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Pharmacology for Nurses 5th Edition Adams Holland Urban Test Bank

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Pharmacology for Nurses 5th Edition Adams Holland Urban Test Bank

ISBN-13: 978-0134255163

ISBN-10: 013425516X

 

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Pharmacology for Nurses 5th Edition Adams Holland Urban Test Bank

ISBN-13: 978-0134255163

ISBN-10: 013425516X

 

 

 

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Free Nursing Test Questions:

 

Adams, Pharmacology for Nurses: A Pathophysiologic Approach, 5/E
Chapter 42

Question 1

Type: MCSA

The nursing instructor is teaching student nurses about lower gastrointestinal (GI) functioning and the large intestine. The nursing instructor evaluates that learning has occurred when the students make which statement?

  1. “The large intestine contains host flora that manufacture vitamin E.”
  2. “The large intestine absorbs most of the nutrients from food.”
  3. “The large intestine absorbs water and eliminates stool.”
  4. “Food travels through the large intestine for 3 to 6 hours.”

Correct Answer: 3

Rationale 1: The large intestine contains host flora that manufacture B-complex vitamins and vitamin K, not vitamin E.

Rationale 2: The small intestine, not the large intestine, absorbs most of the nutrients from food.

Rationale 3: Major functions of the large intestine include absorption of water and elimination of stool.

Rationale 4: Food travels through the large intestine for 12 to 24 hours, not for 3 to 6 hours.

Global Rationale: Major functions of the large intestine include absorption of water and elimination of stool. The large intestine contains host flora that manufacture B-complex vitamins and vitamin K, not vitamin E. The small intestine, not the large intestine, absorbs most of the nutrients from food. Food travels through the large intestine for 12 to 24 hours, not for 3 to 6 hours.

 

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub: Physiological Adaptation

QSEN Competencies: III.A.1 Demonstrate knowledge of basic scientific methods and processes.

AACN Essentials Competencies: III.1 Explain the interrelationships among theory, practice, and research.

NLN Competencies: Knowledge and Science: Integration of knowledge from nursing and other disciplines.

Nursing/Integrated Concepts: Nursing Process: Evaluation

Learning Outcome: 42-1 Identify major anatomic structures of the lower gastrointestinal tract.

MNL Learning Outcome: 7.2.1 Examine etiology, pathophysiology, and clinical manifestations.

Page Number: 697

 

Question 2

Type: MCSA

An elderly client has constipation. He asks the nurse the reason for this. What is the best response by the nurse?

  1. “You could have a serious illness and should check with your doctor.”
  2. “You probably drink too much alcohol and end up constipated.”
  3. “You probably don’t eat enough fiberRemember, the stool stays in your intestine too long.”
  4. “Your large intestine is old and does not work as well as it used to.”

Correct Answer: 3

Rationale 1: The client could have a serious illness, but constipation in the elderly is more likely related to dietary habits.

Rationale 2: Alcohol can be a contributing factor to constipation, but the nurse should first assess alcohol intake and not just assume excessive alcohol intake.

Rationale 3: If the waste material remains in the intestine too long due to lack of fiber, too much water is reabsorbed leading to small, hard stools.

Rationale 4: Telling an elderly client that his intestine is old is very non-therapeutic.

Global Rationale: If the waste material remains in the intestine too long due to lack of fiber, too much water is reabsorbed leading to small, hard stools. The client could have a serious illness, but constipation in the elderly is more likely related to dietary habits. Alcohol can be a contributing factor to constipation, but the nurse should first assess alcohol intake and not just assume excessive alcohol intake. Telling an elderly client that his intestine is old is very non-therapeutic.

 

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub: Physiological Adaptation

QSEN Competencies: III.A.1 Demonstrate knowledge of basic scientific methods and processes.

AACN Essentials Competencies: III.1 Explain the interrelationships among theory, practice, and research.

NLN Competencies: Knowledge and Science: Integration of knowledge from nursing and other disciplines.

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 42-2 Explain the pathophysiology and pharmacotherapy of constipation.

MNL Learning Outcome: 7.2.1 Examine etiology, pathophysiology, and clinical manifestations.

Page Number: 698

 

Question 3

Type: MCSA

The nurse designs a teaching plan for the client with chronic pancreatitis who receives pancrelipase (Pancreaze). What will the best plan by the nurse include as it relates to the rationale for the client to receive this drug?

  1. “These enzymes replace what your ineffective pancreas cannot make.”
  2. “These enzymes will help promote healing of your pancreas.”
  3. “These enzymes promote digestion of starches and fats.”
  4. “These enzymes will help digest all of the food you eat.”

Correct Answer: 1

Rationale 1: Chronic pancreatitis eventually leads to pancreatic insufficiency that may necessitate replacement of pancreatic enzymes.

Rationale 2: Pancreatic enzymes do not help heal the pancreas.

Rationale 3: Pancreatic enzymes will help digest food, but reason the client is receiving them.

Rationale 4: Pancreatic enzymes will help digest food, but reason the client is receiving them.

Global Rationale: Chronic pancreatitis eventually leads to pancreatic insufficiency that may necessitate replacement of pancreatic enzymes. Pancreatic enzymes do not help heal the pancreas. Pancreatic enzymes will help digest food, but reason the client is receiving them.

 

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub: Pharmacological and Parenteral Therapies

QSEN Competencies: V.A.4 Delineate general categories of errors and hazards in care.

AACN Essentials Competencies: IX.3 Implement holistic, patient-centered care that reflects an understanding of human growth and development, pathophysiology, pharmacology, medical management and nursing management across the health-illness continuum, across lifespan, and in all healthcare settings.

NLN Competencies: Knowledge and Science: Integration of knowledge from nursing and other disciplines.

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: 42-8 For each of the drug classes listed in Drugs at a Glance, know representative drug examples, and explain their mechanisms of action, primary action, and important adverse effects.

MNL Learning Outcome: 7.2.3 Apply the nursing process to pharmacotherapy, safe drug administration, and client education.

Page Number: 713

 

Question 4

Type: MCMA

The nurse is planning care for the client who experiences frequent constipation. What will the best plan by the nurse include?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Standard Text: Select all that apply.

  1. Increase protein in the diet.
  2. Drink a glass of water every hour.
  3. Increase dairy products in the diet.
  4. Increase dietary fiber in the diet.
  5. Increase daily physical exercise.

Correct Answer: 4,5

Rationale 1: Increasing protein in the diet will not help prevent constipation.

Rationale 2: Drinking a glass of water every hour is too much fluid and can result in hyponatremia.

Rationale 3: Dairy products in the diet will lead to, not prevent, constipation.

Rationale 4: Increasing fiber in the diet will help prevent constipation.

Rationale 5: Increasing exercise will help prevent constipation.

Global Rationale: Increasing exercise and fiber in the diet will help prevent constipation. Increasing protein in the diet will not help prevent constipation. Drinking a glass of water every hour is too much fluid and can result in hyponatremia. Dairy products in the diet will lead to, not prevent, constipation.

 

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub: Pharmacological and Parenteral Therapies

QSEN Competencies: I.B.3 Provide patient-centered care with sensitivity and respect for the diversity of human experience.

AACN Essentials Competencies: IX.3 Implement holistic, patient-centered care that reflects an understanding of human growth and development, pathophysiology, pharmacology, medical management and nursing management across the health-illness continuum, across lifespan, and in all healthcare settings.

NLN Competencies: Knowledge and Science: Integration of knowledge from nursing and other disciplines.

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: 42-9 Use the nursing process to care for patients receiving pharmacotherapy for bowel disorders, nausea, vomiting and other gastrointestinal conditions.

MNL Learning Outcome: 7.2.3 Apply the nursing process to pharmacotherapy, safe drug administration, and client education.

Page Number: 698

 

Question 5

Type: MCMA

The client is scheduled for bowel surgery. What medications are appropriate for cleansing the bowel, or “bowel prep,” prior to this procedure?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Standard Text: Select all that apply.

  1. Docusate sodium (Colace)
  2. Bisacodyl (Dulcolax)
  3. Methylcellulose (Citrucel)
  4. Sodium phosphate (Fleet Phospho-Soda)
  5. Mineral oil

Correct Answer: 2,4

Rationale 1: Docusate sodium (Colace) is a stool softener and is not appropriate for a “bowel prep.”

Rationale 2: Bisacodyl (Dulcolax) is a stimulant laxative and appropriate for a “bowel prep.”

Rationale 3: Methylcellulose (Citrucel) is a bulk-forming laxative and is not appropriate for a “bowel prep.”

Rationale 4: Sodium phosphate (Fleet Phospho-Soda) is an osmotic saline laxative and appropriate for a “bowel prep.”

Rationale 5: Mineral oil is not appropriate for a “bowel prep.”

Global Rationale: Bisacodyl (Dulcolax) is a stimulant laxative and appropriate for a “bowel prep.” Sodium phosphate (Fleet Phospho-Soda) is an osmotic saline laxative and appropriate for a “bowel prep.” Docusate sodium (Colace) is a stool softener and is not appropriate for a “bowel prep.” Methylcellulose (Citrucel) is a bulk-forming laxative and is not appropriate for a “bowel prep.” Mineral oil is not appropriate for a “bowel prep.”

 

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub: Pharmacological and Parenteral Therapies

QSEN Competencies: I.B.15 Communicate care provided and needed at each transition in care.

AACN Essentials Competencies: IX.8 Implement evidence-based nursing interventions as appropriate for managing the acute and chronic care of patients and promoting health across the lifespan.

NLN Competencies: Knowledge and Science: Relationships between knowledge/science and quality and safe nursing care.

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: 42-7 Describe the nurse’s role in the pharmacologic management of bowel disorders, nausea and vomiting, and other gastrointestinal conditions.

MNL Learning Outcome: 7.2.3 Apply the nursing process to pharmacotherapy, safe drug administration, and client education.

Page Number: 699

 

Question 6

Type: MCSA

The client has been vomiting for several days. The nurse would assess the client for which acid–base disturbance?

  1. Metabolic acidosis
  2. Respiratory alkalosis
  3. Metabolic alkalosis
  4. Respiratory acidosis

Correct Answer: 3

Rationale 1: Metabolic acidosis will not occur as a result of vomiting.

Rationale 2: Respiratory alkalosis will not occur as a result of vomiting.

Rationale 3: Metabolic alkalosis will result from excessive loss of hydrochloric acid from the stomach brought on by prolonged vomiting.

Rationale 4: Respiratory acidosis will not occur as a result of vomiting.

Global Rationale: Metabolic alkalosis will result from excessive loss of hydrochloric acid from the stomach brought on by prolonged vomiting. Respiratory alkalosis will not occur as a result of vomiting. Metabolic and respiratory acidosis will not occur as a result of vomiting.

 

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub: Physiological Adaptation

QSEN Competencies: I.B.3 Provide patient-centered care with sensitivity and respect for the diversity of human experience.

AACN Essentials Competencies: IX.3 Implement holistic, patient-centered care that reflects an understanding of human growth and development, pathophysiology, pharmacology, medical management and nursing management across the health-illness continuum, across lifespan, and in all healthcare settings.

NLN Competencies: Knowledge and Science: Integration of knowledge from nursing and other disciplines.

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 42-9 Use the nursing process to care for patients receiving pharmacotherapy for bowel disorders, nausea, vomiting and other gastrointestinal conditions.

MNL Learning Outcome: 7.2.3 Apply the nursing process to pharmacotherapy, safe drug administration, and client education.

Page Number: 707

 

Question 7

Type: MCSA

The client takes a stool softener on a regular basis and now reports a change in bowel patterns. Which assessment finding is the priority for the nurse to discuss with the physician?

  1. Stools that are smaller in size
  2. An increase in bowel frequency
  3. A decrease in bowel frequency
  4. Cramping with each stool passed

Correct Answer: 4

Rationale 1: Stools that are smaller in size are a concern but are not the priority concern.

Rationale 2: An increase in bowel frequency does not need to be reported at this time.

Rationale 3: A decrease in bowel frequency does not need to be reported at this time.

Rationale 4: Cramping could indicate a serious condition that should be reported to the physician.

Global Rationale: Cramping could indicate a serious condition that should be reported to the physician. Stools that are smaller in size are a concern but are not the priority concern. Changes in bowel frequency does not need to be reported at this time.

 

Cognitive Level: Analyzing

Client Need: Physiological Integrity

Client Need Sub: Pharmacological and Parenteral Therapies

QSEN Competencies: I.B.3 Provide patient-centered care with sensitivity and respect for the diversity of human experience.

AACN Essentials Competencies: IX.3 Implement holistic, patient-centered care that reflects an understanding of human growth and development, pathophysiology, pharmacology, medical management and nursing management across the health-illness continuum, across lifespan, and in all healthcare settings.

NLN Competencies: Knowledge and Science: Integration of knowledge from nursing and other disciplines.

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 42-9 Use the nursing process to care for patients receiving pharmacotherapy for bowel disorders, nausea, vomiting and other gastrointestinal conditions.

MNL Learning Outcome: 7.2.3 Apply the nursing process to pharmacotherapy, safe drug administration, and client education.

Page Number: 707

 

Question 8

Type: MCSA

The nurse has completed medication education for the client who takes psyllium mucilloid (Metamucil). The nurse recognizes that additional teaching is indicated when the client makes which statement?

  1. “I don’t need to drink extra fluids while I take this medication.”
  2. “My cholesterol level will be reduced somewhat with this medication.”
  3. “This medication is a lot more natural than other laxatives.”
  4. “This medication takes several days to work.”

Correct Answer: 1

Rationale 1: Fluids must be increased when clients use psyllium mucilloid (Metamucil).

Rationale 2: Psyllium mucilloid (Metamucil) does help to reduce cholesterol levels.

Rationale 3: Psyllium mucilloid (Metamucil) is more natural than other laxatives.

Rationale 4: Psyllium mucilloid (Metamucil) does take several days to work.

Global Rationale: Fluids must be increased when clients use psyllium mucilloid (Metamucil). Psyllium mucilloid (Metamucil) does help to reduce cholesterol levels. Psyllium mucilloid (Metamucil) is more natural than other laxatives. Psyllium mucilloid (Metamucil) does take several days to work.

 

Cognitive Level: Analyzing

Client Need: Physiological Integrity

Client Need Sub: Pharmacological and Parenteral Therapies

QSEN Competencies: V.A.4 Delineate general categories of errors and hazards in care.

AACN Essentials Competencies: IX.3 Implement holistic, patient-centered care that reflects an understanding of human growth and development, pathophysiology, pharmacology, medical management and nursing management across the health-illness continuum, across lifespan, and in all healthcare settings.

NLN Competencies: Knowledge and Science: Integration of knowledge from nursing and other disciplines.

Nursing/Integrated Concepts: Nursing Process: Evaluation

Learning Outcome: 42-8 For each of the drug classes listed in Drugs at a Glance, know representative drug examples, and explain their mechanisms of action, primary action, and important adverse effects.

MNL Learning Outcome: 7.2.3 Apply the nursing process to pharmacotherapy, safe drug administration, and client education.

Page Number: 700

 

Question 9

Type: MCSA

Which client is most at risk to develop constipation?

  1. The pediatric client who takes antibiotics for ear infections
  2. The elderly client who routinely takes a stimulant laxative twice daily.
  3. The young client in the hospital for an appendectomy
  4. The middle-aged client who uses an enema when he travels

Correct Answer: 2

Rationale 1: The pediatric client is at low risk to develop constipation.

Rationale 2: Elderly clients who abuse laxatives are at risk for constipation.

Rationale 3: The young client is at low risk to develop constipation.

Rationale 4: The middle-aged client is at low risk to develop constipation.

Global Rationale: Elderly clients who abuse laxatives are at risk for constipation. Antibiotics, appendectomy, and occasional use of enemas are not the highest risk for constipation.

 

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub: Pharmacological and Parenteral Therapies

QSEN Competencies: III.A.1 Demonstrate knowledge of basic scientific methods and processes.

AACN Essentials Competencies: III.1 Explain the interrelationships among theory, practice, and research.

NLN Competencies: Knowledge and Science: Integration of knowledge from nursing and other disciplines.

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 42-2 Explain the pathophysiology and pharmacotherapy of constipation.

MNL Learning Outcome: 7.2.1 Examine etiology, pathophysiology, and clinical manifestations.

Page Number: 699

 

Question 10

Type: MCSA

The client takes diphenoxylate with atropine (Lomotil) for diarrhea. The client asks the nurse why he does not experience pain relief since this drug is an opioid. What is the best response by the nurse?

  1. “This drug is not an opioid; did your doctor tell you that?”
  2. “You would really have to take a lot to experience pain relief.”
  3. “It does provide some relief from the pain associated with diarrhea.”
  4. “Because this opioid does not have analgesic properties.”

Correct Answer: 4

Rationale 1: Diphenoxylate with atropine (Lomotil) is an opioid.

Rationale 2: The amount of diphenoxylate with atropine (Lomotil) is not the issue; this opioid does not have analgesic properties.

Rationale 3: Diphenoxylate with atropine (Lomotil) does not have analgesic properties and will not provide any pain relief associated with diarrhea.

Rationale 4: Unlike most opioids, diphenoxylate with atropine (Lomotil) does not have analgesic properties.

Global Rationale: Unlike most opioids, diphenoxylate with atropine (Lomotil) does not have analgesic properties.

The amount of diphenoxylate with atropine (Lomotil) is not the issue; this opioid does not have analgesic properties.

 

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub: Pharmacological and Parenteral Therapies

QSEN Competencies: V.A.4 Delineate general categories of errors and hazards in care.

AACN Essentials Competencies: IX.3 Implement holistic, patient-centered care that reflects an understanding of human growth and development, pathophysiology, pharmacology, medical management and nursing management across the health-illness continuum, across lifespan, and in all healthcare settings.

NLN Competencies: Knowledge and Science: Integration of knowledge from nursing and other disciplines.

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 42-8 For each of the drug classes listed in Drugs at a Glance, know representative drug examples, and explain their mechanisms of action, primary action, and important adverse effects.

MNL Learning Outcome: 7.2.3 Apply the nursing process to pharmacotherapy, safe drug administration, and client education.

Page Number: 702

 

Question 11

Type: MCSA

The client receives prochlorperazine (Compazine) for nausea and vomiting. The nurse notices that the client is exhibiting a stiff neck, turned to the side. What is the best action by the nurse?

  1. Administer the client’s as needed analgesic immediately.
  2. Contact the physician immediately.
  3. Hold the next dose and observe the client.
  4. Ask the client if she has ever experienced this before.

Correct Answer: 2

Rationale 1: Giving an analgesic is not the priority intervention.

Rationale 2: Prochlorperazine (Compazine) is a phenothiazine drug; the client is experiencing an extrapyramidal side effect known as dystonia. The nurse should immediately alert the physician and prepare to administer an antidote.

Rationale 3: The client needs an antidote; holding the next dose will not relieve the symptoms.

Rationale 4: Assessment is good, but the client needs an antidote.

Global Rationale: Prochlorperazine (Compazine) is a phenothiazine drug; the client is experiencing an extrapyramidal side effect known as dystonia. The nurse should immediately alert the physician and prepare to administer an antidote. Giving an analgesic is not the priority intervention. The client needs an antidote; holding the next dose will not relieve the symptoms. Assessment is good, but the client needs an antidote.

 

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub: Pharmacological and Parenteral Therapies

QSEN Competencies: V.A.4 Delineate general categories of errors and hazards in care.

AACN Essentials Competencies: IX.3 Implement holistic, patient-centered care that reflects an understanding of human growth and development, pathophysiology, pharmacology, medical management and nursing management across the health-illness continuum, across lifespan, and in all healthcare settings.

NLN Competencies: Knowledge and Science: Integration of knowledge from nursing and other disciplines.

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: 42-8 For each of the drug classes listed in Drugs at a Glance, know representative drug examples, and explain their mechanisms of action, primary action, and important adverse effects.

MNL Learning Outcome: 7.2.3 Apply the nursing process to pharmacotherapy, safe drug administration, and client education.

Page Number: 710

 

Question 12

Type: MCSA

The primary role of the large intestine is to

  1. excrete fecal matter.
  2. absorb nutrients.
  3. excrete enzymes.
  4. control peristalsis.

Correct Answer: 1

Rationale 1: The large intestine is responsible for reabsorption of water and for fecal excretion.

Rationale 2: The small intestine absorbs nutrients and drugs.

Rationale 3: The stomach and small intestine excrete enzymes for digestion.

Rationale 4: Peristalsis is controlled by the autonomic nervous system.

Global Rationale: The large intestine is responsible for reabsorption of water and for fecal excretion. The small intestine absorbs nutrients and drugs. The stomach and small intestine excrete enzymes for digestion. Peristalsis is controlled by the autonomic nervous system.

 

Cognitive Level: Remembering

Client Need: Physiological Integrity

Client Need Sub: Physiological Adaptation

QSEN Competencies: III.A.1 Demonstrate knowledge of basic scientific methods and processes.

AACN Essentials Competencies: III.1 Explain the interrelationships among theory, practice, and research.

NLN Competencies: Knowledge and Science: Integration of knowledge from nursing and other disciplines.

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 42-1 Identify major anatomic structures of the lower gastrointestinal tract.

MNL Learning Outcome: 7.2.1 Examine etiology, pathophysiology, and clinical manifestations.

Page Number: 697

 

Question 13

Type: MCSA

Which statement best describes the pathogenesis of diarrhea?

  1. It is infrequent passage of stool.
  2. It occurs when the large intestine reabsorbs water.
  3. It is caused by lack of fiber in the diet.
  4. It is an increase in frequency of stool.

Correct Answer: 4

Rationale 1: Constipation is the infrequent passage of hard stools.

Rationale 2: Diarrhea occurs when the large intestine fails to reabsorb water.

Rationale 3: Constipation is caused by lack of exercise and fiber.

Rationale 4: Diarrhea is an increase in the frequency and fluidity of bowel movements.

Global Rationale: Diarrhea is an increase in the frequency and fluidity of bowel movements. Constipation is the infrequent passage of hard stools. Diarrhea occurs when the large intestine fails to reabsorb water. Constipation is caused by lack of exercise and fiber.

 

Cognitive Level: Remembering

Client Need: Physiological Integrity

Client Need Sub: Physiological Adaptation

QSEN Competencies: III.A.1 Demonstrate knowledge of basic scientific methods and processes.

AACN Essentials Competencies: III.1 Explain the interrelationships among theory, practice, and research.

NLN Competencies: Knowledge and Science: Integration of knowledge from nursing and other disciplines.

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 42-3 Explain the pathophysiology and pharmacotherapy of diarrhea.

MNL Learning Outcome: 7.2.1 Examine etiology, pathophysiology, and clinical manifestations.

Page Number: 700

 

Question 14

Type: MCSA

After a client begins pancreatic enzyme replacement therapy, the nurse will assess for

  1. headache.
  2. dry mouth.
  3. nausea and vomiting.
  4. falls.

Correct Answer: 3

Rationale 1: Some anorexiants can cause headache.

Rationale 2: Antidiarrheal therapy can cause dry mouth.

Rationale 3: The most frequent adverse effects are GI symptoms of nausea, vomiting, and diarrhea.

Rationale 4: Antiemetic therapy can cause sedation and falls.

Global Rationale: The most frequent adverse effects are GI symptoms of nausea, vomiting, and diarrhea. Some anorexiants can cause headache. Antidiarrheal therapy can cause dry mouth. Antiemetic therapy can cause sedation and falls.

 

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub: Physiological Adaptation

QSEN Competencies: III.A.1 Demonstrate knowledge of basic scientific methods and processes.

AACN Essentials Competencies: III.2 Demonstrate an understanding of the basic elements of the research process and models for applying evidence to clinical practice.

NLN Competencies: Knowledge and Science: Integration of knowledge from nursing and other disciplines.

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 42-6 Explain the use of pancreatic enzyme replacement in the pharmacotherapy of pancreatitis.

MNL Learning Outcome: 7.2.2 Compare the classes of medications used in pharmacologic management.

Page Number: 713

 

Question 15

Type: MCSA

The mechanism of action of the antidiarrheal atropine (Lomotil) is to

  1. promote stool passage.
  2. block dopamine receptors in the brain.
  3. increase stool formation.
  4. slow peristalsis.

Correct Answer: 4

Rationale 1: Laxatives promote stool passage and increase size of stool.

Rationale 2: Antiemetics block dopamine and inhibit vomiting centers.

Rationale 3: Laxatives increase stool passage.

Rationale 4: Antidiarrheals such as atropine slow peristalsis and allow water reabsorption.

Global Rationale: Antidiarrheals such as atropine slow peristalsis and allow water reabsorption. Laxatives promote stool passage and increase size of stool. Antiemetics block dopamine and inhibit vomiting centers. Laxatives increase stool passage.

 

Cognitive Level: Remembering

Client Need: Physiological Integrity

Client Need Sub: Physiological Adaptation

QSEN Competencies: III.A.1 Demonstrate knowledge of basic scientific methods and processes.

AACN Essentials Competencies: III.1 Explain the interrelationships among theory, practice, and research.

NLN Competencies: Knowledge and Science: Integration of knowledge from nursing and other disciplines.

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 42-3 Explain the pathophysiology and pharmacotherapy of diarrhea.

MNL Learning Outcome: 7.2.1 Examine etiology, pathophysiology, and clinical manifestations.

Page Number: 702

 

Question 16

Type: MCSA

A client has been prescribed prochlorperazine (Compazine) for nausea. Possible adverse effects would include

  1. diarrhea.
  2. dry mouth.
  3. hypertension.
  4. bradycardia.

Correct Answer: 2

Rationale 1: Diarrhea is not an adverse effect of prochlorperazine.

Rationale 2: Phenothiazines block dopamine and can cause dry mouth.

Rationale 3: Hypotension, not hypertension, can occur.

Rationale 4: Tachycardia, not bradycardia, can occur.

Global Rationale: Phenothiazines block dopamine and can cause dry mouth. Diarrhea is not an adverse effect of prochlorperazine. Hypotension, not hypertension, can occur. Tachycardia, not bradycardia, can occur.

 

Cognitive Level: Understanding

Client Need: Physiological Integrity

Client Need Sub: Pharmacological and Parenteral Therapies

QSEN Competencies: V.A.4 Delineate general categories of errors and hazards in care.

AACN Essentials Competencies: IX.3 Implement holistic, patient-centered care that reflects an understanding of human growth and development, pathophysiology, pharmacology, medical management and nursing management across the health-illness continuum, across lifespan, and in all healthcare settings.

NLN Competencies: Knowledge and Science: Integration of knowledge from nursing and other disciplines.

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 42-8 For each of the drug classes listed in Drugs at a Glance, know representative drug examples, and explain their mechanisms of action, primary action, and important adverse effects.

MNL Learning Outcome: 7.2.3 Apply the nursing process to pharmacotherapy, safe drug administration, and client education.

Page Number: 710

 

Question 17

Type: MCSA

Stool softeners

  1. break up fecal material.
  2. decrease peristalsis.
  3. promote water absorption in the intestine.
  4. increase peristalsis.

Correct Answer: 3

Rationale 1: Stimulant laxatives break up fecal material.

Rationale 2: No laxatives cause decrease in peristalsis.

Rationale 3: Stool softeners cause more water and fat to be absorbed.

Rationale 4: Stimulant laxatives increase peristalsis.

Global Rationale: Stool softeners cause more water and fat to be absorbed. Stimulant laxatives break up fecal material. Stimulant laxatives increase peristalsis. No laxatives cause decrease in peristalsis.

 

Cognitive Level: Remembering

Client Need: Physiological Integrity

Client Need Sub: Physiological Adaptation

QSEN Competencies: III.A.1 Demonstrate knowledge of basic scientific methods and processes.

AACN Essentials Competencies: III.1 Explain the interrelationships among theory, practice, and research.

NLN Competencies: Knowledge and Science: Integration of knowledge from nursing and other disciplines.

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 42-2 Explain the pathophysiology and pharmacotherapy of constipation.

MNL Learning Outcome: 7.2.1 Examine etiology, pathophysiology, and clinical manifestations.

Page Number: 700

 

Question 18

Type: MCSA

A client who was diagnosed with Clostridium difficile calls the clinic and says, “I’m still having diarrhea so I started taking an over-the-counter medication to stop it.” How should the nurse respond?

  1. “Which antidiarrheal are you taking?”
  2. “How many doses have you taken?”
  3. “Stop taking the medicine and come to the clinic.”
  4. “Is it stopping your diarrhea?”

Correct Answer: 3

Rationale 1: The identity of the antidiarrheal is not the priority.

Rationale 2: The number of doses taken is not the priority.

Rationale 3: Antidiarrheal use is contraindicated in cases of Clostridium difficile.

Rationale 4: The effectiveness of the antidiarrheal is not the priority.

Global Rationale: Antidiarrheal use is contraindicated in cases of Clostridium difficile. The identity of the antidiarrheal and the number of doses taken are not the priority. The effectiveness of the antidiarrheal is not the priority.

 

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub: Physiological Adaptation

QSEN Competencies: III.A.1 Demonstrate knowledge of basic scientific methods and processes.

AACN Essentials Competencies: III.1 Explain the interrelationships among theory, practice, and research.

NLN Competencies: Knowledge and Science: Integration of knowledge from nursing and other disciplines.

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 42-3 Explain the pathophysiology and pharmacotherapy of diarrhea.

MNL Learning Outcome: 7.2.1 Examine etiology, pathophysiology, and clinical manifestations.

Page Number: 702

 

Question 19

Type: MCSA

A client has been prescribed sulfasalazine (Azulfidine) for treatment of ulcerative colitis. Which nursing assessment question is essential?

  1. “How long have you had ulcerative colitis?”
  2. “What are you allergic to?”
  3. “Are you lactose intolerant?”
  4. “Do you have to stand in one place for long periods of time at your work?”

Correct Answer: 2

Rationale 1: most important assessment data.

Rationale 2: The client who is allergic to sulfa drugs should not take sulfasalazine.

Rationale 3: Lactose intolerance is not a significant assessment finding for this client.

Rationale 4: Standing in one spot for long periods of time is not a significant issue with sulfasalazine.

Global Rationale: The client who is allergic to sulfa drugs should not take sulfasalazine. How long the ulcerative colitis has existed is not the most important data. Lactose intolerance is not a significant assessment finding for this client. Standing in one spot for long periods of time is not a significant issue with sulfasalazine.

 

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub: Physiological Adaptation

QSEN Competencies: III.A.1 Demonstrate knowledge of basic scientific methods and processes.

AACN Essentials Competencies: III.6 Integrate evidence, clinical judgement, interprofessional perspectives and patient preferences in planning, implementing, and evaluating outcomes of care.

NLN Competencies: Knowledge and Science: Integration of knowledge from nursing and other disciplines.

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 42-4 Compare and contrast the pharmacotherapy of inflammatory bowel disease and irritable bowel syndrome.

MNL Learning Outcome: 7.2.1 Examine etiology, pathophysiology, and clinical manifestations.

Page Number: 705

 

Question 20

Type: MCSA

A client has developed nausea and vomiting. What is the nurse’s primary treatment?

  1. Replacing fluids
  2. Identifying and eliminating the cause
  3. Encouraging the client to lie still
  4. Providing the client with soft foods

Correct Answer: 2

Rationale 1: Replacement of fluids is essential but not the primary treatment.

Rationale 2: Nausea and vomiting are often due to modifiable conditions. Eliminating the conditions is the primary treatment.

Rationale 3: If the client is vomiting, lying still is difficult and may be dangerous if aspiration occurs.

Rationale 4: The client should not eat while nauseated and vomiting.

Global Rationale: Nausea and vomiting are often due to modifiable conditions. Eliminating the conditions is the primary treatment. Replacement of fluids is essential but not the primary treatment. If the client is vomiting, lying still is difficult and may be dangerous if aspiration occurs. The client should not eat while nauseated and vomiting.

 

Cognitive Level: Understanding

Client Need: Physiological Integrity

Client Need Sub: Physiological Adaptation

QSEN Competencies: III.A.1 Demonstrate knowledge of basic scientific methods and processes.

AACN Essentials Competencies: III.6 Integrate evidence, clinical judgement, interprofessional perspectives and patient preferences in planning, implementing, and evaluating outcomes of care.

NLN Competencies: Knowledge and Science: Integration of knowledge from nursing and other disciplines.

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 42-5 Explain the pathophysiology and pharmacotherapy of nausea and vomiting.

MNL Learning Outcome: 7.2.1 Examine etiology, pathophysiology, and clinical manifestations.

Page Number: 711

 

Question 21

Type: MCMA

A client asks if he could use an over-the-counter bulk-type laxative. Which assessment finding would cause the nurse to tell the client not to use this drug?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Standard Text: Select all that apply.

  1. The client is over age 60.
  2. The client takes warfarin every other day.
  3. The client has type 2 diabetes.
  4. The client has a history of fecal impaction.
  5. The client is allergic to penicillin.

Correct Answer: 2,4

Rationale 1: There is no contraindication for use of this laxative class in clients over 60.

Rationale 2: Bulk-type laxatives may decrease the absorption and effects of warfarin.

Rationale 3: Bulk-type laxatives may decrease serum glucose levels in clients with type 2 diabetes. This is not an adverse outcome.

Rationale 4: If there is a chance that the client has a fecal impaction, bulk-type laxatives should not be used.

Rationale 5: Allergy to penicillin is not a contraindication for use of bulk-type laxatives.

Global Rationale: Bulk-type laxatives may decrease the absorption and effects of warfarin. If there is a chance that the client has a fecal impaction, bulk-type laxatives should not be used. There is no contraindication for use of this laxative class in clients over 60. Bulk-type laxatives may decrease the absorption and effects of warfarin. Allergy to penicillin is not a contraindication for use of bulk-type laxatives.

 

Cognitive Level: Analyzing

Client Need: Physiological Integrity

Client Need Sub: Pharmacological and Parenteral Therapies

QSEN Competencies: I.B.15 Communicate care provided and needed at each transition in care.

AACN Essentials Competencies: IX.8 Implement evidence-based nursing interventions as appropriate for managing the acute and chronic care of patients and promoting health across the lifespan.

NLN Competencies: Knowledge and Science: Relationships between knowledge/science and quality and safe nursing care.

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 42-7 Describe the nurse’s role in the pharmacologic management of bowel disorders, nausea and vomiting, and other gastrointestinal conditions.

MNL Learning Outcome: 7.2.3 Apply the nursing process to pharmacotherapy, safe drug administration, and client education.

Page Number: 700

 

 

Question 22

Type: MCMA

A client calls the clinic and says, “I have been taking Imodium (loperamide) for diarrhea, but it isn’t helping.” How should the nurse respond?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Standard Text: Select all that apply.

  1. “Are you taking it after every episode of diarrhea?”
  2. “Imodium is not effective against diarrhea.”
  3. “This medication may make you sleepy.”
  4. “You may have to take the maximum dose for 2 or 3 days before diarrhea slows.”
  5. “You should come in for assessment.”

Correct Answer: 1,3,5

Rationale 1: Loperamide (Imodium) is taken as a 4 mg single dose, followed by 2 mg after each diarrhea episode up to 16 mg/day.

Rationale 2: Imodium is indicated for diarrhea.

Rationale 3: Imodium has the adverse effect of drowsiness.

Rationale 4: Diarrhea should slow within a few hours of doses.

Rationale 5: If over-the-counter medications are not effective, prescription medications may be necessary. The client should be seen in the clinic.

Global Rationale: Loperamide (Imodium) is taken as a 4 mg single dose, followed by 2 mg after each diarrhea episode up to 16 mg/day. Imodium has the adverse effect of drowsiness. If over-the-counter medications are not effective, prescription medications may be necessary. The client should be seen in the clinic. Imodium is indicated for diarrhea. Diarrhea should slow within a few hours of doses.

 

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub: Pharmacological and Parenteral Therapies

QSEN Competencies: I.B.15 Communicate care provided and needed at each transition in care.

AACN Essentials Competencies: IX.8 Implement evidence-based nursing interventions as appropriate for managing the acute and chronic care of patients and promoting health across the lifespan.

NLN Competencies: Knowledge and Science: Relationships between knowledge/science and quality and safe nursing care.

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 42-7 Describe the nurse’s role in the pharmacologic management of bowel disorders, nausea and vomiting, and other gastrointestinal conditions.

MNL Learning Outcome: 7.2.3 Apply the nursing process to pharmacotherapy, safe drug administration, and client education.

Page Number: 701

 

Question 23

Type: MCMA

While a nurse is collecting medical history, the client says, “I was diagnosed with a spastic colon.” How should the nurse interpret this statement?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Standard Text: Select all that apply.

  1. The client has ulcerative colitis.
  2. The client has had recurrent abdominal pain for at least 3 months.
  3. The client has irritable bowel syndrome.
  4. The client’s disease is psychosomatic.
  5. The client has Crohn’s disease.

Correct Answer: 2,3

Rationale 1: Typically, the diagnosis of spastic colon is not the same as ulcerative colitis.

Rationale 2: The diagnostic criterion for this disorder is recurrent abdominal pain for at least 3 days per month during the previous 3 months.

Rationale 3: Irritable bowel syndrome is also known as spastic colon.

Rationale 4: While there is often no organic disease found in this disorder, the pain and other findings are real.

Rationale 5: Irritable bowel syndrome is not the same as Crohn’s disease.

Global Rationale: Irritable bowel syndrome is also known as spastic colon. The diagnostic criterion for this disorder is recurrent abdominal pain for at least 3 days per month during the previous 3 months. Typically, the diagnosis of spastic colon is not the same as ulcerative colitis. While there is often no organic disease found in this disorder, the pain and other findings are real. Irritable bowel syndrome is not the same as Crohn’s disease.

 

Cognitive Level: Analyzing

Client Need: Physiological Integrity

Client Need Sub: Physiological Adaptation

QSEN Competencies: III.A.1 Demonstrate knowledge of basic scientific methods and processes.

AACN Essentials Competencies: III.6 Integrate evidence, clinical judgement, interprofessional perspectives and patient preferences in planning, implementing, and evaluating outcomes of care.

NLN Competencies: Knowledge and Science: Integration of knowledge from nursing and other disciplines.

Nursing/Integrated Concepts: Nursing Process: Evaluation

Learning Outcome: 42-4 Compare and contrast the pharmacotherapy of inflammatory bowel disease and irritable bowel syndrome.

MNL Learning Outcome: 7.2.1 Examine etiology, pathophysiology, and clinical manifestations.

Page Number: 702

 

Question 24

Type: MCMA

A nurse would question a prescription for sulfasalazine (Azulfidine) if the client is also taking which medication?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Standard Text: Select all that apply.

  1. Insulin
  2. Digoxin
  3. Warfarin
  4. Penicillin
  5. Vitamin C

Correct Answer: 1,2,3

Rationale 1: Clients with diabetes may experience hypoglycemia if sulfasalazine is taken concurrently.

Rationale 2: Absorption of digoxin may be decreased.

Rationale 3: Anticoagulation effects may be increased.

Rationale 4: There is no drug–drug interaction with penicillin.

Rationale 5: There is no drug–drug interaction with vitamin C.

Global Rationale: Clients with diabetes may experience hypoglycemia if sulfasalazine is taken concurrently. Absorption of digoxin may be decreased. Anticoagulation effects may be increased. There is no drug–drug interaction with penicillin. There is no drug–drug interaction with vitamin C.

 

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub: Pharmacological and Parenteral Therapies

QSEN Competencies: V.A.4 Delineate general categories of errors and hazards in care.

AACN Essentials Competencies: IX.3 Implement holistic, patient-centered care that reflects an understanding of human growth and development, pathophysiology, pharmacology, medical management and nursing management across the health-illness continuum, across lifespan, and in all healthcare settings.

NLN Competencies: Knowledge and Science: Integration of knowledge from nursing and other disciplines.

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 42-8 For each of the drug classes listed in Drugs at a Glance, know representative drug examples, and explain their mechanisms of action, primary action, and important adverse effects.

MNL Learning Outcome: 7.2.3 Apply the nursing process to pharmacotherapy, safe drug administration, and client education.

Page Number: 705

 

Question 25

Type: MCMA

A client says she would like to control her nausea with natural products instead of drugs. What education should the nurse provide?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Standard Text: Select all that apply.

  1. “Peppermint may be effective.”
  2. “Some people believe ginger ale is effective against nausea.”
  3. “Vitamin E oil is sometimes effective for nausea.”
  4. “Milk is usually an effective anti-nausea treatment.”
  5. “There are no natural remedies for nausea.”

Correct Answer: 1,2

Rationale 1: Peppermint is effective for treatment of nausea in some people.

Rationale 2: Ginger ale is sometimes effective for nausea treatment.

Rationale 3: There is no evidence that vitamin E oil is effective as treatment for nausea.

Rationale 4: Milk is not an anti-nausea treatment.

Rationale 5: Natural remedies for nausea do exist.

Global Rationale: Peppermint is effective for treatment of nausea in some people. Ginger ale is sometimes effective for nausea treatment. There is no evidence that vitamin E oil is effective as treatment for nausea. Milk is not an anti-nausea treatment. Natural remedies for nausea do exist.

 

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub: Physiological Adaptation

QSEN Competencies: III.A.1 Demonstrate knowledge of basic scientific methods and processes.

AACN Essentials Competencies: III.6 Integrate evidence, clinical judgement, interprofessional perspectives and patient preferences in planning, implementing, and evaluating outcomes of care.

NLN Competencies: Knowledge and Science: Integration of knowledge from nursing and other disciplines.

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 42-5 Explain the pathophysiology and pharmacotherapy of nausea and vomiting.

MNL Learning Outcome: 7.2.1 Examine etiology, pathophysiology, and clinical manifestations.

Page Number: 708

 

Question 26

Type: Hot Spot

 

The nurse is explaining the action of the gastrointestinal tract to a patient who has chronic constipation. The nurse would explain that which area is where the majority of water is absorbed from the stool mass?

 

 

  1. A
  2. B
  3. C
  4. D

 

Answer: 3

 

Rationale: The main functions of the colon are to reabsorb water from the waste material and to excrete the remaining fecal material from the body.

 

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub: Physiological Adaptation

QSEN Competencies: III.A.1 Demonstrate knowledge of basic scientific methods and processes.

AACN Essentials Competencies: III.1 Explain the interrelationships among theory, practice, and research.

NLN Competencies: Knowledge and Science: Integration of knowledge from nursing and other disciplines.

Nursing/Integrated Concepts: Nursing Process: Evaluation

Learning Outcome: 42-1 Identify major anatomic structures of the lower gastrointestinal tract.

MNL Learning Outcome: 7.2.1 Examine etiology, pathophysiology, and clinical manifestations.

Page Number: 697

 

 

 

Question 27

Type: MCSA

A patient who has been taking diphenoxylate with atropine (Lomotil) is very drowsy and has a respiratory rate of 10 bpm. The roommate, who brought the patient to the emergency department, states that the patient took “a whole bottle” of the drug. Which nursing action is indicated?

 

  1. Administer a beta blocker
  2. Administer naloxone
  3. Administer high volume intravenous fluids
  4. Administer activated charcoal

Correct Answer: 2

Rationale 1: There is no indication that a beta blocker is needed.

Rationale 2: Naloxone is a narcotic antagonist to reverse the effects of opioid overdose.

Rationale 3: The patient will need intravenous access, but there is no information to suggest high volume IV fluids are necessary.

Rationale 4: Activated charcoal will not reverse the patient’s respiratory depression.

 

Global Rationale: Naloxone is a narcotic antagonist to reverse the effects of opioid overdose. The patient will need intravenous access, but there is no information to suggest high volume IV fluids are necessary. Activated charcoal will not reverse the patient’s respiratory depression. There is no indication that a beta blocker is needed.

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub: Pharmacological and Parenteral Therapies

QSEN Competencies: V.A.4 Delineate general categories of errors and hazards in care.

AACN Essentials Competencies: IX.3 Implement holistic, patient-centered care that reflects an understanding of human growth and development, pathophysiology, pharmacology, medical management and nursing management across the health-illness continuum, across lifespan, and in all healthcare settings.

NLN Competencies: Knowledge and Science: Integration of knowledge from nursing and other disciplines.

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: 42-8 For each of the drug classes listed in Drugs at a Glance, know representative drug examples, and explain their mechanisms of action, primary action, and important adverse effects.

MNL Learning Outcome: 7.2.3 Apply the nursing process to pharmacotherapy, safe drug administration, and client education.

Page Number: 702

 

Question 28

Type: MCSA

A patient with constipation has been prescribed a bulk-forming laxative. Which information will the nurse provide about taking this medication?

  1. “You may take this powder dry if you take it in small amounts.”
  2. “Drink a full glass of water after you take this medication.”
  3. “Let the medication mixture set for a few minutes after mixing before drinking.”
  4. “Lie down for 30 minutes after you take this medication.”

Correct Answer: 2

Rationale 1: Do not take this powder dry. It is a choking hazard.

Rationale 2: The patient should drink a full glass of water after taking this medication.

Rationale 3: The medication should be taken as soon as it is mixed.

Rationale 4: There is no reason for the patient to lie down after taking this medication.

 

Global Rationale:

The patient should drink a full glass of water after taking this medication. Do not take this powder dry. It is a choking hazard. The medication should be taken as soon as it is mixed. There is no reason for the patient to lie down after taking this medication

 

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub: Pharmacological and Parenteral Therapies

QSEN Competencies: I.B.3 Provide patient-centered care with sensitivity and respect for the diversity of human experience.

AACN Essentials Competencies: IX.3 Implement holistic, patient-centered care that reflects an understanding of human growth and development, pathophysiology, pharmacology, medical management and nursing management across the health-illness continuum, across lifespan, and in all healthcare settings.

NLN Competencies: Knowledge and Science: Integration of knowledge from nursing and other disciplines.

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: 42-9 Use the nursing process to care for patients receiving pharmacotherapy for bowel disorders, nausea, vomiting and other gastrointestinal conditions.

MNL Learning Outcome: 7.2.3 Apply the nursing process to pharmacotherapy, safe drug administration, and client education.

Page Number: 707

 

Question 29

Type: MCSA

A patient has been started on a stool softener for constipation. Which information should the nurse provide regarding onset of action?

  1. “Continue to take this medication until your stool is very loose and diarrhea-like.”
  2. “If your discomfort gets worse, return to the clinic.”
  3. “This medication will work in about 8 hours.”
  4. “If you do not have a bowel movement by tomorrow, return to the clinic.”

Correct Answer: 2

Rationale 1: There is no reason to take this medication until loose stools occur.

Rationale 2: If the patient has increased discomfort, additional assessment is indicated.

Rationale 3: This medication may take 2 or 3 days to work.

Rationale 4: Tomorrow is too soon to evaluate that therapy is unsuccessful.

 

Global Rationale: If the patient has increased discomfort, additional assessment is indicated. There is no reason to take this medication until loose stools occur. This medication may take 2 or 3 days to work. Tomorrow is too soon to evaluate that therapy is unsuccessful.

 

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub: Pharmacological and Parenteral Therapies

QSEN Competencies: I.B.3 Provide patient-centered care with sensitivity and respect for the diversity of human experience.

AACN Essentials Competencies: IX.3 Implement holistic, patient-centered care that reflects an understanding of human growth and development, pathophysiology, pharmacology, medical management and nursing management across the health-illness continuum, across lifespan, and in all healthcare settings.

NLN Competencies: Knowledge and Science: Integration of knowledge from nursing and other disciplines.

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: 42-9 Use the nursing process to care for patients receiving pharmacotherapy for bowel disorders, nausea, vomiting and other gastrointestinal conditions.

MNL Learning Outcome: 7.2.3 Apply the nursing process to pharmacotherapy, safe drug administration, and client education.

Page Number: 707

 

Question 30

Type: MCMA

A patient who has motion sickness is going on a cruise. The nurse provides which information about the antiemetic prescribed to prevent this disorder?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Standard Text: Select all that apply.

  1. “Take a double dose of the medication for the first 2 days of the trip.”
  2. “Buy an over-the-counter motion sickness medication to take with this prescription.”
  3. “Start taking your medication before you leave for your trip.”
  4. “Find out how sleepy this drug will make you by taking your first dose right before bedtime.”
  5. “Avoid milk products while taking this medication.”

Correct Answer: 3,4

Rationale 1: Taking a double dose is dangerous.

Rationale 2: Taking more than one drug for the same purpose can be dangerous.

Rationale 3: It may take time for the medication to take its full effect. Taking the medication before the trip is advised.

Rationale 4: Taking the medication in the evening before bed will help the patient judge how sleepy it makes him.

Rationale 5: There is no reason to avoid milk products.

 

Global Rationale: It may take time for the medication to take its full effect. Taking the medication before the trip is advised. Taking the medication in the evening before bed will help the patient judge how sleepy it makes him. Taking a double dose is dangerous. Taking more than one drug for the same purpose can be dangerous. There is no reason to avoid milk products.

 

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub: Pharmacological and Parenteral Therapies

QSEN Competencies: I.B.3 Provide patient-centered care with sensitivity and respect for the diversity of human experience.

AACN Essentials Competencies: IX.3 Implement holistic, patient-centered care that reflects an understanding of human growth and development, pathophysiology, pharmacology, medical management and nursing management across the health-illness continuum, across lifespan, and in all healthcare settings.

NLN Competencies: Knowledge and Science: Integration of knowledge from nursing and other disciplines.

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: 42-9 Use the nursing process to care for patients receiving pharmacotherapy for bowel disorders, nausea, vomiting and other gastrointestinal conditions.

MNL Learning Outcome: 7.2.3 Apply the nursing process to pharmacotherapy, safe drug administration, and client education.

Page Number: 711

 

 

 

 

 

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