Ans: A) Chemoreceptor trigger zone (CTZ) Ans: C) 100 mg rectally. Ans: D) Photosensitivity. Ans: D) Alcohol
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1 A high school student starts vomiting and goes to see the school nurse. The student asks the nurse what part of his brain makes him vomit. What area of the brain will the nurse tell the student must be stimulated for vomiting to occur? A) Chemoreceptor trigger zone (CTZ) B) Forebrain C) Hypothalamus D) Thalamus Ans: A) Chemoreceptor trigger zone (CTZ) A 25-pound child is in the clinic because of vomiting the last 24 hours. The nurse is to administer trimethobenzamide (Tigan). What dose will the nurse administer by what route? A) 0.25 mg IV B) 1.1 mg/kg IM C) 100 mg rectally D) 200 mg orally Ans: C) 100 mg rectally The clinic nurse is caring for a 55-year-old farmer who has been prescribed an antiemetic for an inner ear problem. The patient states "I need to get back to work." With this patient especially, what will the nurse caution him about? A) Weight gain B) Suicidal ideation C) Diarrhea D) Photosensitivity Ans: D) Photosensitivity A female college student with migraine headaches that cause nausea and vomiting has been prescribed trimethobenzamide (Tigan). It is important for the nurse to caution the student to avoid using what? A) St. John's wort B) Calcium channel blockers C) Selective serotonin reuptake inhibitors (SSRIs) D) Alcohol Ans: D) Alcohol A cancer patient is in the outpatient department to receive chemotherapy. The nurse administers prochlorperazine (Compazine) prophylactically before the infusion. What will the nurse's teaching for this patient include? A) Avoid driving or any dangerous activities if dizziness or drowsiness occurs. B) Cover the head in extreme of temperatures. C) Take extra precautions to avoid heat stroke. D) Check blood pressure at home on a regular basis. Ans: A) Avoid driving or any dangerous activities if dizziness or drowsiness occurs.
2 What is an appropriate nursing action for a hospitalized patient receiving aprepitant (Emend)? A) Elevate the head of the bed. B) Encourage fluids. C) Take the patient's temperature. D) Place an NPO sign on the door. Ans: B) Encourage fluids. The nurse is working in the medical station at a local amusement park. An adult is being seen complaining of dizziness and feelings of "seasickness" after going on several rides. What would the nurse suspect the patient may benefit from? A) An anticholinergic B) A histamine H2 blocker C) Substance P/neurokinin 1 receptor antagonist D) Cannabis Ans: A) An anticholinergic A women's community group is attending the first-aid class the nurse is teaching. The nurse will instruct the women to do what if a child ingests a possible overdose of medication or other potential poison? A) Call an ambulance. B) Make an appointment to see the health care provider. C) Induce vomiting by sticking a finger down the child's throat. D) Call the local poison control center and follow their directions. Ans: D) Call the local poison control center and follow their directions. The nurse is caring for a child who has been vomiting intermittently for 24 hours. What is the drug of choice for children who need an antiemetic? A) Dronabinol (Marinol) B) Metoclopramide (Reglan) C) Meclizine (Antivert) D) Prochlorperazine (Compazine) Ans: D) Prochlorperazine (Compazine) The nurse is caring for a patient who has begun vomiting after undergoing bariatric surgery. When including this complication in the plan of care, what would be an appropriate nursing diagnosis related to the adverse effects of drowsiness and weakness associated with an antiemetic? A) Acute pain related to central nervous system (CNS), skin, and gastrointestinal (GI) effects B) Risk for injury related to CNS effects C) Decreased cardiac output related to cardiac effects D) Deficient knowledge regarding drug therapy Ans: B) Risk for injury related to CNS effects
3 What medication, given with aprepitant (Emend), is used to effectively manage chemotherapy-induced emesis? A) Bonamine B) Dexamethasone C) Phenergan D) Ativan What symptom may be related to the use of dronabinol (Marinol)? A) Bradycardia B) Hypertension C) Rash D) Anxiety Ans: B) Dexamethasone Ans: D) Anxiety People taking phenothiazines need to be assessed for extrapyramidal symptoms. What effects are considered adverse effects of the phenothiazines? A) Dysphoria, anxiety, and dizziness B) Drowsiness, dystonia, and blurred vision C) Dry mouth, blurred vision, and urinary retention D) Hypertension, confusion, and shuffling gait Ans: B) Drowsiness, dystonia, and blurred vision A 57-year-old patient is to receive metoclopramide (Reglan) for nausea. What statement by the patient leads the nurse to believe that the patient has understood the nurse's teaching? A) "During episodes of nausea, I will drink clear liquids." B) "I may be drowsy as a result of taking this medication." C) "This medication should be taken on a full stomach." D) "I will need to take supplemental potassium while I am taking this medication." Ans: B) "I may be drowsy as a result of taking this medication." Prochlorperazine (Compazine) is contraindicated in which population? A) Children under the age of 12 years B) Preoperative patients C) Pregnant women D) People weighing 100 pounds Ans: C) Pregnant women
4 A clinic nurse is caring for a 5-year-old brought to the clinic with a history of intermittent vomiting for 24 hours. The nurse would recognize that which drug is not recommended for use in children? A) Dimenhydrinate B) Promethazine C) Metoclopramide D) Diphenhydramine Ans: C) Metoclopramide A 54-year-old patient is going on an ocean cruise. What medication would be most effective for motion sickness? A) Meclizine (Antivert) B) Diphenhydramine (Benadryl) C) Hydroxyzine (Atarax) D) Metoclopramide (Reglan) What is the best indicator of decreased nausea after administering ondansetron (Zofran) IV? A) Heart rate 64 beats/min B) Blood pressure 110/64 C) Patient hungry D) Patient states, "I feel less nauseated." What is an example of a locally acting antiemetic? A) Phenothiazine B) Antacid C) Nonphenothiazine D) Antihistamine What is the therapeutic action of the phenothiazines in reducing nausea? A) Increasing gastric motility B) Change responsiveness of the chemoreceptor trigger zone (CTZ) C) Blocking histamine receptors D) Producing sedation Ans: A) Meclizine (Antivert) Ans: D) Patient states, "I feel less nauseated." Ans: B) Antacid Ans: B) Change responsiveness of the chemoreceptor trigger zone (CTZ)
5 How does buclizine (Bucladin) function as an effective antiemetic? A) Lowers blood glucose levels B) Lowers HA1c C) Increases sensitivity to insulin D) Promotes anticholinergic effects Ans: D) Promotes anticholinergic effects What is the main action of antiemetics? A) Altering central nervous system (CNS) actions to decrease perception of nausea B) Speeding up the gastrointestinal (GI) tract so the stomach empties rapidly C) Depressing hyperactive vomiting reflex D) Changing the perception of motion in motion sickness Ans: C) Depressing hyperactive vomiting reflex When would the nurse recommend that a traveler take an oral antiemetic to prevent motion sickness? A) When symptoms first begin B) 10 minutes prior to trip C) 30 minutes prior to trip D) 1 day prior to trip The nurse is caring for a patient who is vomiting. Which nursing intervention is most important after the patient vomits? A) Rinse patient's mouth with water B) Provide a back rub C) Offer dry crackers D) Wash patient's face and hands Ans: C) 30 minutes prior to trip Ans: A) Rinse patient's mouth with water The nurse is caring for a patient who is receiving ondansetron (Zofran) for nausea associated with chemotherapy. The nurse would teach the patient that what adverse effect may occur with this medication? A) Weakness and rash B) Dysuria and photosensitivity C) Headache and myalgia D) Fever and diarrhea Ans: C) Headache and myalgia
6 The obstetrics nurse is caring for a patient who started vomiting before delivering her son. The patient is still complaining of nausea and vomiting an hour after her delivery. What medicine would the nurse expect the physician to order for this patient? A) Hydroxyzine (Vistaril) B) Trimethobenzamide (Tigan) C) Dronabinol (Marinol) D) Nabilone (Cesamet) Ans: A) Hydroxyzine (Vistaril) The patient has begun complaining about nausea and vomiting. What would the nurse assess to determine the need for therapy? A) How well the patient is eating B) Color, amount, and frequency of vomiting episodes C) Number of times patient's family complains of vomiting episodes D) Number of times patient's family reports the patient is nauseated Ans: B) Color, amount, and frequency of vomiting episodes The nurse is caring for an oncology patient who is vomiting. When writing a plan of care for this patient, what would be an appropriate nursing diagnosis? A) Risk for injury related to cardiovascular effects B) Deficient knowledge regarding motion sickness C) Decreased cardiac output related to cardiac effects D) Acute pain related to constipation Ans: C) Decreased cardiac output related to cardiac effects What are some nonpharmacologic measures a nurse can use to help a patient who is nauseated or vomiting? (Select all that apply.) A) Quiet environment B) Visitors C) Soft, bland meals (if not contraindicated) D) Deep breathing E) Carbonated drinks (if not contraindicated) Ans: A) Quiet environment D) Deep breathing E) Carbonated drinks (if not contraindicated) The nurse is discharging a patient being sent home on antiemetic therapy. How would the nurse evaluate the plan of care that this patient has had while hospitalized? A) Monitor for adverse effects. B) Provide comfort and safety measures, including mouth care, ready access to bathroom facilities, assistance with ambulation and periodic orientation, ice chips to suck, protection from sun exposure, and remedial measures to treat dehydration if it occurs. C) Assess the patient carefully for any potential drug-drug interactions. D) Monitor laboratory test results including liver and kidney function tests. Ans: A) Monitor for adverse effects.
7 A nursing student correctly identifies which body system as being associated with most of the adverse effects of antiemetics? A) Renal B) Central nervous system (CNS) C) Cardiovascular D) Integumentary Ans: B) Central nervous system (CNS) A patient has received a prescription for nabilone (Cesamet) for treatment of nausea. The nurse is aware that this medication is used for what reason? A) The patient has a substance abuse problem. B) The patient is under age 18. C) The patient is experiencing motion sickness. D) The patient has not responded to other medications. Ans: D) The patient has not responded to other medications The nurse is performing an admission assessment of a female teenage patient who has been experiencing nausea and vomiting. What question would be most important for the nurse to ask this patient? A) "What is the date of your last period?" B) "What makes your nausea worse?" C) "Have you also had diarrhea?" D) "When did you last urinate?" Ans: A) "What is the date of your last period?" A patient develops intractable hiccoughs after surgery. The nurse anticipates that the physician will order which drug? A) Metoclopramide (Reglan) B) Chlorpromazine (Thorazine) C) Meclizine (Antivert) D) Granisetron (Kytril) Ans: B) Chlorpromazine (Thorazine) The nurse is aware that patients who experience motion sickness are experiencing problems with which body system? A) Gastrointestinal B) Peripheral nervous system C) Vestibular D) Central nervous system (CNS) Ans: C) Vestibular
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