A nurse is preparing to administer phenylephrine as a vasopressor to treat a patient for hypotension. The desired therapeutic effect of phenylephrine in this context is:

Vasoconstriction

Bronchodilation

Diuresis

Decreased heart rate

Answer and Explanation

The Correct Answer is A

Choice A reason: Vasoconstriction is the desired therapeutic effect of phenylephrine in this context. Phenylephrine is a medication that stimulates the alpha1 receptors on the blood vessels, causing them to constrict or narrow. This increases the resistance to blood flow and raises the blood pressure. Phenylephrine is used as a vasopressor to treat hypotension, which is a condition of low blood pressure that can cause dizziness, fainting, or organ damage. The nurse should monitor the blood pressure and the peripheral pulses of the patient after administering phenylephrine.

Choice B reason: Bronchodilation is not the desired therapeutic effect of phenylephrine in this context. Phenylephrine is a medication that stimulates the alpha1 receptors on the blood vessels, causing them to constrict or narrow. It has no effect on the beta2 receptors on the bronchial smooth muscle, which are responsible for bronchodilation or widening of the airways. Phenylephrine is not used to treat respiratory conditions, such as asthma or chronic obstructive pulmonary disease, that cause bronchoconstriction or narrowing of the airways. The nurse should assess the respiratory rate and the breath sounds of the patient after administering phenylephrine.

Choice C reason: Diuresis is not the desired therapeutic effect of phenylephrine in this context. Phenylephrine is a medication that stimulates the alpha1 receptors on the blood vessels, causing them to constrict or narrow. It has no effect on the kidney function or the urine output. Phenylephrine is not used to treat fluid retention or edema, which are conditions of excess fluid in the body that can cause swelling, weight gain, or heart failure. The nurse should measure the urine output and the specific gravity of the patient after administering phenylephrine.

Choice D reason: Decreased heart rate is not the desired therapeutic effect of phenylephrine in this context. Phenylephrine is a medication that stimulates the alpha1 receptors on the blood vessels, causing them to constrict or narrow. It has little or no effect on the beta1 receptors on the heart, which are responsible for increasing the heart rate and the contractility. Phenylephrine may actually cause a reflex bradycardia, which is a slow heart rate that occurs when the baroreceptors in the blood vessels sense an increase in blood pressure and send signals to the brain to lower the heart rate. Phenylephrine is not used to treat tachycardia, which is a fast heart rate that can cause palpitations, chest pain, or arrhythmias. The nurse should monitor the electrocardiogram and the heart rate of the patient after administering phenylephrine.

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Correct Answer is D

Explanation

Choice A reason: Administering the medication with meals only is not a valid adjustment for a medication that is primarily excreted by the kidneys. The food intake does not affect the renal clearance of the drug, unless it alters the pH of the urine or the blood flow to the kidneys. The nurse should follow the instructions on the medication label or the prescriber's order regarding the timing of the administration.

Choice B reason: No dose adjustment is required is an incorrect statement for a medication that is primarily excreted by the kidneys. The renal impairment can reduce the elimination of the drug and increase its concentration in the blood. This can cause adverse effects and toxicity. The nurse should consult with the prescriber or the pharmacist about the appropriate dose reduction or frequency change for the patient's level of renal function.

Choice C reason: Increasing the dose to ensure therapeutic effect is a dangerous and inappropriate adjustment for a medication that is primarily excreted by the kidneys. The renal impairment can reduce the elimination of the drug and increase its concentration in the blood. This can cause adverse effects and toxicity. The nurse should not increase the dose without the prescriber's order and should monitor the patient for signs of overdose or toxicity.

Choice D reason: Decreasing the dose to prevent toxicity is the correct and rational adjustment for a medication that is primarily excreted by the kidneys. The renal impairment can reduce the elimination of the drug and increase its concentration in the blood. This can cause adverse effects and toxicity. The nurse should consult with the prescriber or the pharmacist about the appropriate dose reduction or frequency change for the patient's level of renal function. The nurse should also monitor the patient for the therapeutic response and the adverse effects of the drug.

A. Relief of heartburn B. Cessation of diarrhea C. Passage of flatus D. Absence of constipation

Correct Answer is A

Explanation

Choice A reason: Relief of heartburn is the correct outcome that indicates that famotidine is therapeutic. Famotidine is a medication that belongs to the class of H2 receptor antagonists, which work by blocking the action of histamine on the H2 receptors of the stomach cells, thereby reducing the production of gastric acid. Famotidine is used to treat and prevent conditions such as gastroesophageal reflux disease (GERD), peptic ulcer disease, and Zollinger Ellison syndrome, which are characterized by excessive acid secretion and irritation of the esophagus and stomach. Famotidine can relieve the symptoms of heartburn, which is a burning sensation in the chest or throat caused by the reflux of stomach acid into the esophagus.

Choice B reason: Cessation of diarrhea is not an outcome that indicates that famotidine is therapeutic. Famotidine is a medication that belongs to the class of H2 receptor antagonists, which work by blocking the action of histamine on the H2 receptors of the stomach cells, thereby reducing the production of gastric acid. Famotidine does not affect the motility or secretion of the intestines, and it is not used to treat diarrhea, which is a condition of frequent and loose bowel movements. Diarrhea can have various causes, such as infections, medications, food intolerance, or inflammatory bowel disease, and it requires different treatments depending on the underlying cause. Famotidine is not effective for treating diarrhea, and it may even worsen it by reducing the acidity of the stomach and increasing the risk of bacterial overgrowth.

Choice C reason: Passage of flatus is not an outcome that indicates that famotidine is therapeutic. Famotidine is a medication that belongs to the class of H2 receptor antagonists, which work by blocking the action of histamine on the H2 receptors of the stomach cells, thereby reducing the production of gastric acid. Famotidine does not affect the digestion or fermentation of food in the gastrointestinal tract, and it is not used to treat flatulence, which is the accumulation and expulsion of gas from the stomach or intestines. Flatulence can have various causes, such as swallowing air, eating certain foods, or having a bacterial imbalance in the gut, and it requires different treatments depending on the underlying cause. Famotidine is not effective for treating flatulence, and it may even increase it by reducing the acidity of the stomach and altering the gut flora.

Choice D reason: Absence of constipation is not an outcome that indicates that famotidine is therapeutic. Famotidine is a medication that belongs to the class of H2 receptor antagonists, which work by blocking the action of histamine on the H2 receptors of the stomach cells, thereby reducing the production of gastric acid. Famotidine does not affect the motility or secretion of the intestines, and it is not used to treat constipation, which is a condition of infrequent or difficult bowel movements. Constipation can have various causes, such as dehydration, lack of fiber, medications, or bowel obstruction, and it requires different treatments depending on the underlying cause. Famotidine is not effective for treating constipation, and it may even cause it by reducing the acidity of the stomach and slowing down the digestion.

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A nurse is preparing to administer phenylephrine as a vasopressor to treat a patient for hypotension. The desired therapeutic effect of phenylephrine in this context is:

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A patient with renal impairment is prescribed a medication that is primarily excreted by the kidneys. What adjustment should the nurse anticipate?

Correct Answer is D

Explanation

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

Correct Answer is A

Explanation

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