Lewis Med Surg - Upper and Lower GI NCLEX Practice Questions

Lewis Med Surg - Upper and Lower GI NCLEX Practice Questions 4.7 (10 reviews) Terms in this set (25) Science MedicineNursing Save Following administration of a dose of metoclopramide (Reglan) to the patient, the nurse determines that the medication has been effective when what is noted?

• Decreased blood pressure
• Absence of muscle tremors
• Relief of nausea and vomiting
• No further episodes of diarrhea
• Relief of nausea and vomiting

Metoclopramide is classified as a prokinetic and antiemetic medication. If it is effective, the patient's nausea and vomiting should resolve.Metoclopramide does not affect blood pressure, muscle tremors, or diarrhea.The patient receiving chemotherapy rings the call bell and reports the onset of nausea. The nurse should prepare an as-needed dose of which medication?

• Morphine sulfate
• Zolpidem (Ambien)
• Ondansetron (Zofran)
• Dexamethasone (Decadron)

Ondansetron is a 5-HT3 receptor antagonist antiemetic that is especially effective in reducing cancer chemotherapy-induced nausea and vomiting. Morphine sulfate may cause nausea and vomiting. Zolpidem does not relieve nausea and vomiting. Dexamethasone is usually used in combination with ondansetron for acute and chemotherapy-induced emesis.

The patient who is admitted with a diagnosis of diverticulitis and a history of irritable bowel disease and gastroesophageal reflux disease (GERD) has received a dose of Mylanta 30 mL PO. The nurse should evaluate its effectiveness by questioning the patient as to whether which symptom has been resolved?

• Diarrhea
• Heartburn
• Constipation
• Lower abdominal pain
• Heartburn

Mylanta is an antacid that contains both aluminum and magnesium. It is indicated for the relief of GI discomfort, such as heartburn associated with GERD. Mylanta can cause both diarrhea and constipation as a side effect. Mylanta does not affect lower abdominal pain.A patient complains of nausea. When administering a dose of metoclopramide (Reglan), the nurse should teach the patient to report which potential adverse effect?

• Tremors
• Constipation
• Double vision
• Numbness in fingers and toes
• Tremors

Extrapyramidal side effects, including tremors and tardive dyskinesias, may occur as a result of metoclopramide (Reglan) administration.Constipation, double vision, and numbness in fingers and toes are not adverse effects of metoclopramide.

After administering a dose of promethazine (Phenergan) to a patient with nausea and vomiting, what common temporary adverse effect of the medication does the nurse explain may be experienced?

• Tinnitus
• Drowsiness
• Reduced hearing
• Sensation of falling
• Drowsiness

Although being given to this patient as an antiemetic, promethazine also has sedative and amnesic properties. For this reason, the patient is likely to experience drowsiness as an adverse effect of the medication. Tinnitus, reduced hearing, and loss of balance are not side effects of promethazine.The nurse determines that a patient has experienced the beneficial effects of therapy with famotidine (Pepcid) when which symptom is relieved?

• Nausea
• Belching
• Epigastric pain
• Difficulty swallowing
• Epigastric pain

Famotidine is an H2-receptor antagonist that inhibits parietal cell output of HCl acid and minimizes damage to gastric mucosa related to hyperacidity, thus relieving epigastric pain.Famotidine is not indicated for nausea, belching, and dysphagia.A patient reports having a dry mouth and asks for something to drink. The nurse recognizes that this symptom can most likely be attributed to a common adverse effect of which medication that the patient is taking?

• Digoxin (Lanoxin)
• Cefotetan (Cefotan)
• Famotidine (Pepcid)
• Promethazine (Phenergan)
• Promethazine (Phenergan)

A common adverse effect of promethazine, an antihistamine/antiemetic agent, is dry mouth; another is blurred vision. Common side effects of digoxin are yellow halos and bradycardia.Common side effects of cefotetan are nausea, vomiting, stomach pain, and diarrhea. Common side effects of famotidine are headache, abdominal pain, constipation, or diarrhea.

A patient with a history of peptic ulcer disease has presented to the emergency department reporting severe abdominal pain and has a rigid, boardlike abdomen that prompts the health care team to suspect a perforated ulcer. What intervention should the nurse anticipate?

• Providing IV fluids and inserting a

nasogastric (NG) tube

• Administering oral bicarbonate

and testing the patient's gastric pH level

• Performing a fecal occult blood

test and administering IV calcium gluconate

• Starting parenteral nutrition and

placing the patient in a high-Fowler's position

• Providing IV fluids and inserting a nasogastric

(NG) tube A perforated peptic ulcer requires IV replacement of fluid losses and continued gastric aspiration by NG tube. Nothing is given by mouth, and gastric pH testing is not a priority. Calcium gluconate is not a medication directly relevant to the patient's suspected diagnosis, and parenteral nutrition is not a priority in the short term.A female patient has a sliding hiatal hernia. What nursing interventions will prevent the symptoms of heartburn and dyspepsia that she is experiencing?

• Keep the patient NPO.
• Put the bed in the Trendelenberg

position.

• Have the patient eat 4 to 6 smaller

meals each day.

• Give various antacids to determine

which one works for the patient.

• Have the patient eat 4 to 6 smaller meals each

day.Eating smaller meals during the day will decrease the gastric pressure and the symptoms of hiatal hernia. Keeping the patient NPO or in a Trendelenberg position are not safe or realistic for a long period of time for any patient. Varying antacids will only be done with the care provider's prescription, so this is not a nursing intervention.