Chapter 33 Drugs Used to Treat Nausea and Vomiting

Chapter 33  Drugs Used to Treat Nausea and Vomiting

Complete Chapter Questions And Answers
 

Sample Questions

MULTIPLE CHOICE

1. A patient is beginning the second round of high-dose cisplatin. Severe, chemotherapy-induced nausea and vomiting (CINV) occurred following the first treatment, requiring 72 hours of continuous IV hydration. In addition to her chemotherapy regimen, which medication would be best to administer?
a.
Prochlorperazine (Compazine) suppository daily, on the day of treatment and the next 3 days
b.
Anticholinergic agents, such as diphenhydramine or meclizine
c.
Parenteral ondansetron 1 hour before chemotherapy, with oral ondansetron to continue for the next 4 days
d.
Parenteral ondansetron during chemotherapy, with prochlorperazine suppositories daily for 1 week

ANS: C
With the patient’s first treatment history and the emetogenic chemotherapy agent, cisplatin, ondansetron has shown to be the most effective for prevention of severe nausea and vomiting. Prochlorperazine and anticholinergic agents are not used for the treatment of CINV. The ondansetron should be administered 1 hour before the chemotherapy and continued for the next several days to prevent vomiting and dehydration associated with chemotherapy administration.

DIF: Cognitive Level: Application REF: Page 514 OBJ: 5
TOP: Nursing Process Step: Implementation
MSC: NCLEX Client Needs Category: Physiological Integrity
NOT: CONCEPT(S): Clinical Judgment; Fluid and Electrolytes

2. A patient expresses concerns about motion sickness. Which medication is most effective in preventing motion sickness?
a.
Serotonin antagonists
b.
Phenothiazines
c.
Corticosteroids
d.
Anticholinergics

ANS: D
Anticholinergic agents are used to treat motion sickness by counterbalancing the excessive amounts of acetylcholine present. Serotonin antagonists are used in the treatment of emesis associated with cancer chemotherapy, radiation therapy, and postoperative nausea and vomiting. Phenothiazines are used in the treatment of mild to moderate nausea and vomiting associated with anesthesia and surgery, radiation therapy, and cancer chemotherapy. Corticosteroids are used in the treatment of nausea and vomiting related to pregnancy, postsurgical state, chemotherapy, radiation, and bowel obstruction.

DIF: Cognitive Level: Knowledge REF: Page 521 OBJ: 1 | 3
TOP: Nursing Process Step: Implementation
MSC: NCLEX Client Needs Category: Physiological Integrity
NOT: CONCEPT(S): Clinical Judgment; Health Promotion

3. What is the purpose for the nurse administering metoclopramide (Reglan) IV postoperatively?
a.
Prolong the effects of anesthesia
b.
Decrease the potential for thrombus formation
c.
Prevent postoperative nausea and vomiting
d.
Decrease postoperative pain

ANS: C
Metoclopramide (Reglan) is an antiemetic and antagonist of dopamine and serotonin receptors. In addition to acting on receptor sites in the brain, metoclopramide increases sphincter tone in the gastrointestinal tract, which reduces nausea and vomiting. Metoclopramide does not affect anesthesia or the vascular system and does not have analgesic effects.

DIF: Cognitive Level: Comprehension REF: Page 513 OBJ: 1
TOP: Nursing Process Step: Implementation
MSC: NCLEX Client Needs Category: Health Promotion and Maintenance
NOT: CONCEPT(S): Clinical Judgment; Health Promotion

4. The nurse is assessing a patient with nausea and vomiting. Which additional autonomic symptoms that often accompany vomiting will the nurse observe?
a.
Bradycardia, diarrhea, and flushing
b.
Pallor, sweating, and tachycardia
c.
Urinary urgency, chills, and dizziness
d.
Fever, hyperventilation, and bradycardia

ANS: B
Autonomic symptoms of pallor, sweating, and tachycardia cause additional discomfort associated with vomiting. Bradycardia, diarrhea, flushing, urinary urgency, chills, dizziness, fever, and hyperventilation are not autonomic symptoms associated with vomiting.

DIF: Cognitive Level: Knowledge REF: Page 507 | Page 508
OBJ: N/A TOP: Nursing Process Step: Assessment
MSC: NCLEX Client Needs Category: Health Promotion and Maintenance
NOT: CONCEPT(S): Clinical Judgment; Safety

5. The nurse would expect to administer which drug when treating hyperemesis gravidarum?
a.
THC (Marinol)
b.
Haloperidol (Haldol)
c.
Dexamethasone (Prednisone)
d.
Metoclopramide (Reglan)

ANS: D
Metoclopramide is the drug of choice when treating hyperemesis gravidarum because no teratogenic effects have been reported with the use of this drug. THC is used in the treatment of nausea and vomiting associated with cancer and cancer treatment. Haloperidol is used in the treatment of nausea associated with chemotherapy. Prednisone is used in the treatment of nausea associated with pregnancy, postsurgical state, chemotherapy, radiation, and bowel obstruction.

DIF: Cognitive Level: Knowledge REF: Page 511 OBJ: 3
TOP: Nursing Process Step: Implementation
MSC: NCLEX Client Needs Category: Health Promotion and Maintenance
NOT: CONCEPT(S): Clinical Judgment; Safety