Nursing 326 Exam Questions with
Verified Solutions
The client complaining of "acid" when lying down at night asks the nurse if there is any
medication that might help. Which statement is the nurse's best response?1.
A. "There are no medications to treat this problem, but losing weight will sometimes
help the symptoms."
B. "There are several over-the-counter and prescription medications available to treat
this. You should discuss this with the HCP."
C. "Have you had any x-rays or other tests to determine if you have cancer or some
other serious illness?"
D. "Acid reflux at night can lead to serious complications. You need to have tests done
to determine the cause." - ANS-B
The nurse on a medical unit has received the morning report. Which medication should
the nurse administer first?
A. The proton-pump inhibitor pantoprazole (Protonix) to a client on call to surgery.
B. The antacid calcium carbonate (TUMS) to a client complaining of indigestion.
C. The antimicrobial bismuth (Pepto-Bismol) to a client diagnosed with an ulcer.
D, The H2 blocker famotidine (Pepcid) to a client diagnosed with GERD. - ANS-A
A medication for a client on call to sur- gery is a priority; the client's surgery could be
delayed if the medication has not been administered when the call to surgery comes.
Which statement is the scientific rationale for administering a proton-pump inhibitor
(PPI) to a client diagnosed with gastrointestinal reflux disease (GERD)?
A. PPI medications neutralize the gastric secretions.
B. PPI medications block H2 receptors on the parietal cells.
C. PPI medications inhibit the enzyme that generates gastric acid.
D. PPI medications form a protective barrier against acid and pepsin. - ANS-c
Proton-pump inhibitors inhibit the enzyme that generates gastric acid.
Which statement is an advantage to administering a histamine2 blocker rather than an
antacid to a client diagnosed with gastroesophageal reflux disease (GERD)?
,1. Antacids are more potent than H2 blockers in relieving the symptoms of GERD.
2. Histamine2 blockers have more side effects than antacids.
3. Histamine2 blockers are less expensive than antacids.
4. Histamine2 blockers require less frequent dosing than antacids. - ANS-d
H2 blockers require less frequent administration than do antacids, which require
frequent administration, seven or more times a day, for therapeutic effects. The fewer
times a client is expected to take a medication, the more likely the client is to comply
with a medication regimen.
Which side effects would the nurse explain to the male client who is prescribed cime-
tidine (Tagamet), a histamine2 blocker?
A. The medication can cause indigestion and heartburn.
B. The medication can cause impotence and gynecomastia.
C. The medication can cause insomnia and hypervigilance.
D. The medication can cause Zollinger-Ellison syndrome. - ANS-B
Over time, Tagamet can cause males to become impotent, have decreased libido, and
have breast development (gynecomastia).
The home health-care nurse is caring for a male client diagnosed with a hiatal hernia
and reflux. Which data indicates the medication therapy is effective?
A. The client takes the antacid 1 hour before and 3 hours after a meal.
B. The client complains of indigestion after eating a large meal.
C. The client states that he did not wake up with heartburn during the night.
D. The client has lost 3 pounds in the past 2 weeks. - ANS-C
The nurse is preparing to administer the proton-pump inhibitor esomeprazole (Nexium).
Which intervention should the nurse implement? Select all that apply.
1. Order an infusion pump for the client.
2. Elevate the client's head of the bed.
3. Check the client's ID band with MAR.
4. Check for allergies to cephalosporin.
5. Ask the client his or her date of birth. - ANS-2,3,5
The nurse is discharging a client diagnosed with gastroesophageal reflux disease
(GERD). Which information should the nurse include in the teaching?
A. There are no complications of GERD as long as the client takes the medications.
B. Notify the health-care provider if the medication does not resolve the symptoms.
C. Immediately after a meal, lie down for at least 45 minutes.
,D. If any discomfort is noted, take an NSAID for the pain. - ANS-B
The nurse is discharging a client 2 days postoperative hiatal hernia repair. Which
discharge instructions should the nurse include? Select all that apply.
A. Take all the prescribed antibiotic.
B. Eat six small meals per day.
C. Use the legs to bend down, not the back.
D. Take esomeprazole (Nexium) twice a day.
E. Use the pain medication when the pain is at 8-10. - ANS-A,B,C
The adult client recently has been diagnosed with asthma. Which medication is
recommended to treat this problem?
A. Omeprazole (Prilosec), a proton-pump inhibitor, daily.
B. Amoxicillin (Amoxil), an antibiotic, twice daily.
C. Loratadine (Claritin), an antihistamine, twice daily.
D. Prednisone, a glucocorticoid, daily. - ANS-A
Up to 90% of adult-onset asthma is the result of gastroesophageal reflux disease
(GERD). Treating the gastric reflux will treat the asthma.
The client diagnosed with ulcerative colitis is prescribed mesalamine (Asacol), an
aspirin product. Which information should the nurse discuss with the client?
1. Explain to the client that undissolved tablets may be expelled in stool.
2. Discuss the importance of taking the medication on an empty stomach only.
3. Tell the client to avoid drinking any type of carbonated beverages.
4. Instruct the client not to crush, break, or chew the tablets or capsules. - ANS-4
The tablets must be swallowed whole because they are specially formulated to release
the medication after it has passed through the stomach.
The client with inflammatory bowel disease is prescribed sulfasalazine (Azulfidine), a
sulfonamide antibiotic. Which intervention should the nurse implement when
administering this medication?
1. Ensure the client drinks at least 2000 mL of water daily.
2. Administer the medication once a day with breakfast.
3. Explain that the medication may cause slight bruising.
4. Assess the client's stool for steatorrhea and mucus. - ANS-1
Increasing fluid intake dilutes the drug, which helps to prevent crystalluria (crystals in
the urine) from occurring.
, The client diagnosed with severe ulcerative colitis is prescribed azathioprine (Imuran),
an immunosuppressant. Which assessment data concerning the medication warrants
immediate intervention by the nurse?
1. Complaints of a sore throat, fever, and chills.
2. Reports of 10-20 loose stools a day.
3. Complaints of abdominal pain and tenderness.
4. Reports of dry mouth and oral mucosa. - ANS-1
Azathioprine can cause a decrease in the number of blood cells in the bone marrow
(agranulocytosis). Signs or symptoms that would warrant inter- vention by the nurse
include sore throat, fever, chills, unusual bleeding or bruising, pale skin, headache,
confusion, tachycardia, insomnia,
and shortness of breath.
The client with a severe acute exacerbation of Crohn's disease is prescribed total
parenteral nutrition (TPN). Which interventions should the nurse implement when
administering TPN? Select all that apply.
1. Monitor the client's glucose level every 6 hours.
2. Administer the TPN on an intravenous pump.
3. Assess the peripheral intravenous site every 4 hours.
4. Check the TPN according to the five rights prior to administering. 5. Encourage the
client to eat all of the food offered at meals. - ANS-1 2 4
TPN is 50% dextrose; therefore, the client's blood glucose level should be checked
every 6 hours; sliding-scale regular insulin coverage is usually ordered.
TPN should always be administered using an intravenous pump and notvia gravity; fluid
volume resulting from an overload of TPN could cause a life-threatening hyperglycemic
crisis.
TPN is considered a medication and should be administered as any other medication.
The client diagnosed with inflammatory bowel disease taking mesalamine (Asacol), an
aspirin product, has complaints of nausea, vomiting, and diarrhea. Which intervention
should the clinic nurse take?
1. Instruct the client to quit taking the medication immediately.
2. Tell the client to take Prevacid, a proton-pump inhibitor, with the medication.
3. Advise the client to keep taking the medication, but notify the HCP.
4. Explain that these symptoms are expected and will resolve with time. - ANS-3
These are side effects of the medication, and the HCP should be notified, but the client
should not stop taking the medication.
Which statement indicates to the nurse the client with Crohn's disease understands the
medication teaching concerning sulfasalazine (Azulfidine), a sulfonamide antibiotic?
1. "I will take an antacid 30 minutes before taking my medication."
Verified Solutions
The client complaining of "acid" when lying down at night asks the nurse if there is any
medication that might help. Which statement is the nurse's best response?1.
A. "There are no medications to treat this problem, but losing weight will sometimes
help the symptoms."
B. "There are several over-the-counter and prescription medications available to treat
this. You should discuss this with the HCP."
C. "Have you had any x-rays or other tests to determine if you have cancer or some
other serious illness?"
D. "Acid reflux at night can lead to serious complications. You need to have tests done
to determine the cause." - ANS-B
The nurse on a medical unit has received the morning report. Which medication should
the nurse administer first?
A. The proton-pump inhibitor pantoprazole (Protonix) to a client on call to surgery.
B. The antacid calcium carbonate (TUMS) to a client complaining of indigestion.
C. The antimicrobial bismuth (Pepto-Bismol) to a client diagnosed with an ulcer.
D, The H2 blocker famotidine (Pepcid) to a client diagnosed with GERD. - ANS-A
A medication for a client on call to sur- gery is a priority; the client's surgery could be
delayed if the medication has not been administered when the call to surgery comes.
Which statement is the scientific rationale for administering a proton-pump inhibitor
(PPI) to a client diagnosed with gastrointestinal reflux disease (GERD)?
A. PPI medications neutralize the gastric secretions.
B. PPI medications block H2 receptors on the parietal cells.
C. PPI medications inhibit the enzyme that generates gastric acid.
D. PPI medications form a protective barrier against acid and pepsin. - ANS-c
Proton-pump inhibitors inhibit the enzyme that generates gastric acid.
Which statement is an advantage to administering a histamine2 blocker rather than an
antacid to a client diagnosed with gastroesophageal reflux disease (GERD)?
,1. Antacids are more potent than H2 blockers in relieving the symptoms of GERD.
2. Histamine2 blockers have more side effects than antacids.
3. Histamine2 blockers are less expensive than antacids.
4. Histamine2 blockers require less frequent dosing than antacids. - ANS-d
H2 blockers require less frequent administration than do antacids, which require
frequent administration, seven or more times a day, for therapeutic effects. The fewer
times a client is expected to take a medication, the more likely the client is to comply
with a medication regimen.
Which side effects would the nurse explain to the male client who is prescribed cime-
tidine (Tagamet), a histamine2 blocker?
A. The medication can cause indigestion and heartburn.
B. The medication can cause impotence and gynecomastia.
C. The medication can cause insomnia and hypervigilance.
D. The medication can cause Zollinger-Ellison syndrome. - ANS-B
Over time, Tagamet can cause males to become impotent, have decreased libido, and
have breast development (gynecomastia).
The home health-care nurse is caring for a male client diagnosed with a hiatal hernia
and reflux. Which data indicates the medication therapy is effective?
A. The client takes the antacid 1 hour before and 3 hours after a meal.
B. The client complains of indigestion after eating a large meal.
C. The client states that he did not wake up with heartburn during the night.
D. The client has lost 3 pounds in the past 2 weeks. - ANS-C
The nurse is preparing to administer the proton-pump inhibitor esomeprazole (Nexium).
Which intervention should the nurse implement? Select all that apply.
1. Order an infusion pump for the client.
2. Elevate the client's head of the bed.
3. Check the client's ID band with MAR.
4. Check for allergies to cephalosporin.
5. Ask the client his or her date of birth. - ANS-2,3,5
The nurse is discharging a client diagnosed with gastroesophageal reflux disease
(GERD). Which information should the nurse include in the teaching?
A. There are no complications of GERD as long as the client takes the medications.
B. Notify the health-care provider if the medication does not resolve the symptoms.
C. Immediately after a meal, lie down for at least 45 minutes.
,D. If any discomfort is noted, take an NSAID for the pain. - ANS-B
The nurse is discharging a client 2 days postoperative hiatal hernia repair. Which
discharge instructions should the nurse include? Select all that apply.
A. Take all the prescribed antibiotic.
B. Eat six small meals per day.
C. Use the legs to bend down, not the back.
D. Take esomeprazole (Nexium) twice a day.
E. Use the pain medication when the pain is at 8-10. - ANS-A,B,C
The adult client recently has been diagnosed with asthma. Which medication is
recommended to treat this problem?
A. Omeprazole (Prilosec), a proton-pump inhibitor, daily.
B. Amoxicillin (Amoxil), an antibiotic, twice daily.
C. Loratadine (Claritin), an antihistamine, twice daily.
D. Prednisone, a glucocorticoid, daily. - ANS-A
Up to 90% of adult-onset asthma is the result of gastroesophageal reflux disease
(GERD). Treating the gastric reflux will treat the asthma.
The client diagnosed with ulcerative colitis is prescribed mesalamine (Asacol), an
aspirin product. Which information should the nurse discuss with the client?
1. Explain to the client that undissolved tablets may be expelled in stool.
2. Discuss the importance of taking the medication on an empty stomach only.
3. Tell the client to avoid drinking any type of carbonated beverages.
4. Instruct the client not to crush, break, or chew the tablets or capsules. - ANS-4
The tablets must be swallowed whole because they are specially formulated to release
the medication after it has passed through the stomach.
The client with inflammatory bowel disease is prescribed sulfasalazine (Azulfidine), a
sulfonamide antibiotic. Which intervention should the nurse implement when
administering this medication?
1. Ensure the client drinks at least 2000 mL of water daily.
2. Administer the medication once a day with breakfast.
3. Explain that the medication may cause slight bruising.
4. Assess the client's stool for steatorrhea and mucus. - ANS-1
Increasing fluid intake dilutes the drug, which helps to prevent crystalluria (crystals in
the urine) from occurring.
, The client diagnosed with severe ulcerative colitis is prescribed azathioprine (Imuran),
an immunosuppressant. Which assessment data concerning the medication warrants
immediate intervention by the nurse?
1. Complaints of a sore throat, fever, and chills.
2. Reports of 10-20 loose stools a day.
3. Complaints of abdominal pain and tenderness.
4. Reports of dry mouth and oral mucosa. - ANS-1
Azathioprine can cause a decrease in the number of blood cells in the bone marrow
(agranulocytosis). Signs or symptoms that would warrant inter- vention by the nurse
include sore throat, fever, chills, unusual bleeding or bruising, pale skin, headache,
confusion, tachycardia, insomnia,
and shortness of breath.
The client with a severe acute exacerbation of Crohn's disease is prescribed total
parenteral nutrition (TPN). Which interventions should the nurse implement when
administering TPN? Select all that apply.
1. Monitor the client's glucose level every 6 hours.
2. Administer the TPN on an intravenous pump.
3. Assess the peripheral intravenous site every 4 hours.
4. Check the TPN according to the five rights prior to administering. 5. Encourage the
client to eat all of the food offered at meals. - ANS-1 2 4
TPN is 50% dextrose; therefore, the client's blood glucose level should be checked
every 6 hours; sliding-scale regular insulin coverage is usually ordered.
TPN should always be administered using an intravenous pump and notvia gravity; fluid
volume resulting from an overload of TPN could cause a life-threatening hyperglycemic
crisis.
TPN is considered a medication and should be administered as any other medication.
The client diagnosed with inflammatory bowel disease taking mesalamine (Asacol), an
aspirin product, has complaints of nausea, vomiting, and diarrhea. Which intervention
should the clinic nurse take?
1. Instruct the client to quit taking the medication immediately.
2. Tell the client to take Prevacid, a proton-pump inhibitor, with the medication.
3. Advise the client to keep taking the medication, but notify the HCP.
4. Explain that these symptoms are expected and will resolve with time. - ANS-3
These are side effects of the medication, and the HCP should be notified, but the client
should not stop taking the medication.
Which statement indicates to the nurse the client with Crohn's disease understands the
medication teaching concerning sulfasalazine (Azulfidine), a sulfonamide antibiotic?
1. "I will take an antacid 30 minutes before taking my medication."
