Chapter 79: Other Gastrointestinal Drugs

Chapter 79: Other Gastrointestinal Drugs

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

1. The nurse on an oncology unit is caring for a patient with lung cancer. Prior to the next dose of cisplatin (Platinol-AQ), which antiemetic would the nurse most likely administer to the patient?

a.	Metoclopramide (Reglan)
b.	Droperidol (Inapsine)
c.	Ondansetron (Zofran)
d.	Prochlorperazine

 

 

ANS:   C

Serotonin-receptor antagonists, such as ondansetron, are the most effective drugs available for suppressing nausea and vomiting caused by cisplatin and other highly emetogenic anticancer drugs.

Metoclopramide is used to suppress postoperative nausea and vomiting and emesis associated with cancer chemotherapy. However, it would not be the drug of choice in this situation.

Butyrophenones, such as droperidol, are used as antiemetics; however, they are not the most effective antiemetics for cancer patients. They typically are used for postoperative nausea.

Phenothiazines, such as prochlorperazine, may be used with cancer chemotherapy and surgery, but they are not as effective for emesis caused by cisplatin.

 

DIF:    Cognitive Level: Application             REF:    p. 937

TOP:    Nursing Process: Implementation

MSC:   NCLEX Client Needs Category: Physiological Integrity: Pharmacological and Parenteral Therapies

 

2. The nurse is caring for a patient who is receiving chemotherapy. The patient complains of nausea and begins to vomit. The nurse administers ondansetron (Zofran) to alleviate the nausea. Which medication given concurrently with ondansetron would increase its effectiveness?

a.	Dexamethasone (Decadron)
b.	Ranitidine (Zantac)
c.	Loperamide (Imodium)
d.	Alosetron (Lotronex)

 

 

ANS:   A

Ondansetron is very effective by itself and even more effective when combined with dexamethasone.

Ranitidine and loperamide do not increase the effectiveness of ondansetron.

Alosetron is indicated for irritable bowel syndrome (IBS), not for patients receiving chemotherapy.

 

DIF:    Cognitive Level: Application             REF:    p. 938

TOP:    Nursing Process: Implementation

MSC:   NCLEX Client Needs Category: Physiological Integrity: Pharmacological and Parenteral Therapies

 

3. The recovery room nurse is caring for a patient status post surgery and administers an antiemetic agent for postoperative nausea and vomiting. The patient is transferred to the unit and beings to display extrapyramidal effects. The nurse suspects that which category of agents is most likely responsible?

a.	Phenothiazines
b.	Glucocorticoids
c.	Cannabinoids
d.	Serotonin-receptor antagonists

 

 

ANS:   A

Side effects of phenothiazines include extrapyramidal reactions, anticholinergic effects, hypotension, and sedation.

Glucocorticoids and cannabinoids do not cause extrapyramidal side effects.

The most common side effects of serotonin-receptor antagonists are headache, diarrhea, and dizziness. They do not cause extrapyramidal side effects.

 

DIF:    Cognitive Level: Analysis                  REF:    p. 939

TOP:    Nursing Process: Evaluation

MSC:   NCLEX Client Needs Category: Physiological Integrity: Pharmacological and Parenteral Therapies

 

4. The nurse is preparing to administer dronabinol (Marinol) to a newly admitted patient. Prior to administration, the nurse reviews the patient’s health history. For which of the following reasons found in the health history would the nurse clarify the order?

a.	The patient has a history of bradycardia.
b.	The patient has a history of drug abuse.
c.	The patient has acquired immunodeficiency syndrome (AIDS).
d.	The patient has a history of psychiatric disorders.

 

 

ANS:   D

The nurse would clarify the order because of the patient’s history of psychiatric disorders. Dronabinol can cause temporal disintegration, dissociation, depersonalization, and dysphoria.

Dronabinol is not contraindicated in patients with bradycardia. The medication actually causes tachycardia.

Nothing indicates that the patient has a history of drug abuse; however, there is a small potential for abuse.

Dronabinol is used in patients with AIDS to stimulate appetite.

 

DIF:    Cognitive Level: Analysis                  REF:    p. 940

TOP:    Nursing Process: Assessment

MSC:   NCLEX Client Needs Category: Physiological Integrity: Pharmacological and Parenteral Therapies