A nurse is instructing a patient who has just been prescribed bumetanide. What should the nurse include in the instructions?

Choice A rationale

While toddlers begin to develop a sense of right and wrong, explaining the difference between the two is a complex task that is typically beyond their cognitive abilities at this age.

Choice B rationale

Toddlers are often able to start cooperating in performing simple chores. This is part of their development of independence and understanding of responsibility.

Choice C rationale

Printing letters and numbers is a skill that is typically developed later in childhood, often during the preschool years.

Choice D rationale

While toddlers do begin to develop some independence, they typically still have difficulty separating from their primary caregiver for extended periods of time.

Choice A rationale

Metoclopramide is a medication used for stomach and esophageal problems. It is commonly used to treat and prevent nausea and vomiting, to help with emptying of the stomach in people

with delayed stomach emptying, and to help with gastroesophageal reflux disease. The antiemetic action of metoclopramide is due to its antagonist activity at D2 receptors in the chemoreceptor trigger zone in the central nervous system — this action prevents nausea and vomiting triggered by most stimuli.

Choice B rationale

While metoclopramide does have an effect on the muscles of the gastrointestinal tract, it does not work by relaxing them. Instead, it works by blocking dopamine receptors, which in turn stimulates motility in the upper gastrointestinal tract without stimulating gastric, biliary, or pancreatic secretions. This increased motility helps to speed up the rate at which the stomach empties into the intestines.

Choice C rationale

Metoclopramide does not work by decreasing gastric acid secretions. In fact, one unique property of this drug is that it does not increase gastric acid secretion. Its primary mechanism of action is to block dopamine receptors, thereby increasing muscle contractions in the upper digestive tract.

Choice D rationale

This is correct. Metoclopramide enhances gastric emptying. It is used to treat conditions like gastroesophageal reflux disease and diabetic gastroparesis, where delayed gastric emptying is a problem. By blocking dopamine receptors, metoclopramide increases muscle contractions in the upper digestive tract, speeding up the rate at which the stomach empties into the intestines.