Chapter 80: Other Gastrointestinal Drugs

Chapter 80: Other Gastrointestinal Drugs

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

MULTIPLE CHOICE

 

1. A nurse caring for a patient who is undergoing a third round of chemotherapy is preparing to administer ondansetron [Zofran] 30 minutes before initiation of the chemotherapy. The patient tells the nurse that the ondansetron did not work as well the last time as it had the first time. What will the nurse do?

a.	Administer the ondansetron at the same time as the chemotherapy.
b.	Contact the provider to suggest using high-dose intravenous dolasetron [Anzemet].
c.	Request an order to administer dexamethasone with the ondansetron.
d.	Suggest to the provider that loperamide [Lomotil] be given with the ondansetron.

 

 

ANS:  C

Ondansetron is a serotonin receptor antagonist; drugs in this class are the most effective drugs available for suppressing nausea and vomiting associated with anticancer drugs. The drug is even more effective when combined with dexamethasone. For best effect, ondansetron should be given 30 minutes before beginning chemotherapy. Dolasetron is similar to ondansetron, but when given intravenously in high doses, it is associated with fatal dysrhythmias. Loperamide is used to treat diarrhea.

 

PTS:   1                    DIF:    Cognitive Level: Application           REF:   pp. 971-972

TOP:   Nursing Process: Planning

MSC:  NCLEX Client Needs Category: Physiologic Integrity: Pharmacologic and Parenteral Therapies

 

2. A pregnant patient who is taking ondansetron [Zofran] for morning sickness tells the nurse she is experiencing headache and dizziness. What will the nurse tell her?

a.	It is not safe to take this drug during pregnancy.
b.	These are common side effects of ondansetron.
c.	She should stop taking the ondansetron immediately.
d.	She should report these adverse effects to her provider.

 

 

ANS:  B

The most common side effects of ondansetron are headache, diarrhea, and dizziness. Ondansetron is used off-label to treat morning sickness. These side effects do not indicate a need to stop taking the drug or to report the side effects to the provider.

 

PTS:   1                    DIF:    Cognitive Level: Application           REF:   pp. 971-972

TOP:   Nursing Process: Implementation

MSC:  NCLEX Client Needs Category: Physiologic Integrity: Pharmacologic and Parenteral Therapies

 

3. A patient is being treated for chemotherapy-induced nausea and vomiting (CINV) with ondansetron [Zofran] and dexamethasone. The patient reports getting relief during and immediately after chemotherapy but has significant nausea and vomiting several days after each chemotherapy treatment. What will the nurse do?

a.	Contact the provider to discuss increasing the dose of ondansetron.
b.	Suggest giving prolonged doses of dexamethasone.
c.	Suggest adding aprepitant [Emend] to the medication regimen.
d.	Tell the patient to ask the provider about changing the ondansetron to aprepitant.

 

 

ANS:  C

The current regimen of choice for patients taking highly emetogenic drugs consists of three agents: aprepitant plus dexamethasone plus a 5-HT₃ antagonist, such as ondansetron. Aprepitant has a prolonged duration of action and can prevent delayed CINV as well as acute CINV. Increasing the dose of ondansetron will not help treat the delayed CINV. Glucocorticoids should be given intermittently and for short periods to avoid side effects. Changing the ondansetron to aprepitant is not recommended.

 

PTS:   1                    DIF:    Cognitive Level: Application

REF:   pp. 971-972 | pp. 973-974 | pp. 975-976                             TOP:   Nursing Process: Evaluation

MSC:  NCLEX Client Needs Category: Physiologic Integrity: Pharmacologic and Parenteral Therapies

 

4. A patient is receiving intravenous promethazine [Phenergan] 25 mg for postoperative nausea and vomiting. What is an important nursing action when giving this drug?

a.	Giving the dose as an IV push over 3 to 5 minutes
b.	Infusing the dose with microbore tubing and an infusion pump
c.	Observing the IV insertion site frequently for patency
d.	Telling the patient to report dry mouth and sedation

 

 

ANS:  C

If IV administration must be done with this drug, it should be given through a large-bore, freely flowing line. The site should be monitored closely for local burning or pain or any sign of extravasation, which can cause abscess formation, tissue necrosis, and gangrene requiring amputation. Giving the medication as a rapid IV push or through microbore tubing does not adequately slow the infusion or dilute the drug. Dry mouth and sedation are expected side effects of this drug and are not dangerous.

 

PTS:   1                    DIF:    Cognitive Level: Application           REF:   pp. 974-975

TOP:   Nursing Process: Planning

MSC:  NCLEX Client Needs Category: Physiologic Integrity: Pharmacologic and Parenteral Therapies