Which of these clients would the nurse expect to be the best candidate for misoprostol?

A 12-year-old child with obsessive-compulsive disorder.

A 46-year-old trial lawyer with hypertension.

An 83-year-old client with rheumatoid arthritis.

A 22-year-old pregnant client.

None

Answer and Explanation

The Correct Answer is C

A. A 12-year-old child with obsessive-compulsive disorder is not typically a candidate for misoprostol, as it is not indicated for this condition.

B. A 46-year-old trial lawyer with hypertension might need caution when using misoprostol, as it can cause diarrhea and abdominal pain, which could be problematic.

C. An 83-year-old client with rheumatoid arthritis is the best candidate for misoprostol, particularly if they are taking nonsteroidal anti-inflammatory drugs (NSAIDs) for their condition. Misoprostol is often used to prevent NSAID-induced gastric ulcers in patients at high risk, such as elderly individuals or those with a history of ulcers.

D. A 22-year-old pregnant client should not be given misoprostol unless it is used for specific obstetric indications under close supervision. Misoprostol can induce uterine contractions and is contraindicated in pregnancy unless used for medical reasons like inducing labor or treating postpartum hemorrhage.

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Correct Answer is A

Explanation

This is because proton pump inhibitors (PPIs) are drugs that block the enzyme that produces hydrochloric acid in the stomach, thereby reducing the amount of acid secreted into the lumen. PPIs are commonly used to treat peptic ulcer disease and gastroesophageal reflux disease.

Choice B. Histamine-2 antagonist is wrong because histamine-2 antagonists (H blockers) are drugs that block the action of histamine on the parietal cells of the stomach, thereby reducing the amount of acid secreted into the lumen.

However, PPIs are more potent and effective than H blockers in suppressing acid secretion.

Choice C. Prostaglandin is wrong because prostaglandins are substances that protect the stomach lining from the damaging effects of acid and other factors.

Prostaglandins do not directly affect the secretion of acid into the lumen, but they may increase the production of mucus and bicarbonate that buffer the acid.

Choice D. Antipeptic agent is wrong because antipeptic agents are drugs that form a protective barrier over the ulcer crater, preventing further damage from acid and pepsin.

Antipeptic agents do not affect the secretion of acid into the lumen, but they may enhance healing by creating a favorable environment for tissue repair.

Normal ranges for hydrochloric acid secretion in the stomach are 1.5 to 3.5 liters per day, with a pH of 1.5 to 3.53.

A. Decrease theophylline dosage immediately. B. Decrease theophylline dose when normal thyroid function returns. C. Discontinue the client’s theophylline. D. Increase theophylline dosage immediately.

Correct Answer is B

Explanation

This is because hypothyroidism can reduce the metabolism and clearance of theophylline, leading to higher serum levels and increased risk of toxicity. Therefore, when the thyroid function is restored by levothyroxine or liothyronine, the dose of theophylline may need to be lowered to avoid excessive effects.

Choice A is wrong because decreasing theophylline dosage immediately may result in suboptimal control of asthma symptoms.

The dose adjustment should be based on serum theophylline levels and clinical response.

Choice C is wrong because discontinuing the client’s theophylline may cause worsening of asthma and potentially life-threatening complications.

Theophylline is an important bronchodilator that should not be stopped abruptly without medical supervision.

Choice D is wrong because increasing theophylline dosage immediately may cause overdose and adverse effects such as nausea, vomiting, headache, tachycardia, arrhythmias, seizures and even death.

The dose of theophylline should be carefully titrated according to serum levels and clinical response.

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Which of these clients would the nurse expect to be the best candidate for misoprostol?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client with peptic ulcer disease is experiencing fewer symptoms because of the suppression of hydrochloric acid secretion into the lumen of the stomach. What category of medication is this client most likely receiving?

Correct Answer is A

Explanation

The nurse is caring for a client newly diagnosed with hypothyroidism. The client also takes theophylline to control asthma symptoms. What change may need to be made to the client’s theophylline dose?

Correct Answer is B

Explanation

The nurse is caring for a client with neurogenic diabetes insipidus and administers what drug to treat the condition.

A client with type 1 diabetes presents to the diabetes educator and asks about a change in insulin. The client’s occupation requires long international flights, and the client does not want to administer insulin on the plane. What kind of insulin would best meet this client’s needs?

A client with type 2 diabetes presents at the clinic for a routine follow-up appointment. The client asks the nurse whether he or she can take the herbal supplement ginseng. What is the correct response by the nurse?

A client has responded poorly to conservative treatment for nausea and vomiting and has subsequently been prescribed dronabinol. In addition to monitoring the client’s nausea, the nurse should prioritize what assessment after administering the drug?

The client is 8 weeks pregnant and requires an antithyroid medication. The nurse identifies what drug as the drug of choice for this client?

The nurse is caring for a client who has begun vomiting. The nurse is aware that which part of the client’s brain has been stimulated?

A client has begun reporting nausea and vomiting. What would the nurse assess to determine the need for therapy?

The nurse should question an order for bismuth salts for a client with what condition?