Chapter 34 Drugs Used to Treat Nausea and Vomiting

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Chapter 34  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, 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

Feedback
A
Prochlorperazine is not indicated for the treatment of CINV.
B
Anticholinergic agents are not used for the treatment of CINV.
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.
D
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. Prochlorperazine is not indicated for the treatment of CINV.

DIF: Cognitive Level: Application REF: 542
TOP: Nursing Process Step: Implementation
MSC: NCLEX Client Needs Category: Physiological Integrity

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

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

DIF: Cognitive Level: Knowledge REF: 551
TOP: Nursing Process Step: Implementation
MSC: NCLEX Client Needs Category: Physiological Integrity

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

Feedback
A
Metoclopramide does not affect anesthesia.
B
Metoclopramide does not affect the vascular system.
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.
D
Metoclopramide does not have analgesic effects.

DIF: Cognitive Level: Comprehension REF: 541
TOP: Nursing Process Step: Implementation
MSC: NCLEX Client Needs Category: Health Promotion and Maintenance

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

Feedback
A
Bradycardia, diarrhea, and flushing are not autonomic symptoms associated with vomiting.
B
Autonomic symptoms of pallor, sweating, and tachycardia cause additional discomfort associated with vomiting.
C
Urinary urgency, chills, and dizziness are not autonomic symptoms associated with vomiting.
D
Fever, hyperventilation, and bradycardia are not autonomic symptoms associated with vomiting.

DIF: Cognitive Level: Knowledge REF: 538-539
TOP: Nursing Process Step: Assessment
MSC: NCLEX Client Needs Category: Health Promotion and Maintenance

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