Question

A nurse is taking a health history of a client who reports occasionally taking several over-the-counter medications, including an H₂ receptor antagonist (H₂RA). Which of the following outcomes indicates the H₂RA is therapeutic?

Answer 1

Correct Answers:

Relief of heartburn

Rationale :

🧠H₂ receptor antagonists work by blocking H₂ receptors in the stomach, which reduces gastric acid secretion.

🩺By lowering gastric acid, these medications help relieve symptoms associated with GERD and peptic ulcer disease, such as burning epigastric pain.

🔥Heartburn is a classic manifestation of acid-related irritation of the esophagus or upper GI tract, so its relief indicates that the drug is achieving its intended therapeutic effect.

📉The improvement of reflux-related discomfort such as heartburn is the best indicator that the medication is effective in decreasing acid production.

📌Core Message

The main therapeutic effect of H₂ receptor antagonists is reduction of gastric acid, so relief of heartburn is the key sign that the drug is working.

Answer 2

Correct Answers:

"I will take this medication 1 hour before meals and at bedtime."

Rationale :

🧠Sucralfate is a mucosal protectant that forms a barrier over an ulcer, protecting it from acid and pepsin.

⏰It must be taken on an empty stomach, typically 1 hour before meals and at bedtime, so it can coat the ulcer effectively before food and acid enter the stomach.

🛡️By forming a protective layer on the ulcer surface, sucralfate allows for healing and reduction of ulcer-related pain.

📘Correct timing enhances the drug’s local protective action, making pre-meal and bedtime dosing essential for therapeutic effectiveness.

📌Core Message

Sucralfate is a mucosal protectant that must be taken on an empty stomach (1 hour before meals and at bedtime) so it can form a protective barrier over the ulcer.

Answer 3

Correct Answers:

Constipation

Rationale :

🧠Aluminum-containing antacids commonly cause constipation due to their effect on intestinal motility.

⚕️Clients taking aluminum hydroxide should be taught to monitor bowel patterns and report reduced stool frequency or hard stools.

🥦Increasing fluid and fiber intake may be recommended to help prevent this common adverse effect.

📚Recognizing constipation as a typical aluminum antacid side effect helps the nurse provide appropriate education and monitoring.

📌Core Message

Aluminum hydroxide frequently causes constipation, so clients should be taught to monitor bowel habits and manage this common adverse reaction.

Answer 4

Correct Answers:

"Your doctor might need to reduce your theophylline dose while taking this medication."

Rationale :

🧠Cimetidine can inhibit hepatic metabolism of several drugs, including theophylline, leading to increased serum levels.

⚕️When both medications are used together, there is a risk of theophylline toxicity, making dose reduction necessary.

📈Toxic levels of theophylline can cause serious cardiovascular and CNS effects, so monitoring and possible dosage adjustment are essential.

📚Teaching the client that the provider may need to adjust other medications emphasizes the importance of drug–drug interactions with cimetidine.

📌Core Message

Cimetidine inhibits drug metabolism, so the dose of interacting medications like theophylline may need to be reduced to prevent toxicity.

Answer 5

Correct Answers:

30 minutes before breakfast

Rationale :

🧠Lansoprazole is a proton pump inhibitor (PPI) that suppresses gastric acid secretion by blocking proton pumps in the parietal cells.

⏰PPIs are most effective when taken before meals, especially before breakfast, so they can inhibit acid secretion stimulated by food intake.

🍽️Taking the medication 30 minutes before breakfast ensures it is absorbed and active when the largest meal-related acid surge occurs.

📉Correct timing maximizes acid suppression, improving outcomes in conditions like GERD and peptic ulcer disease.

📌Core Message

Lansoprazole, a PPI, should be taken about 30 minutes before breakfast to ensure optimal acid suppression during meal-stimulated secretion.

Answer 6

Correct Answers:

Prolonged QT interval

Rationale :

🧠Ondansetron is an antiemetic that can prolong the QT interval as an adverse effect on cardiac conduction.

⚡Clients with a pre-existing prolonged QT interval are at increased risk for torsades de pointes and other serious arrhythmias if given this medication.

📋This makes a prolonged QT interval a contraindication, requiring the nurse to notify the provider and consider alternative antiemetics.

❤️Assessing cardiac history and ECG findings before administration is essential for safe use of ondansetron.

📌Core Message

Ondansetron can further prolong the QT interval, so it is contraindicated in clients with existing QT prolongation due to arrhythmia risk.

Answer 7

Correct Answers:

WBC 1.2 (5,000-10,000)

Rationale :

🧠Glucocorticoids suppress the immune system, increasing risk for infection, especially in clients already immunocompromised by cancer and chemotherapy.

📉A WBC count of 1.2 is critically low (severe leukopenia/neutropenia), placing the client at very high risk for life-threatening infections.

⚕️This lab value is a priority to report because it may necessitate changes in therapy, protective isolation, or administration of growth factors.

📚Although glucocorticoids can also raise glucose and affect other labs, severely low WBC represents the most urgent safety concern.

📌Core Message

In a client on glucocorticoids, a critically low WBC indicates severe immunosuppression and must be reported immediately due to high infection risk.

Answer 8

Correct Answers:

Send stool specimen to lab

Rationale :

🧠With multiple loose stools, the priority is to assess and identify the cause, especially the possibility of infection.

🧫Sending a stool specimen to the lab allows evaluation for pathogens, blood, or other abnormalities, guiding appropriate treatment.

⚕️Assessment steps, including obtaining necessary diagnostic tests, should occur before routinely administering antidiarrheals or other medications.

📚Determining the underlying etiology supports safe, targeted therapy and helps avoid masking serious conditions like C. difficile infection.

📌Core Message

In acute diarrhea, the nurse should first assess by obtaining a stool sample to determine the cause before initiating specific treatments.

Answer 9

Correct Answers:

"I can still drink my morning coffee"

Rationale :

🧠Iron supplements are best absorbed on an empty stomach, but certain foods and drinks can impair absorption.

☕Coffee and tea contain compounds that decrease iron absorption, so they should be avoided around the time the medication is taken.

📚Correct teaching includes avoiding antacids, dairy, and caffeine close to dosing, while encouraging vitamin C–rich fluids to enhance absorption.

⚕️The statement about still drinking morning coffee shows a misunderstanding of iron administration and indicates a need for further instruction.

📌Core Message

Iron absorption is reduced by coffee/tea, so clients must avoid these around dosing, making the coffee statement a sign of incorrect understanding.

Answer 10

Correct Answers:

Respirations of 8

Rationale :

🧠Magnesium sulfate can depress the central nervous system and respiratory drive when levels become too high.

🫁A respiratory rate of 8 breaths per minute indicates significant respiratory depression, a hallmark of magnesium toxicity.

⚕️This is an emergency finding that must be reported immediately and typically requires stopping the infusion and preparing to give calcium gluconate as the antidote.

📋Monitoring respiratory rate and deep tendon reflexes is crucial during magnesium therapy to detect early signs of toxicity.

📌Core Message

Magnesium sulfate toxicity can cause severe respiratory depression, so a respiratory rate of 8 is a critical finding that requires immediate intervention.

Med-Surg Exam-3 FA25

No.

1 :
A nurse is taking a health history of a client who reports occasionally taking several over-the-counter medications, including an H₂ receptor antagonist (H₂RA). Which of the following outcomes indicates the H₂RA is therapeutic?

2 :
A nurse is teaching a client who has a new prescription for sucralfate to treat a gastric ulcer. Which of the following statements by the client indicates an understanding of the teaching?

3 :
A nurse is teaching a client who has a new prescription for aluminum hydroxide to treat heartburn. The nurse should instruct the client to monitor for and report which of the following adverse reactions?

4 :
A nurse is teaching a client who has a duodenal ulcer about his new prescription for cimetidine. The nurse should include which of the following instructions in the teaching?

5 :
A client is prescribed lansoprazole 15 mg PO once a day. At which of the following times should the nurse administer the medication?

6 :
Ondansetron would be contraindicated in a client who presents with what clinical manifestation?

7 :
A client with cancer is prescribed a glucocorticoid medication to help treat chemotherapy induced nausea and vomiting. Which of the following lab values would need to be reported to the physician?

8 :
A patient presents to the ER with multiple loose stools. Which priority action would be indicated by the nurse?

9 :
A nurse is preparing to administer an iron supplement to a client. Which of the following statements made by the client would indicate a need for further instruction?

10 :
A client is receiving a magnesium sulfate replacement intravenously. Which of the following would need to be reported to the provider immediately?

Med-Surg Exam-3 FA25

No.

1 : A nurse is taking a health history of a client who reports occasionally taking several over-the-counter medications, including an H₂ receptor antagonist (H₂RA). Which of the following outcomes indicates the H₂RA is therapeutic?

2 : A nurse is teaching a client who has a new prescription for sucralfate to treat a gastric ulcer. Which of the following statements by the client indicates an understanding of the teaching?

3 : A nurse is teaching a client who has a new prescription for aluminum hydroxide to treat heartburn. The nurse should instruct the client to monitor for and report which of the following adverse reactions?

4 : A nurse is teaching a client who has a duodenal ulcer about his new prescription for cimetidine. The nurse should include which of the following instructions in the teaching?

5 : A client is prescribed lansoprazole 15 mg PO once a day. At which of the following times should the nurse administer the medication?

6 : Ondansetron would be contraindicated in a client who presents with what clinical manifestation?

7 : A client with cancer is prescribed a glucocorticoid medication to help treat chemotherapy induced nausea and vomiting. Which of the following lab values would need to be reported to the physician?

8 : A patient presents to the ER with multiple loose stools. Which priority action would be indicated by the nurse?

9 : A nurse is preparing to administer an iron supplement to a client. Which of the following statements made by the client would indicate a need for further instruction?

10 : A client is receiving a magnesium sulfate replacement intravenously. Which of the following would need to be reported to the provider immediately?

1 :
A nurse is taking a health history of a client who reports occasionally taking several over-the-counter medications, including an H₂ receptor antagonist (H₂RA). Which of the following outcomes indicates the H₂RA is therapeutic?

2 :
A nurse is teaching a client who has a new prescription for sucralfate to treat a gastric ulcer. Which of the following statements by the client indicates an understanding of the teaching?

3 :
A nurse is teaching a client who has a new prescription for aluminum hydroxide to treat heartburn. The nurse should instruct the client to monitor for and report which of the following adverse reactions?

4 :
A nurse is teaching a client who has a duodenal ulcer about his new prescription for cimetidine. The nurse should include which of the following instructions in the teaching?

5 :
A client is prescribed lansoprazole 15 mg PO once a day. At which of the following times should the nurse administer the medication?

6 :
Ondansetron would be contraindicated in a client who presents with what clinical manifestation?

7 :
A client with cancer is prescribed a glucocorticoid medication to help treat chemotherapy induced nausea and vomiting. Which of the following lab values would need to be reported to the physician?

8 :
A patient presents to the ER with multiple loose stools. Which priority action would be indicated by the nurse?

9 :
A nurse is preparing to administer an iron supplement to a client. Which of the following statements made by the client would indicate a need for further instruction?

10 :
A client is receiving a magnesium sulfate replacement intravenously. Which of the following would need to be reported to the provider immediately?