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A:Nurselabs CARDIO 1 8. Answer: D.

Review medication regimen to


identify if client is on IV furosemide (Lasix).
1. Answer: D. An 80-year-old client with CHF
Milrinone (Primacor) is incompatible with IV
Extremely old clients are at greater risk for digitalis furosemide (Lasix), and many clients with CHF are
toxicity. Remember when it comes to adversity, the taking furosemide. Assessing potassium, not
very old and very young are always at highest risk. sodium, is essential. Choice B is not done before
administration but during administration.
2. Answer: C. Heart rate below 60 Assessment of CV status is not specific for
The apical heart rate must be monitored during milrinone and is indicated for any drug that affects
therapy with digoxin, and the drug held for pulse the circulatory system.
below 60 and above 120. Remember that digoxin 9. Answer: D. lidocaine (Xylocaine)
lowers the heart rate; therefore, the choice that
reflects a low heart rate is the best selection. Lidocaine is the only choice used to treat
ventricular ectopy. A and C are class
3. Answer: C. Increases the force of contraction IA antiarrhythmics. Digoxin is a cardiac glycoside.
Inotropic drugs increase the force of contraction. 10. Answer: B. SA node
Preload, not afterload, is decreased. Chronotropic
drugs increase heart rate. Treatment of CHF is an Class IA antiarrhythmics have little effect on the SA
indication for use not an action of inotropic drug. node.

4. Answer: A. Monitor potassium level 11. Answer: D. procainamide (Pronestyl)

Monitoring potassium is especially important Pronestyl is known for this serious side effect.
because hypokalemia potentiates digoxin toxicity. B Associate Pronestyl with plasma — P and P. This
and C are incorrect because these data reflect drug is known for its hematologic side effects.
overall CV status but are not specific for digoxin.
Choice D are drugs usually administered with 12. Answer: D. Frequent ventricular ectopy
digoxin.
Ventricular ectopy can be a life-threatening
5. Answer: D. 0.5-2.0 ng/mg arrhythmia; therefore, the client needs an
arrhythmic. Other choices are not arrhythmias that
This is the correct therapeutic range for digoxin. need to be treated.
Every nurse should know this information.
13. Answer: A. ECG
6. Answer: B. Digoxin toxicity
The ECG is the most important parameter to
Halos is a hallmark sign of digoxin toxicity. A, C and assess. B, C, and D need to be monitored, but the
D are incorrect because subtherapeutic digoxin ECG is the most important.
levels have no such effects.
14. Answer: C. Drug levels
7. Answer: A. Increasing stroke volume and
heart rate Knowing drug levels (peak and trough) is the only
way to ensure there is enough drug in the body to
The action of amrinone (Inocor) is to increase work. Other choices do not demonstrate drug
stroke volume, ejection fraction, and heart rate. effect.
Lanoxin, not amrinone, slows ventricular rate and
increases cardiac output. The vasodilator effect of 15. Answer: A. bretylium (Bretylol)
amrinone decreases peripheral vascular resistance.
Among the choices, this is the only agent that must
Any increase in cardiac output will enhance renal
be monitored this closely. B, C, and D are given to
perfusion; this is not just specific to amrinone.
outpatients as oral preparations.
16. Answer: C. amiodarone (Cordarone) Dobutamine (Dobutrex) is not used to treat
arrhythmias. Choices A, B, and D are conditions
This is the most toxic drug and should be used only are conditions that respond to dobutamine.
if other less toxic agents have been tried. Digoxin,
on the other hand, is cardiotonic, not antiarrhythmic 22. Answer: A. verapamil
agent. B and D are not known for their toxicity.
Verapamil (Calan) has the strongest chronotropic
17. Answer: B. Bronchodilation and increased effect and will cause a delay in conduction at the
heart rate, contractility, and conduction SA and AV nodes.

Bronchodilation results from stimulated beta 23. Answer: B. nifedipine


receptors, and cardiac effects result from the
stimulation of ß1 receptors. Choice A does not Nifedipine has the strongest peripheral smooth
address respiratory effects of medication. Choice C muscle dilator effect of all the calcium channel
is incorrect because α-stimulating drugs cause blockers. Other choices have less of a vasodilator
vasoconstriction. Bronchodilation, not effect.
bronchoconstriction, results from ß2 activity. 24. Answer: D. Hypotension
18. Answer: B. color and temperature of toes
Hypotension is more likely to occur in the elderly.
and fingers Choices A, B, and C may occur but are not
Because decreased perfusion is a side effect of necessarily increased in frequency in elderly
norepinephrine (Levophed), the nurse must check clients.
circulation frequently. Capillary refill is not a reliable 25. Answer: B. nimodipine
indication of perfusion in a shock state. Choices A
and D are not specific for norepinephrine. Nimodipine is given in the neurologic client to
prevent cerebral vasospasm. Choices A, C, and D
19. Answer: A. Hypovolemic shock
are given in cardiac disease and in the
Norepinephrine (Levophed) is contraindicated management of hypertension only.
in hypovolemia. Neurogenic shock is an indication 26. Answer: B. Decreased peripheral vascular
for norepinephrine use. Norepinephrine is given to resistance
maintain a systolic blood pressure of 80-100
mmHG. Decreased renal perfusion is an adverse One of the effects of calcium channel blockers is to
reaction. decrease peripheral vascular resistance. A, C, and
D describe the opposite effects of calcium channel
20. Answer: C. the drug cannot be directly blockers.
mixed in solutions containing bicarbonate or
aminophylline. 27. Answer: A. Pulmonary function tests

The nurse is responsible for knowing compatible Unless the client has a history of pulmonary
solutions before administering dopamine (Intropin). disease and pulmonary function tests are indicated,
It is important to know that drug action varies by there is no need to include this in the routine
dose, but the physician is responsible for assessment of the client taking ß blockers.
determining the dose. Dopamine should not be
used instead of fluid replacement. Choice D is 28. Answer: B. Glucose
incorrect because, although it is true, it is not the
ß blockers influence glucose metabolism. Although
nurse’s primary concern. It is a collaborative action
A, C, and D are nice to have, there is no indication
in which the physician is involved in determining the
that routine assessment of thyrotropin, sodium, or
rate.
creatine phosphokinase is needed.
21. Answer: C. arrhythmias
29. Answer: A. Catecholamines
Catecholamine receptor sites are blocked by the
action of ß-blocking agents. Adrenergic sites may
be blocked, but the more appropriate response is
catecholamine receptors. Acetylcholine is not
affected by ß blockers. Norepinephrine is a
catecholamine.

30. Answer: A. Bronchoconstriction

ß blockers should be avoided in


bronchoconstrictive disease. B, C, and D are
indications for the use of ß blockers.
A: Nurselabs CARDIO 2 7. Answer: D. Hypotension

1. Answer: C. Smooth muscle relaxation ACE inhibitors prevent vasoconstriction and lower
blood pressure, placing the client at greater risk for
Nitrates cause smooth muscle relaxation, postural (orthostatic) hypotension. ACE inhibitors
vasodilation, reduction of preload, and improved reduce potassium excretion placing the client at risk
blood flow to the myocardium. Other choices have for hyperkalemia. ACE inhibitors do not affect heart
opposite effect of nitrates. rate. ACE inhibitor promote sodium excretion
thereby decreasing edema.
2. Answer: A. Decreased myocardial oxygen
demand 8. Answer: B. “I need to increase my intake of
orange juice, bananas, and green vegetables.”
Nitrate administration will result in reduced preload
and a decrease in myocardial oxygen demand and The client needs to understand the risk of
left ventricular end-diastolic volume. hyperkalemia and foods to eat in moderation.
Taking medications with food will decrease
3. Answer: C. isosorbide PO therapeutic effects of ACE inhibitors. Excessive
Isosorbide is one of the most frequently amounts of caffeine should be avoided. Avoidance
administered long-acting nitrates. PO nitrates are of salt substitutes that are high in potassium
longer acting than IV or SL agents. decrease the risk of hyperkalemia.

4. Answer: C. Reduced mortality 9. Answer: D. “This drug is used when other


drugs have failed.”
Research has shown that when nitrates are
administered early to the acute MI client, the effect This response provides accurate information about
is reduced mortality, infarct size, infarct extension, the medication. Choice A placates the client and
and related complications. Hypotension will result provides no information about the new medication.
from nitrate administration, but it is not the reason Choice B is defensive. Although choice C is true,
for prescribing the drug. Tachycardia rather than there is no information provided to motivate the
bradycardia is more likely to occur with nitrate client.
administration. The morbidity is already present 10. Answer: D. Increased sodium excretion and
because the client has the pain. potassium reabsorption
5. Answer: A. Change position slowly. The inhibition of aldosterone increases sodium
Clients taking nitrates should change position excretion and reduces potassium excretion. ACE
slowly to avoid orthostatic hypotension. It is not inhibitors increases renal blood flow. Excretion of
necessary to take the pulse before taking this drug. sodium and water is enhanced by ACE inhibitors.
It is also not necessary to change the diet while Peripheral vascular resistance is decreased by
taking this drug. It is contraindicated to chew vasodilation effect of ACE inhibitors.
sustained-release tablets. 11. Answer: A. Relax smooth muscles
6. Answer: C. Promote sodium and water Vasodilators relax smooth muscle. They are used
retention to treat hypertension, not hypotension. Stimulating
Angiotensin is a potent vasoconstrictor that the adrenergic receptors of peripheral sympathetic
stimulate the release of aldosterone. Aldosterone nerves causes blood vessels to contract. Choice D
release promotes sodium and water retention. The is not an action of vasodilators.
conversion of angiotensin I to II is not inhibited. 12, Answer: B. Hypertension
Aldosterone promotes sodium retention not
depletion. Vasoconstriction not vasodilation results. Vasodilators are used to treat hypertension. They
are not used to treat diabetes. Atrial fibrillation is
not treated with vasodilators. Vasodilators are not These drugs block aldosterone’s effects. These
used to treat hypotension. drugs cause hyperkalemia, not hypokalemia.

13. Answer: D. All of the above 20. Answer: D. A 75-year-old man

All are vasodilators used primarily to treat Elderly clients are more sensitive to the effects of
peripheral or cerebral vascular obstructive disease. diuretics.

14. Answer: D. nitroprusside (Nitropress) 21. Answer: D. Increase HDL

Nitroprusside (Nitropress) is used in this situation. The desired effect of lipid-lowering agents is to
A and B are sympathomimetics used to treat decrease cardiac risk by lowering TC, TG, and LDL
hypotension. Papaverine is contraindicated in and increasing or maintaining HDL.
myocardial depressant states.
22. Answer: B. LDL
15. Answer: D. All of the above
An elevated LDL is the most significant risk factor
An important component in the treatment of for the development of atherosclerosis; therefore,
peripheral vascular disease is health education on for drug therapy to be effective, LDL must be
preventing further injury to ischemic tissues. reduced.
Medication therapy is only one aspect.
23. Answer: C. Liver disease
16. Answer: B. Inhibit the exchange of sodium
for potassium All lipid-lowering agents except the bile acid
sequestrants are potentially hepatotoxic, so the
Aldosterone antagonists compete with endogenous most significant contraindication is liver disease.
aldosterone and prevent sodium reabsorption in
exchange for potassium elimination. Aldosterone 24. Answer: D. Vitamin K
antagonists work on inhibiting the action of
Vitamin K absorption may be reduced when giving
aldosterone rather than creating an osmotic these drugs. The only fat-soluble vitamin here is
gradient. Aldosterone antagonist do not cause vitamin K, which is synthesized in the liver.
metabolic acidosis. Aldosterone antagonists must
work in the presence of endogenous aldosterone. 25. Answer: A. lovastatin (Mevacor)

17. Answer: D. Hearing loss Mevacor is known to cause constipation.

Patients receiving large doses of loop diuretics are 26. Answer: A. Conversion of prothrombin to
at risk for developing ototoxicity. thrombin

18. Answer: A. Fluid volume excess Parenteral anticoagulants such as heparin work by
disrupting conversion of prothrombin to thrombin.
Mannitol’s osmotic effect extends to the Tissue thromboplastin is formed in the extrinsic
bloodstream, where increased osmotic pressure pathway as tissue is damaged. Oral anticoagulants
draws fluid into the vascular space, thus elevating work by interfering with vitamin K-dependent
intravascular volume. clotting factors. Prothrombin does not convert to
19. Answer: D. Are weak diuretics fibrin.

Potassium-sparing diuretics are not potent diuretics 27. Answer: B. Abdominal fat
when used alone. They are used as adjunctive Heparin should be given in the abdominal area
therapy with other diuretics to minimize potassium around the umbilicus, deep into the fat.
loss. Potassium-sparing diuretics given during
blood transfusions tend to cause hyperkalemia 28. Answer: B. 1 to 1.5 hours
because potassium is present in the transfusion.
The half-life of heparin is 60 to 90 minutes. This is
important to know when bleeding occurs during
heparin administration.

29. Answer: D. protamine sulfate (Protamine)

Protamine is the drug used to reverse the adverse


effects of bleeding that occurs with heparin
administration.

30. Answer: C. 8 to 12

Initial extension of PT occurs within 8 to 12 hours


after warfarin therapy begins.
A: NurseLabs CARDIO 3 Thrombolytic therapy is contraindicated with
uncontrolled hypertension (systolic BP >180 mm
1. Answer: B. “I will take Ecotrin (Enteric coated Hg and/or diastolic BP >110 mm Hg) because of
aspirin) for my headaches”. the risk of cerebral hemorrhage.

Ecotrin is an aspirin-containing product and should  Options A, B, and C may be present during
be avoided due to the risk of bleeding. the therapy but will not warrant the
immediate knowledge of the physician
2. Answer: B. Activated partial thromboplastin before starting the therapy.
time (aPTT).
7. Answer: C. Aminocaproic acid (Amicar).
Activated partial thromboplastin time assess the
therapeutic level of heparin. Bleeding can be reversed with the use of
aminocaproic acid as an antidote for streptokinase.
 Option A: Assess the therapeutic level of
warfarin sodium (Coumadin).  Option A is the antidote for warfarin sodium
toxicity.
 Options C and D: Measures the aspect of
the red blood cells.  Option B is the antidote for iron toxicity.

3. Answer: B. Activated partial thromboplastin  Option D is an antihistamine that can be


time of 60 seconds. used for any allergic reaction.

The normal range for activated partial 8. Answer: B. Antiplatelet medications cannot
thromboplastin time is 20-36 seconds. The be used with anticoagulants.
activated partial thromboplastin time must be 1.5 to
2.5 times the normal value, the client’s Appt would Antiplatelet and anticoagulant therapies are
be considered therapeutic if it was 60 seconds. effective in keeping a clot from forming or stopping
the growth of one.
4. Answer: D. Protamine sulfate.
9. Answer: A. Check the blood pressure and
Protamine sulfate is the antidote that reverses the heart rate.
anticoagulant effects of heparin by binding to it.
The client is experiencing signs of procainamide
 Option A is the antidote for acetaminophen toxicity, the priority nursing action is to obtain vital
toxicity. signs immediately.

 Option B is the antidote for magnesium  Options B and C are done after checking
sulfate toxicity. the vital signs.

 Option C is the antidote for warfarin sodium  Option D will cause hypotension.
toxicity.
10. Answer: D. Observe for signs of bleeding.
5. Answer: A. Stop the infusion and call the
physician. Bleeding is the priority concern for a client taking
thrombolytic medication.
Severe allergic reaction to streptokinase requires
immediate discontinuation of Streptokinase,then  Options A and B are monitored but are not
notify the physician and administer an adrenergic, the primary concern.
antihistamine, and/or corticosteroid agents as
 Option C is not related to the use of
ordered.
medication.
6. Answer: D. A blood pressure of 185/100 mm
11. Answer: B. 0.5-2 ng/ml.
Hg.
The therapeutic level of digoxin is 0.5-2 ng/ml. The use of aspirin or a nonsteroidal anti-
inflammatory drug 30 minutes before decreases
12. Answer: D. Complaints of dyspnea. flushing which is a side effect of taking nicotinic
Complaints of dyspnea is a sign of bronchospasm acid.
which is one of the serious complication of beta  Option B: Drinking alcohol will cause liver
blockers. abnormalities.
 Options A and B shows a decrease in the  Option C is a sign of liver dysfunction and
blood pressure and heart rate which are should be immediately informed the
expected in this therapy. physician.
 Option C is a side effect of this medication.  Option D: This medication is taken with
13. Answer: C. “This medication may mask meals to decrease gastrointestinal upset.
some of the symptoms of hypoglycemia such 18. Answer: D. Tremors.
as tremor, palpitation, and rapid heartbeat.
Signs of digoxin toxicity are as follows, anorexia,
Beta-blockers such as metoprolol may increase the nausea, vomiting, diarrhea, and blurred vision.
risk of hypoglycemia in patients receiving insulin. In
addition, beta-blockers may mask some of the 19. Answer: B. Sulfa allergy.
symptoms of hypoglycemia such as tremor,
palpitation, and rapid heartbeat, making it more Loop diuretics such as bumetanide are sulfa-based
difficult to recognize an oncoming episode. medications, and a client with sulfa allergy is at risk
for an allergic reaction.
14. Answer: D. Hypokalemia and
hyperglycemia. 20. Answer: C. The client still complains
of chest pain with a pain scale of 2/10.
Metolazone is a thiazide diuretic that may put
clients risk for hypokalemia, hyperglycemia, The goal for the client with an acute myocardial
hyperlipidemia, hypercalcemia and hyperuricemia. infarction is to eliminate the pain. Even pain related
at a level of 2/10 should be managed with an
15. Answer: C. Blood pressure. additional dose of morphine.

The priority assessment in this situation will be the  Options A, B, and D: although hypotension,
monitoring of the blood pressure respiratory depression, and tachycardia are
because hypotension poses a risk in this the side effects of morphine but they do not
medication. require further action at this time.

 Options A, B, and D are monitored but they


are not the priority.

16. Answer: C. “I will continue taking nicotinic


acid as part of the treatment”.

 A combination of Cholestyramine
(Questran) and nicotinic acid damages the
liver.
Options A, B, and D are true regarding this
medication.

17. Answer: A. “I should take aspirin 30 minutes


before nicotinic acid”.
A: KEE AND HAYES CARDIO 6

A: KEY AND HAYES CARDIO 7

A: KEE AND HAYES CARDIO 8

A: KEE AND HAYES CARDIO 9

A: KEE AND HAYES CARDIO 10


A: NurseLabs GASTRO 1  Options B, C, and D: They are considered
as the less common side effect.
1. Answer: D. “I will sip the cholestyramine
powder for a long time for faster absorption”. 5. Answer: C. Blood pressure.

Cholestyramine is a bile acid sequestrant. It works Intravenous administration of Cimetidine


by helping the body remove bile acids, which can causes hypotension.
lower cholesterol levels in the blood. A powder form
 Options A, B, and D are not related to this
of this medication can cause tooth problems such
medication.
as discoloration, erosion of enamel, or decay. Other
side effects of this medication are decreased 6. Answer: B. Patients with an ileostomy.
vitamin absorption and constipation.
Loperamide hydrochloride is an antidiarrheal agent.
2. Answer: C. Patient undergoing radiotherapy. It can also be used to reduce the volume of
drainage from an ileostomy.
Metoclopramide can be safely administered to
patients having vomiting episodes following  Options A, C, and D: It is contraindicated in
radiation, chemotherapy, and surgery. patients with abdominal pain in the absence
of diarrhea, and in patients with acute
 Options A and B: It is contraindicated in
dysentery, which is characterized by blood
patients with conditions where stimulation of
in stools and high fever.
gastrointestinal motility might be harmful,
such as mechanical bowel obstruction, 7. Answer: A. Vomiting.
bowel perforation, or gastrointestinal
hemorrhage. Ondansetron is used to prevent nausea and
vomiting that may be caused by surgery or by
 Option D: Hypertensive crises may occur in medicine to treat cancer (chemotherapy or
patients with pheochromocytoma due to radiation).
induction of catecholamine release from
the tumor.  Options B, C, and D, are not related to this
medication.
3. Answer: A. Relief of gastric ulcer.
8. Answer: B. “These medicines will stop the
Misoprostol (Cytotec) is a synthetic (man-made) acid production and will kill the bacteria”.
prostaglandin that is used to reduce the risk of
stomach ulcers in patients treated with nonsteroidal The triple therapy treatment of H-pylori infection is
antiinflammatory drugs (NSAIDs, for the includes 2 antibiotics (Clarithromycin and
example, aspirin, ibuprofen, etc.). Amoxicillin) and one proton pump inhibitor such
as omeprazole, lansoprazole, pantoprazole, or
 Option B: Although a side effect, but it is not esomeprazole.
the intended therapeutic effect.
9. Answer: D. Relief from GERD.
 Options C and D are not related to the
medication. Omeprazole is used to treat symptoms
of gastroesophageal reflux disease (GERD) and
4. Answer: A. Agitation. other conditions caused by excess stomach acid. It
is also used to promote healing of erosive
Cimetidine an H2-receptor antagonist passes the
esophagitis (damage to your esophagus caused by
blood brain barrier, and central nervous
stomach acid).
system side effects can happen. Most common
serious side effects  Options B, C, and D are not related to this
are confusion, agitation, depression, and medication.
disorientation.
10. Answer: C. Monitoring the frequency and 15. Answer: C. Has an unpleasant taste and can
consistency of bowel movements. be diluted with 15-30 ml of water.

Crohn’s disease is a condition in which the body Opium tincture is an oral liquid medication used to
attacks the lining of the digestive tract, causing control diarrhea. It has an unpleasant taste so it
pain, diarrhea, weight loss, and fever. Infliximab should be diluted with 15-30 ml of water.
works by reducing the inflammation in the colon,
thereby decreasing diarrhea.  Option A: Opium tincture
contains morphine which is a controlled
 Options A, B, and D are not related to this substance.
medication.
 Option B: Opium tincture should not be
11. Answer: D. Reduction of excess fat in feces. used with medications like naltrexone and
buprenorphine because they increase
Pancrelipase is used to help improve food digestion sedation and lower beneficial effect of
in certain conditions (cystic fibrosis, pancreatitis) opium tincture.
where the pancreas is not working properly. This
medicine minimizes the amount of steatorrhea  Option D: It is an antidiarrheal, so a
(fatty stools). decrease motility and peristalsis is
expected.
 Options A, B, and C are not related to this
medication. 16. Answer: D. “I can use mineral oil liquid for
an extended period to prevent further damage”.
12. Answer: C. “It will decrease your diarrhea,
and your bowel can rest”. Mineral oil liquid is a lubricant laxative that works by
slowing the absorption of water from the bowel,
The priority in this kind of situation is to stop which softens the stool. The use of mineral oil liquid
diarrhea and to provide fluids and electrolyte thru for a long time may result in loss of normal bowel
the use of TPN. The bowel is rested so that the function.
abdominal cramping will also stop.
 Options A, B, and C are true regarding
13. Answer: B. Decreased urine output. mineral oil.
Sulfasalazine is used to treat bowel inflammation, 17. Answer: A. Docusate Sodium (Colace).
diarrhea (stool frequency), rectal bleeding, and
abdominal pain in patients with ulcerative colitis. It  Option A is an example of surfactant
is nephrotoxic, so a decrease in urine output is the laxative.
most serious concern.
18. Answer: B. Tegaserod (Zelnorm).
 Options A, C, and D are also side effects
but are less serious. The use of tegaserod is restricted to patients with
IBS due to the serious cardiovascular adverse
14. Answer: A. 1 hour before meals. effect that may happen such as heart
attack and stroke.
Sucralfate is a gastric protective agent. It works by
forming a protective layer on the ulcer to serve as a 19. Answer: D. Keep bed in low position with
barrier against acid, bile salts, and enzymes in the side rails up.
stomach. Taken by mouth on an empty stomach at
least 1 hour before or 2 hours after eating. Antiemetics can cause drowsiness; hence the
priority nursing intervention is to protect the client
 Options B and D are incorrect. from injury such as raising the side rails and
keeping the bed in low position.
 Option C: Do not take an antacid for at least
30 minutes before or after taking sucralfate.
 Option A is not the most priority
intervention.

 Options B and C will risk the client for fall.

20. Answers: C. Polyethylene glycol and


electrolytes (GoLYTELY)., D. Sodium Phosphate
(Fleet enema).

Osmotics are used to attract water into the large


intestines to produce bulk and stimulate peristalsis.
Other osmotic are Magnesium hydroxide (Milk of
Magnesia) and Magnesium citrate (Citrate of
Magnesia).

 Options A and E are stimulants.

 Option B is a lubricant.
A: NurseLabs GASTRO 2 +Respi Theophylline levels must be drawn to determine if
the drug is present in therapeutic amounts in the
1. Answer: A. Avoid ingesting alcohol. client’s serum.
Because alcohol and antihistamines have sedating 9. Answer: D. Cimetidine
properties, concurrent administration of these drugs
should be avoided. Antihistamines and Cimetidine will increase the effects of theophylline.
decongestants are often given together.
10. Answer: A. Antacids neutralize gastric acid.
Dry mouth is a common side effect, not increased
salivation. Not all antihistamines last 24 hours. Antacids act to bring the pH above 3. Other choices
are incorrect because they describe actions of
2. Answer: B. Meclizine
antiacid drugs.
Meclizine (Antivert) is given for vertigo and motion
11. Answer: A. metoclopramide
sickness. Choices C and D are not antihistamines.
Choice A is an antihistamine, but meclizine is the This is the only drug among the choices that is
standard drug in the treatment of vertigo. indicated to prevent nausea.
3. Answer: C. Clients minimize the effects of 12. Answer: A. ranitidine
over-the-counter drugs because they are
available without prescription. Ranitidine decreases the effectiveness of sucralfate
because it decreases the acid content of gastric
This choice is correct because it includes the other secretion. Choice B is the trade name for
three risks noted in choices A, B, and D. sucralfate. Choice C is a gastric stimulant that does
not alter pH. Choice D is an antihistamine and its
4. Answer: D. relieve a dry cough.
GI effect is antiemetic.
An antitussive is a cough suppressant. Choices A
13. Answer: D. metoclopramide
and C describe the action of an expectorant.
Choice D describes the action of a decongestant. A side effect of metoclopramide is EPS.
5. Answer: B. increase fluids. 14. Answer: B. cimetidine
Increasing fluids will help liquefy secretions and Cimetidine was the first histamine-2 antagonist
facilitate removal. developed and is associated with the most toxic
drug interactions of the group.
6. Answer: B. Increased pulmonary function
15. Answer: C. histamine-2 antagonists
Theophylline will improve ventilation so there will be
an overall improvement of pulmonary This is the only category of drugs that reduces the
measurements. Other choices are the opposite of volume of secretions.
what will actually occur with theophylline
administration. 16. Answer: C. Hyperosmotic agents

7. Answer: A. Cardiac disorder Hyperosmotic agents change the osmotic gradient


between the intestine and extravascular space
A client with a heart condition may experience causing water to move into the intestinal lumen and
dangerous stimulation from this drug. Theophylline balance the gradient.
should be administered cautiously with all the other
choices, but consequences are most dangerous or 17. Answer: C. FiberCon
possibly fatal for clients with a heart condition.
FiberCon is the bulk-forming agent. Choices A and
8. Answer: D. Theophylline levels B are incorrect because they are hyperosmotic
agents. Choice D, meanwhile, is a saline laxative.
18. Answer: C. Saline laxatives with magnesium

Saline laxatives are the best agents for rapid bowel


cleansing. Bacid is an intestinal flora modifier. Bulk-
forming agents will not produce rapid cleansing.
Intestinal flora modifiers will not not produce rapid
cleansing as well.

19. Answer: A. Bulk-forming agents

Bulk-forming agents are used for diarrhea and


constipation.

20. Answer: D. castor oil

Castor oil is not recommended for treatment of


constipation because it causes such severe
abdominal pain.