The client prescribed ondansetron (Zofran) for persistent nausea and vomiting demonstrates understanding about his medication when he states:

“This medication should be taken after eating to reduce nausea.”

“This medication should not be taken with starfruit.”

“This medication may make me tired and confused.”

“This medication may cause rebound nausea.”

Answer and Explanation

The Correct Answer is C

Choice A reason: “This medication should be taken after eating to reduce nausea.” is not a correct statement that demonstrates understanding about ondansetron. Ondansetron is a medication that prevents nausea and vomiting by blocking the action of serotonin, a chemical that stimulates the vomiting center in the brain. Ondansetron can be taken with or without food, and it does not affect the digestion or absorption of food. Ondansetron is usually taken before the start of chemotherapy, radiation, or surgery, which are the common causes of nausea and vomiting.

Choice B reason: “This medication should not be taken with starfruit.” is not a correct statement that demonstrates understanding about ondansetron. Ondansetron is a medication that prevents nausea and vomiting by blocking the action of serotonin, a chemical that stimulates the vomiting center in the brain. Ondansetron does not interact with starfruit, which is a tropical fruit that contains substances that can inhibit the enzyme CYP3A4, which is involved in the metabolism of many drugs. Ondansetron is mainly metabolized by another enzyme, CYP1A2, and it has a low potential for drug interactions¹.

Choice C reason: “This medication may make me tired and confused.” is a correct statement that demonstrates understanding about ondansetron. Ondansetron is a medication that prevents nausea and vomiting by blocking the action of serotonin, a chemical that stimulates the vomiting center in the brain. Ondansetron can also cross the blood brain barrier and affect other serotonin receptors in the brain, which are involved in regulating mood, cognition, and sleep. Ondansetron can cause side effects such as fatigue, drowsiness, headache, and confusion, which can impair the mental alertness and performance of the client. The client should be advised to avoid driving, operating machinery, or doing other tasks that require attention after taking ondansetron.

Choice D reason: “This medication may cause rebound nausea.” is not a correct statement that demonstrates understanding about ondansetron. Ondansetron is a medication that prevents nausea and vomiting by blocking the action of serotonin, a chemical that stimulates the vomiting center in the brain. Ondansetron does not cause rebound nausea, which is a condition of nausea that occurs after the discontinuation of a medication that suppresses nausea. Ondansetron is not a medication that suppresses nausea, but rather prevents it by blocking the stimulation of the vomiting center. Ondansetron does not cause dependence or withdrawal symptoms, and it can be stopped without causing rebound nausea.

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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. Miosis B. Sedation C. Respiratory depression D. Euphoria

Correct Answer is C

Explanation

Choice A reason: This is incorrect. Miosis is the constriction of the pupils, which can also be caused by morphine, but it is not a life-threatening side effect. Miosis occurs because morphine stimulates the parasympathetic nervous system, which controls the muscles that constrict the pupils¹.

Choice B reason: This is incorrect. Sedation is the state of being calm, relaxed, and sleepy, which can also be caused by morphine, but it is not a life-threatening side effect. Sedation occurs because morphine depresses the central nervous system, which reduces the activity of the brain and the body.

Choice C reason: This is correct. Respiratory depression is the slowing down of breathing, which can be a life-threatening side effect of morphine. Respiratory depression occurs because morphine depresses the respiratory center in the brainstem, which regulates the rate and depth of breathing. If the breathing becomes too slow or shallow, the patient may not get enough oxygen and may lose consciousness or die.

Choice D reason: This is incorrect. Euphoria is the feeling of intense happiness, pleasure, or wellbeing, which can also be caused by morphine, but it is not a life-threatening side effect. Euphoria occurs because morphine stimulates the reward system in the brain, which releases dopamine, a neurotransmitter that causes positive emotions.

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The client prescribed ondansetron (Zofran) for persistent nausea and vomiting demonstrates understanding about his medication when he states:

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Naxlex Comprehensive Predictor Exams

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Correct Answer is D

Explanation

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Correct Answer is C

Explanation

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