”
  3. “Bismuth (Pepto-Bismol) increases stomach acid to help kill bacteria.”
  4. “Bismuth (Pepto-Bismol) is effective with inhibiting bacterial growth.”
  5. “Bismuth (Pepto-Bismol) helps relieve ulcer-related constipation.”
    Answer: 2, 4

Rationale:Bismuth compounds (Pepto-Bismol) are added to the antibiotic regimen to inhibit bacterial growth. Bismuth compounds (Pepto-Bismol) prevent H. Pylori from adhering to the gastric mucosa. Bismuth (Pepto-Bismol) does not prevent the side effects of antibiotics. Bismuth (Pepto-Bismol) does not increase stomach acid. Bismuth (Pepto-Bismol) is used to relieve diarrhea, not constipation.

Implementation

Physiological Integrity

Analysis

Objective: 40-6

40.3 The physician orders misoprostol (Cytotec) for the female client with peptic ulcer disease (PUD). What is a priority question for the nurse to ask the client prior to administration of this medication?

  1. “Are your menstrual cycles irregular?”
  2. “Are you pregnant?”
  3. “Do you plan on becoming pregnant?”
  4. “Are you sexually active?”

Answer: 2

Rationale:Misoprostol (Cytotec) is contraindicated during pregnancy; it is sometimes used to terminate pregnancies.There is no contraindication for misoprostol (Cytotec) in a client with irregular menstrual cycles. Misoprostol (Cytotec) is safe as long as the client is not pregnant.Asking if a client is sexually active could be appropriate, but the nurse would also ask if the client is using birth control.

Assessment

Physiological Integrity

Analysis

Objective: 40-8

40.4 The client receives esomeprazole (Nexium). He asks the nurse why that little purple pill is better than his cimetidine (Tagamet). What is the best response by the nurse?

  1. “It is not as effective as cimetidine (Tagamet), but kills bacteria better.”
  2. “It is about the same, but has fewer side effects than your cimetidine (Tagamet).”
  3. “It is about the same, but a lot cheaper than your cimetidine (Tagamet).”
  4. “It decreases acid in your stomach, better than cimetidine (Tagamet).”
    Answer: 4

Rationale:Proton-pump inhibitors reduce acid secretion to a greater extent than H2-receptor antagonists, and have a longer duration of action. Esomeprazole (Nexium) is more effective than cimetidine (Tagamet), but will not kill bacteria. Esomeprazole (Nexium) does not have fewer side effects than cimetidine (Tagamet). Esomeprazole (Nexium) is not cheaper than cimetidine (Tagamet).

Implementation

Physiological Integrity

Analysis

Objective: 40-9

40.5 The client is admitted for treatment of a duodenal ulcer. During the client’s admission, what will the best assessment of the nurse reveal?

  1. Low back pain radiating down the left leg.
  2. Anorexia and weight loss.
  3. Burning pain several hours after eating a meal.
  4. Nausea and lower right quadrant abdominal pain.
    Answer: 3

Rationale:Duodenal ulcers are associated with burning upper abdominal pain after a meal. Duodenal ulcers do not cause low back pain radiating down the left leg.Anorexia and weight loss are more common with gastric, not duodenal, ulcers. Nausea and lower right quadrant abdominal pain are more likely associated with appendicitis.

Assessment

Physiological Integrity

Application

Objective: 40-3

40.6 The nurse has completed education about peptic ulcer disease (PUD) with the client.The nurse evaluates learning has occurred when the client makes which statement?

  1. “I will join a gym and increase my exercise.”
  2. “I will drink more milk and limit spicy foods.”
  3. “I will take ibuprofen (Motrin) for my headaches.”
  4. “I will limit my intake of caffeine products.”
    Answer: 4

Rationale:Caffeine is a risk factor for peptic ulcer disease (PUD)Remember, limiting caffeine will be beneficial in the treatment of peptic ulcer disease (PUD).There is no correlation between exercise and the management of peptic ulcer disease (PUD). Milk can increase acid production and spicy foods are not an issue with peptic ulcer disease (PUD). Nonsteroidal anti-inflammatory drugs (NSAIDS) are a primary cause of peptic ulcer disease (PUD).

Evaluation

Physiological Integrity

Analysis

Objective: 40-2

40.7 An elderly client comes to the emergency department with his wife. He has a history of peptic ulcer disease (PUD), and is currently experiencing confusion and severe headaches. What does the best plan of the nurse include?

  1. Obtain a magnetic resonance imaging (MRI) exam to assess if the client has experienced a stroke.
  2. Ask the client if he has experienced any head injuries recently.
  3. Ask the client’s wife for a list of medications that the client has taken.
  4. Obtain a complete blood count (CBC), chemistry profile, and urine drug screen.
    Answer: 3

Rationale:There is a known correlation between H2-receptor antagonists and confusion and headaches in the elderly population, the nurse should ascertain what medications the client is taking. It is premature to obtain a magnetic resonance imaging (MRI) exam until other causes have been ruled out.A confused client may not be able to answer a question regarding recent head injuries.A complete blood count (CBC), chemistry profile, and urine drug screen are worthwhile tests, but the first priority for a client with a history of peptic ulcer disease (PUD) should be to find out what medications he has been taking.

Planning

Physiological Integrity

Analysis

Objective: 40-10

40.8 The client has gastroesophageal reflux disease (GERD) and has been receiving medication treatment for many years. What priority assessment findings associated with the medication must the nurse report to the physician?

  1. Hypotension and tachycardia
  2. Anemia, fatigue, and weakness
  3. Diarrhea and soft stools
  4. Vomiting and mild upper mid-epigastric pain
    Answer: 2

Rationale:Anemia, fatigue, and weakness are common signs of pernicious anemia or vitamin B12 deficiency. With chronic suppression of stomach acid by medications used for gastroesophageal reflux disease (GERD), the stomach may not be able to absorb vitamin B12, and there is the possibility of pernicious anemia. Hypotension and tachycardia are not signs of pernicious anemia or vitamin B12 deficiency that may result from chronic suppression of stomach acid from medications. Diarrhea and soft stools are not signs of pernicious anemia or vitamin B12 deficiency that may result from chronic suppression of stomach acid from medications. Vomiting and mild upper mid-epigastric pain are not signs of pernicious anemia or vitamin B12 deficiency that may result from chronic suppression of stomach acid from medications.

Assessment

Physiological Integrity

Analysis

Objective: 40-2

40.9 The physician has ordered combination therapy for the client with peptic ulcer disease (PUD).The nurse plans to do medication education. What will the best plan of the nurse include?

  1. Combination therapy has the best outcomes when antibiotics are used with antacids.
  2. Combination therapy has the best outcomes when antibiotics are used with proton-pump inhibitors.
  3. Various antibiotics are used to eradicate the bacteria that are responsible for the development of peptic ulcer disease (PUD).
  4. The use of sucralfate (Carafate) along with antibiotics is the best combination therapy for peptic ulcer disease (PUD).
    Answer: 2

Rationale:Combination therapy has the best outcomes when antibiotics are used with proton-pump inhibitors. Combination therapy has the best outcomes when antibiotics are used with proton-pump inhibitors, not with antacids. Combination therapy has the best outcomes when antibiotics are combined with proton-pump inhibitors, rather than when used alone. Combination therapy has the best outcomes when antibiotics are used with proton-pump inhibitors, not with sucralfate (Carafate).

Planning

Physiological Integrity

Analysis

Objective: 40-8

40.10 The nurse designs a plan of care for the client with peptic ulcer disease (PUD). Who is taking omeprazole (Prilosec) for the management of his illness. What will the best plan of the nurse include? Select all that apply.

  1. Omeprazole (Prilosec) is recommended for long-term treatment of peptic ulcer disease (PUD).
  2. Omeprazole (Prilosec) should be administered after meals.
  3. Omeprazole (Prilosec) is best augmented with yogurt, but not at the same time.
  4. Omeprazole (Prilosec) should not be crushed or chewed.
  5. Omeprazole (Prilosec) should be administered before meals.
    Answer: 3, 4, 5

Rationale:Yogurt is very beneficial for replacing helpful bacteria while taking this medication. Omeprazole (Prilosec) is enteric-coated and needs to dissolve in the intestine; it should not be crushed or chewed. Omeprazole (Prilosec) should be administered before meals. Omeprazole (Prilosec) is recommended for short-term, not long-term, use. Omeprazole (Prilosec) should be administered before, not after, meals in order to be most effective.

Planning

Physiological Integrity

Analysis

Objective: 40-10

40.11 What is the correct administration technique for the client receiving antacids?

  1. Antacids can be safely administered with antibiotics.
  2. Antacids should be administered two hours before other oral medications.
  3. Antacids cannot be administered through a feeding tube.
  4. Antacids can be safely administered with H2-receptor medications.
    Answer: 2

Rationale:Administering antacids with other oral medications can affect the absorption of the other medications; they should be taken two hours before other oral medications.Administering antacids with antibiotics will decrease their absorption.Antacids can be administered through a feeding tube.Administering antacids with H2-receptor antagonists will decrease their absorption.

Implementation

Physiological Integrity

Application

Objective: 40-8

40.12 The client receives H2-receptor antagonists for treatment of peptic ulcer disease (PUD). Which assessment finding should be reported immediately to the physician?

  1. The client reports pain after 24 hours of treatment.
  2. The client reports episodes of melana.
  3. The client reports he took Tums with his H2-receptor antagonist.
  4. The client reports he is constipated.
    Answer: 2

Rationale:Melana could indicate GI bleeding and should be reported to the physician immediately.The client may still experience pain for several days with this type of medication.Taking Tums with an H2-receptor antagonist will cause deceased absorption of the H2-receptor antagonist, but this does not need to be reported to the physician; the nurse should educate the client. Constipation is a common side effect that does not need to be immediately reported to the physician.

Implementation

Physiological Integrity

Analysis

Objective: 40-5

40.13 The nurse completes medication education for the client receiving sucralfate (Carafate).The nurse evaluates learning has occurred when the client makes which statement?

  1. “This works by decreasing the amount of acid in my stomach.”
  2. “This works by inhibiting bacterial growth in my stomach.”
  3. “This works by neutralizing the acid in my stomach.”
  4. “This works by dissolving into a jelly and sticking to my ulcer.”
    Answer: 4

Rationale:Sucralfate (Carafate) works by dissolving into a gel and adhering to the site of the ulcer, not by decreasing stomach acid, not by inhibiting bacterial growth, nor by neutralizing stomach acid.

Evaluation

Physiological Integrity

Analysis

Objective: 40-8

40.14 What is the correct administration technique for sucralfate (Carafate)?

  1. Administer it after meals.
  2. Administer it with milk.
  3. Administer it prior to meals.
  4. Administer it with eight ounces of water.
    Answer: 3

Rationale:Sucralfate (Carafate) provides a protective coating and should be administered before meals in order to be effective.Administering sucralfate (Carafate) after meals will inhibit its ability to adhere to the ulcer.Administering sucralfate (Carafate) with milk will inhibit its action.Administering sucralfate (Carafate) with eight ounces of water will decrease its bioavailability and effectiveness.

Implementation

Physiological Integrity

Application

Objective: 40-10

40.15 The client receives misoprostol (Cytotec) for treatment of peptic ulcer disease (PUD).The client asks the nurse why he is receiving this medication. What is the best response by the nurse?

  1. “It dissolves into a gel and sticks to your ulcer.”
  2. “It neutralizes stomach acid.”
  3. “It inhibits bacterial growth.”
  4. “It increases mucus production in your stomach.”
    Answer: 4

Rationale:Misoprostol (Cytotec) inhibits gastric secretion and stimulates the production of protective mucus. Sucralfate (Carafate), not misoprostol (Cytotec), dissolves into a gel and adheres to the ulcer site.Antacids, not misoprostol (Cytotec), neutralize stomach acid. Bismuth (Pepto-Bismol), not misoprostol (Cytotec), inhibits bacterial growth.

Implementation

Physiological Integrity
Analysis

Objective: 40-8

 

40.16 The pyloric sphincter regulates flow of food into the:

  1. Rectum.
  2. Small intestine.
  3. Esophagus.
  4. Stomach.

Answer: B
Rationale:

  1. The pyloric sphincter regulates food out of the stomach, not the rectum.
  2. The pyloric sphincter regulates food out of the stomach into the small intestine.
  3. The cardiac sphincter keeps food from moving back into the esophagus.
  4. The pyloric sphincter moves food out of the stomach.

Nursing Process: Assessment

Cognitive Level: Knowledge

Client Need: Physiological Integrity

Objective 40.1

 

40.17 Which of the following best describes a risk factor associated with peptic ulcer disease?

  1. Use of spicy foods
  2. Presence of bacteria such as Helicobacter pylori
  3. Eating small meals
  4. Type AB blood

Answer: B

Rationale:

  1. Spicy foods do not cause peptic ulcer disease.
  2. The most common cause of peptic ulcer disease is the H. pylori bacteria.
  3. Eating small meals is better for digestion.
  4. Type O blood is a risk factor.

Nursing Process: Assessment

Cognitive Level: Comprehension

Client Need: Physiological Integrity

Objective 40.2

 

 

40.18 An erosion of the mucosal layer of the stomach or duodenum describes a:

  1. Hiatal hernia.
  2. Diverticulum.
  3. Peptic ulcer.
  4. Crohn’s lesion.

Answer: C

Rationale:

  1. Hiatal hernias are an outpouching in the esophagus.
  2. Diverticulum occurs in the large intestine.
  3. A peptic ulcer is erosion of the mucosal layer of the stomach or duodenum.
  4. Crohn’s lesion can occur anyway in the gastrointestinal tract.

Nursing Process: Assessment

Cognitive Level: Knowledge

Client Need: Physiological Integrity

Objective 40.3

 

 

40.19 The primary goal in treatment of gastroesophageal reflux disease is to:

  1. Decrease stomach pain.
  2. Promote ulcer healing.
  3. Prevent infection.
  4. Reduce gastric acid secretions.

Answer: D

Rationale:

  1. Heartburn occurs, but not pain in the stomach.
  2. Promoting ulcer healing is not the goal
  3. Preventing infection is not the goal.
  4. The primary goal is to reduce gastric secretions, which produce the reflux.

Nursing Process: Assessment

Cognitive Level: Knowledge

Client Need: Physiological Integrity

Objective 40.4

 

 

  1. 20. Peptic ulcer disease is treated primarily with:
  2. Pharmacotherapy.
  3. Diet.
  4. Exercise.
  5. A combination of lifestyle changes and pharmacotherapy.

Answer: D

Rationale: A combination of lifestyle changes and pharmacotherapy is the best and most effctive way to treat peptic ulcer disease.

Objective 40.5

Nursing Process: Implementation

Cognitive Level: Knowledge

Client Need: Physiological Integrity

 

 

 

40.21 A client has just been diagnosed with peptic ulcer disease. The drug most likely to be used is:

 

  1. Aluminum/magnesium (Maalox).
  2. Famotidine (Pepcid).
  3. Omeprazole (Prilosec).
  4. Magaldrate (Riopan).

 

Answer: B

Rationale:

  1. Maalox is an antacid.
  2. H2-receptor blockers are the drugs of first choice in treating peptic ulcers.
  3. Prilosec is a proton pump inhibitor;.
  4. Riopan is an antacid.

 

 

Nursing Process: Planning

Cognitive Level: Knowledge

Client Need: Physiological Integrity

 

Objective 40.5

 

40.22 The nurse is aware that antacids containing magnesium and aluminum can cause:

  1. Indigestion.
  2. Constipation.
  3. Diarrhea.
  4. Abdominal pain.

Answer: C

Rationale:

  1. Antacid would help the indigestion.
  2. Calcium-based products, such as Tums, cause constipation.
  3. Magnesium and aluminum, such as in Maalox, can cause diarrhea.
  4. Antacids do not cause abdominal pain.

Nursing Process: Evaluation

Cognitive Level: Comprehension

Client Need: Physiologic Integrity

Objective 40.7

 

 

40.23 The mechanism of action of proton pump inhibitors is to:

  1. Block H2 receptors in the stomach.
  2. Reduce acid secretion in the stomach.
  3. Neutralize acid.
  4. Decrease infection.

Answer: B

Rationale: The mechanism of action of proton pump inhibitors is to reduce acid secretion in the stomach.

Nursing Process: Implementation

Cognitive Level: Knowledge

Client Need: Physiologic Integrity

Objective 40.9

 

 

40.24 The client is taking ranitidine (Zantac), an H2 receptor blocker. The nurse will teach the client to take the drug:

  1. At the same time as antacids.
  2. With or without food.
  3. With other medications.
  4. Only once per day.

Answer: B

Rationale:

  1. H2 receptor blockers should not be taken with antacids.
  2. H2 receptor blockers can be taken with or without food.
  3. Other medications can interact with H2 receptor blockers.
  4. H2 receptors blockers may be given more than once, whatever is prescribed.

Nursing Process: Implementation

Cognitive Level: Knowledge

Client Need: Physiological Integrity

Objective 40.10

 

 

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