A client who has been taking nonsteroidal anti-inflammatory drugs (NSAIDs) is experiencing gastric pain and blood in his stool. The healthcare provider discontinues the NSAIDs and prescribes esomeprazole. Which information should the nurse include in this client’s teaching plan?

Resume a diet that consists of milk, cream, and bland foods.

Call the clinic if diarrhea or headache occurs when taking esomeprazole.

Once pain subsides, NSAID therapy can be resumed.

Notify the healthcare provider of the passage of black stools.

Answer and Explanation

The Correct Answer is D

Choice A reason:

Resuming a diet that consists of milk, cream, and bland foods is not the most critical instruction for a client taking esomeprazole. While bland foods can help reduce gastric irritation, they do not address the primary concern of monitoring for serious side effects. Esomeprazole is a proton pump inhibitor (PPI) that reduces stomach acid, and dietary changes alone are not sufficient to manage potential complications.

Choice B reason:

Calling the clinic if diarrhea or headache occurs when taking esomeprazole is important, but it is not the most critical instruction. Diarrhea and headache are common side effects of esomeprazole, but they are usually not severe. The client should be aware of these potential side effects, but the primary concern is monitoring for signs of gastrointestinal bleeding.

Choice C reason:

Once pain subsides, NSAID therapy should not be resumed without consulting the healthcare provider. NSAIDs can cause significant gastrointestinal issues, including ulcers and bleeding. The client should be advised to avoid NSAIDs unless specifically directed by their healthcare provider.

Choice D reason:

Notifying the healthcare provider of the passage of black stools is the most critical instruction. Black stools can indicate gastrointestinal bleeding, which is a serious side effect of both NSAIDs and esomeprazole. Immediate medical attention is necessary if this occurs to prevent further complications.

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Correct Answer is C

Explanation

Choice A reason:

Calcium acetate is not used to lower potassium levels. Potassium levels in the blood are typically managed through dietary restrictions, medications like potassium binders, and dialysis in patients with CKD. The normal range for blood potassium levels is 3.5 to 5.2 mEq/L for adults.

Choice B reason:

Calcium acetate can increase calcium levels in the blood, not decrease them. It is important to monitor calcium levels to avoid hypercalcemia, which can lead to complications such as vascular calcification and cardiac issues. The normal range for blood calcium levels is 8.6 to 10.2 mg/dL.

Choice C reason:

Calcium acetate is used to lower phosphate levels in patients with CKD. It works by binding to dietary phosphate in the intestines, forming insoluble calcium phosphate that is excreted in the stool. This helps prevent hyperphosphatemia, a common issue in CKD patients. The normal range for blood phosphate levels is 2.5 to 4.5 mg/dL.

Choice D reason:

Calcium acetate does not directly affect blood pH levels. Blood pH is regulated by the kidneys and lungs, and the normal range is 7.35 to 7.45. While CKD can affect acid-base balance, calcium acetate’s primary role is to manage phosphate levels.

A. Omeprazole. B. Acetaminophen. C. Captopril. D. Prednisone.

Correct Answer is B

Explanation

Choice A reason: Omeprazole is a proton pump inhibitor used to treat gastroesophageal reflux disease (GERD). While it is generally safe, it is not commonly associated with causing jaundice. Omeprazole can cause liver enzyme elevations in rare cases, but it is not a primary concern for drug-induced jaundice.

Choice B reason: Acetaminophen is known to cause hepatotoxicity, especially in high doses or with prolonged use. It is one of the most common causes of drug-induced liver injury, which can lead to jaundice. The nurse should notify the healthcare provider about the use of acetaminophen, as it is a likely culprit for the client’s jaundice.

Choice C reason: Captopril is an ACE inhibitor used to treat hypertension. While it can cause various side effects, it is not typically associated with causing jaundice. The primary concerns with captopril are related to renal function and electrolyte imbalances.

Choice D reason: Prednisone is a corticosteroid used to reduce inflammation in conditions like osteoarthritis. Although long-term use of corticosteroids can affect liver function, it is not commonly associated with causing jaundice. The nurse should still monitor liver function but focus on more likely causes.

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A client who has been taking nonsteroidal anti-inflammatory drugs (NSAIDs) is experiencing gastric pain and blood in his stool. The healthcare provider discontinues the NSAIDs and prescribes esomeprazole. Which information should the nurse include in this client’s teaching plan?

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Naxlex Comprehensive Predictor Exams

A client with chronic kidney disease (CKD) is receiving calcium acetate 667 mg PO. A decrease in which blood value indicates to the nurse that the medication is having the desired effect?

Correct Answer is C

Explanation

Correct Answer is B

Explanation

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