A nurse is caring for four clients who have peptic ulcer disease.
The nurse should recognize that misoprostol is contraindicated for which of the following clients?

A client who is receiving long-term NSAID therapy.

A client who might be pregnant.

A client who has a gastrointestinal bleed.

A client who is experiencing diarrhea.

Answer and Explanation

The Correct Answer is B

Choice A rationale

Misoprostol is indicated to prevent NSAID-induced gastric ulcers due to its cytoprotective properties. It increases mucus and bicarbonate production, protecting the stomach lining without contraindications for long-term NSAID therapy.

Choice B rationale

Misoprostol is contraindicated in pregnancy due to its uterotonic effects, which can cause uterine contractions and potentially lead to miscarriage or preterm labor, posing significant risks to the fetus and pregnancy.

Choice C rationale

Misoprostol is used for gastrointestinal protection and is not contraindicated for clients with a GI bleed. It can aid in preventing further mucosal damage and promoting healing in the gastrointestinal tract.

Choice D rationale

Misoprostol can cause diarrhea as a side effect but is not contraindicated. Management of diarrhea involves supportive care and dose adjustment rather than discontinuation of the medication unless symptoms are severe.

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Correct Answer is A

Explanation

Choice A rationale

Removing the patch for two to four hours daily helps prevent tolerance development by allowing nitrate-free intervals, thus maintaining the effectiveness of nitroglycerin.

Choice B rationale

Applying a new patch each day after waking up ensures continuous delivery of nitroglycerin; however, this does not provide nitrate-free intervals necessary to avoid tolerance.

Choice C rationale

Covering the patch with plastic wrap can increase the risk of overdose by enhancing nitroglycerin absorption, which may lead to severe hypotension and other adverse effects.

Choice D rationale

Replacing the patch as soon as anginal pain begins does not allow for a consistent delivery system and may lead to erratic blood levels of nitroglycerin, reducing its effectiveness.

A. Educate the client about the possible consequences of not taking the medication. B. Suggest the client take food with the medication to minimize GI effects. C. Document the client’s refusal in the medication administration record. D. Recommend the client ask the provider to prescribe an enteric-coated medication.

Correct Answer is ["A","B","C","D"]

Explanation

Choice A rationale

Educating the client on the consequences of not taking valproic acid is important for informed decision-making. Without the medication, seizure control may be compromised, leading to potential health risks.

Choice B rationale

Taking valproic acid with food can help minimize gastrointestinal side effects such as nausea by reducing gastric irritation and improving drug absorption.

Choice C rationale

Documenting the client's refusal in the medication administration record ensures accurate medical records and provides information for future healthcare decisions and assessments.

Choice D rationale

Enteric-coated formulations of valproic acid can reduce gastrointestinal irritation by allowing the drug to pass through the stomach and dissolve in the intestine.

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A nurse is caring for four clients who have peptic ulcer disease.The nurse should recognize that misoprostol is contraindicated for which of the following clients?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is providing teaching to a client who has a new prescription for transdermal nitroglycerin patches to treat angina pectoris.Which of the following instructions should the nurse include in the teaching?

Correct Answer is A

Explanation

A nurse is caring for a client who refused a prescribed dose of valproic acid 250 mg PO. The client states, “I don’t want to take that pill because it makes me feel nauseated.”. Which of the following actions should the nurse take? (Select all that apply.)

Correct Answer is ["A","B","C","D"]

Explanation

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A nurse is caring for four clients who have peptic ulcer disease.
The nurse should recognize that misoprostol is contraindicated for which of the following clients?