Question 28 1 out of 1 points It is determined that a patient, who is in a hepatic coma, needs a laxative. Lactulose is prescribed. Which of the following should the nurse monitor to assess the efficacy of the lactulose therapy? Response Feedback : Similar to the saline laxative magnesium hydroxide, lactulose pulls water into the colon. Unlike magnesium hydroxide, lactulose is a synthetic disaccharide of lactose. In the colon, bacteria metabolize lactulose into acids and carbon dioxide, increasing the oncotic pressure in the colon and drawing water into the stool. The acids formed also draw ammonia into the stool. Therefore, lactulose is used not only to treat constipation but also to decrease blood ammonia levels in patients in hepatic coma and those with hepatic encephalopathy. The other factors, although significant, would not indicate the efficacy of the lactulose therapy as accurately as blood ammonia levels. Question 29 1 out of 1 points Following an endoscopy, a 66-year-old man has been diagnosed with a
duodenal ulcer resulting from Helicobacter pylori infection. Which of the following medications will likely be used in an attempt to eradicate the patient's H. pylori infection? (Select all that apply.) Response Feedback : Classic quadruple therapy for H. pylori eradication (bismuth, a PPI, 1,500 mg of metronidazole, and 1,500 mg of tetracycline) is highly effective and is frequently the regimen of choice. A newer sequential therapy (PPI plus amoxicillin followed by a PPI plus clarithromycin plus metronidazole) has been proposed and is expected to replace legacy therapy. Both regimens include PPIs and antibiotics and exclude aluminum hydroxide, ondansetron, and cisapride. Question 30 1 out of 1 points Mesalamine (Asacol) is prescribed for a 22-year-old woman with Crohn disease. The nurse will discuss with the patient the possibility for which of the following adverse effects related to the new drug therapy? Response Feedback: The nurse will explain that one possible adverse effect of mesalamine (Asacol) therapy is hair loss. The nurse will emphasize that the hair loss is generally mild and transient. Metallic taste, fatigue, and increased appetite are not adverse effects of mesalamine. Question 31 1 out of 1 points A 29-year-old woman has been prescribed alosetron (Lotronex) for irritable bowel syndrome. Before starting the drug therapy, the nurse will advise the patient about which of the following adverse effect(s)? Response Feedback: The primary adverse effect of alosetron is constipation. Patients are also at risk for ischemic colitis, a rare but potentially fatal complication. This drug does not cause breathlessness, hypotension, impaired cardiac function, or hyperthyroidism. Question 32 1 out of 1 points A patient on 5-FU calls the clinic and reports that he has between five and seven loose bowel movements daily. The nurse will instruct the patient to Response Feedback : If the patient has more than three bowel movements daily, the nurse should instruct the patient to observe the stools and
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- Fall '13