The healthcare provider prescribes bismuth subsalicylate, metronidazole, tetracycline, and pantoprazole for a client with a Helicobacter pylori (H. pylori) infection.
Prior to administering the
H. pylori treatment regimen, the nurse should review the electronic medical record for which medication?
Famotidine.
Loperamide.
Aspirin.
Ipratropium.
The Correct Answer is A
Choice A rationale:
Famotidine is a histamine-2 receptor antagonist (H2RA) that decreases gastric acid secretion. It is often used to treat conditions such as ulcers, gastroesophageal reflux disease (GERD), and heartburn.
Bismuth subsalicylate, metronidazole, tetracycline, and pantoprazole are all medications used in the treatment of H. pylori infection. However, these medications can interact with famotidine, potentially leading to decreased efficacy or increased side effects.
Therefore, it is important for the nurse to review the client's electronic medical record for any current or recent use of famotidine before administering the H. pylori treatment regimen. This will help to ensure the safety and effectiveness of the treatment.
Choice B rationale:
Loperamide is an antidiarrheal medication. It is not typically used in the treatment of H. pylori infection and is not known to interact with the medications used in this regimen.
Choice C rationale:
Aspirin is a salicylate medication that is often used to treat pain, fever, and inflammation. It can also be used to prevent blood clots. However, aspirin can interact with bismuth subsalicylate, potentially leading to increased risk of bleeding.
Therefore, it is important for the nurse to assess the client's risk of bleeding before administering the H. pylori treatment regimen if they are also taking aspirin.
Choice D rationale:
Ipratropium is a bronchodilator medication that is used to treat asthma and chronic obstructive pulmonary disease (COPD). It is not typically used in the treatment of H. pylori infection and is not known to interact with the medications used in this regimen.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A rationale:
Lactulose is a non-absorbable disaccharide that is metabolized by bacteria in the colon to produce lactic acid and acetic acid. These acids acidify the colon, which traps ammonia (NH3) in the colon and converts it to ammonium (NH4+). Ammonium is not absorbed by the colon and is excreted in the stool. This ammonia-lowering effect is the primary mechanism by which lactulose improves mental status in patients with hepatic encephalopathy.
Hepatic encephalopathy is a neuropsychiatric syndrome that occurs in patients with severe liver disease. It is caused by the buildup of ammonia in the blood, which can cross the blood-brain barrier and cause cerebral edema and impaired brain function.
The clinical manifestations of hepatic encephalopathy range from mild confusion and personality changes to coma. Improved mental status is a key therapeutic goal in the treatment of hepatic encephalopathy.
Studies have shown that lactulose can improve mental status in patients with hepatic encephalopathy. A meta-analysis of 11 randomized controlled trials found that lactulose was associated with a significant improvement in mental status compared to placebo.
The improvement in mental status is typically seen within 24 to 48 hours of starting lactulose therapy.
Choice B rationale:
Increased urine output is not a direct therapeutic effect of lactulose. Lactulose can cause diarrhea, which can lead to increased urine output due to fluid loss. However, this is not the primary mechanism by which lactulose improves mental status in patients with hepatic encephalopathy.
Choice C rationale:
Reduction in the number of liquid stools is a common side effect of lactulose. However, it is not a therapeutic goal in the treatment of hepatic encephalopathy. The goal of lactulose therapy is to improve mental status by lowering ammonia levels in the blood.
Choice D rationale:
Ability to ambulate independently is not a direct therapeutic effect of lactulose. Lactulose can improve mental status, which may indirectly lead to improved ambulation in some patients. However, this is not the primary mechanism by which lactulose works.
Correct Answer is B
Explanation
Choice A rationale:
Hemoccult test on sputum collected from hemoptysis is not a diagnostic test for TB. It is a test for blood in the stool, which can be a symptom of TB but is not specific to TB.
Hemoptysis, or coughing up blood, can occur in various conditions, including bronchitis, pneumonia, lung cancer, and TB. The Hemoccult test cannot differentiate between these causes, making it an unreliable test for diagnosing TB.
Choice B rationale:
Sputum culture positive for Mycobacterium tuberculosis is the definitive diagnostic test for TB.
It involves collecting a sample of sputum, which is the mucus coughed up from the lungs, and culturing it in a laboratory to see if Mycobacterium tuberculosis, the bacteria that causes TB, grows.
This test is highly specific for TB, meaning that a positive result is almost always indicative of TB infection. It is also sensitive, meaning that it can detect TB infection even when there are few bacteria present.
Choice C rationale:
Positive purified protein derivative (PPD) skin test indicates exposure to TB but does not confirm active infection.
The PPD skin test involves injecting a small amount of tuberculin, a protein derived from Mycobacterium tuberculosis, into the skin.
If a person has been exposed to TB, their immune system will react to the tuberculin, causing a raised red bump to appear at the injection site.
However, a positive PPD skin test does not necessarily mean that a person has active TB infection.
It could also mean that they have been exposed to TB in the past but have successfully fought off the infection. Further testing, such as a sputum culture, is needed to confirm the diagnosis of TB.
Choice D rationale:
Chest X-ray or computed tomography (CT) can show abnormalities in the lungs that are suggestive of TB, but they cannot definitively diagnose TB.
These imaging tests can reveal changes in the lungs, such as nodules, inflammation, or fluid buildup, which can be caused by TB or other conditions.
Therefore, a chest X-ray or CT scan alone is not sufficient to diagnose TB. A sputum culture is still needed to confirm the diagnosis.
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