Chapter 36 Drug Therapy for Nausea and Vomiting


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Chapter 36  Drug Therapy for Nausea and Vomiting



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1. A patient is experiencing nausea and vomiting as a response to radiation therapy. Which of the following antiemetic agents is a phenothiazine administered to control nausea and vomiting?

  1. A)  Prochlorperazine (Compazine)
  2. B)  Metoclopramide (Reglan)
  3. C)  Mesna (Mesnex)
  4. D)  Dexamethasone

Ans: A


Prochlorperazine (Compazine) is a commonly used phenothiazine administered for nausea and vomiting related to radiation therapy. Metoclopramide is a prokinetic agent that increases GI motility and the rate of gastric emptying by increasing the release of acetylcholine from nerve endings in the GI tract. Mesna is used for thrombocytopenia. Dexamethasone is a corticosteroid.

2. A pregnant woman suffers from morning sickness. Which of the following should be considered a first-line treatment?

  1. A)  Vitamin B6
  2. B)  Promethazine (Phenergan)
  3. C)  Vitamin E
  4. D)  Diphenhydramine (Benadryl)

Ans: A
For pregnant women, taking pyridoxine (vitamin B6) 30 to 75 mg daily in three divided doses with or without the antihistamine doxylamine 12.5 mg every 8 hours as needed is considered a first-line treatment option that is safe and effective. Phenergan is not a first-line treatment for morning sickness. Benadryl and vitamin E are not used to treat nausea.

3. A patient with Parkinson’s disease develops nausea and vomiting. Promethazine may be contraindicated because it depletes levels of what neurotransmitter?

  1. A)  Acetylcholine
  2. B)  Serotonin
  3. C)  Dopamine
  4. D)  Adenosine

Ans: C
Promethazine and other phenothiazines have widespread effects on the body. The therapeutic effects in nausea and vomiting are attributed to their ability to block dopamine from receptor sites in the brain and CTZ. This blockage of dopamine has the potential to exacerbate parkinsonian effects.

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4. What is a nonpharmacological measure that is effective in treating nausea and vomiting in pregnant women?

  1. A)  Ginkgo biloba
  2. B)  Ginger
  3. C)  Garlic
  4. D)  Ginseng

Ans: B
Clinical trials indicate that ginger can effectively reduce nausea and vomiting associated with motion sickness, pregnancy, and surgery.

5. A patient is administered promethazine (Phenergan) for nausea and vomiting. Which of the following is an adverse effect of promethazine (Phenergan)?

  1. A)  Urinary incontinence
  2. B)  Tachycardia
  3. C)  Taste alteration
  4. D)  Extrapyramidal symptoms

Ans: D
Extrapyramidal symptoms are adverse effects of promethazine. Urinary retention is an adverse effect, not urinary incontinence. Tachycardia is not an adverse effect of promethazine. Taste alteration is not an adverse effect of promethazine.

6. A patient is administered an antihistamine for nausea. Which of the following is an adverse effect of this classification of medication?

  1. A)  Diarrhea
  2. B)  Prolonged QRS complex
  3. C)  Urinary retention
  4. D)  Inverted T wave

Ans: C Feedback:

Adverse anticholinergic effects of antihistamines are dizziness, confusion, dry mouth, and urinary retention. Diarrhea, prolonged QRS complex, and inverted T wave are not adverse effects of antihistamines.

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