HESI-P HESI Pharmacology - Set 3 - Part 3

Correct Answer: Vomiting following cancer chemotherapy

Metoclopramide is a gastrointestinal stimulant and antiemetic used in vomiting after surgery, chemotherapy, or radiation. It is contraindicated in mechanical obstruction, perforation, or gastrointestinal hemorrhage because the drug stimulates motility and would worsen these conditions. Option a is incorrect because mechanical intestinal obstruction is a contraindication for metoclopramide because the medication stimulates upper gastrointestinal motility. Increasing motility against an obstruction could cause severe complications and is not safe. Option b is incorrect because peptic ulcer with melena represents gastrointestinal hemorrhage, which is a contraindication for metoclopramide. Stimulating motility in active bleeding worsens the situation and the medication should be avoided. Option d is incorrect because diverticulitis with bowel perforation rules out this prokinetic, since pushing intestinal contents forward would force more material through the leak. Active perforation makes

Correct Answer: Nausea and vomiting episodes

Ondansetron is an antiemetic used to treat postoperative nausea and vomiting as well as nausea and vomiting associated with chemotherapy. It is a serotonin antagonist and acts to suppress vomiting through serotonin receptor blockade in the central nervous system. Option b is incorrect because paralytic ileus is treated with prokinetics like metoclopramide, not with ondansetron. Ondansetron is specifically used for nausea and vomiting, not for restoring bowel motility. Option c is incorrect because incisional pain is treated with analgesics, not with ondansetron, which is an antiemetic. The medication targets nausea and vomiting through serotonin blockade, not pain pathways. Option d is incorrect because urinary retention requires assessment for bladder distention and possible catheterization, not ondansetron. The medication is an antiemetic and has no role in managing urinary retention after a procedure.

Correct Answer: Relief of epigastric pain symptoms

Misoprostol is a gastric protectant given to prevent gastric mucosal injury in clients who use nonsteroidal anti-inflammatory drugs frequently. Relief of epigastric pain indicates the medication is protecting the mucosa. Diarrhea is a side effect. Option a is incorrect because diarrhea is a side effect of misoprostol, not an intended therapeutic effect. Resolution of epigastric pain is the chapter-directed indicator of effective gastric protection from NSAID injury. Option b is incorrect because a decreased platelet count is not associated with misoprostol effectiveness. The intended effect is relief of epigastric pain through mucosal protection from NSAID-induced injury. Option c is incorrect because a decreased white blood cell count has no link to this prostaglandin analog, which acts directly on stomach lining. Success appears as easing of upper abdominal burning that signals restored gastric defenses.

Correct Answer: Complete relief of heartburn

Pancrelipase replaces pancreatic enzymes and should reduce the amount of fatty stools, also called steatorrhea. Another intended effect could be improved nutritional status and weight gain, while the medication is not used for abdominal pain or heartburn relief. Option a is incorrect because weight loss is the opposite of what pancrelipase aims for, since improved digestion supports weight gain. The expected benefit is reduction in steatorrhea along with improved nutritional status. Option c is incorrect because absence of abdominal pain is not the chapter-directed indicator of pancrelipase effectiveness. The intended benefit is reduction in fatty stools that signals proper fat digestion with the enzyme replacement. Option d is incorrect because reduction of fatty stools is the actual chapter-directed effect, but it appears reordered here for review. The optimal benefit involves the steatorrhea reduction along with weight gain and improved nutrition.

Correct Answer: Medication should only be taken with water

Cholestyramine has poor palatability that can affect compliance, so flavored products or fruit juices can be used to improve taste not only water. A high-fiber diet helps prevent constipation, and vitamin supplements may be needed because absorption is decreased. Option a is incorrect because stating the medication will help lower cholesterol is correct because cholestyramine is a bile acid sequestrant prescribed for this purpose. This statement reflects accurate understanding and does not require correction. Option b is incorrect because a high-fiber diet is correct because bile acid sequestrants commonly cause constipation. This statement reflects accurate teaching and does not require correction by the nurse. Option d is incorrect because continuing vitamin supplements is appropriate because resin binding in the bowel reduces uptake of fat-soluble vitamins during long-term therapy. The client demonstrates safe practice, so the nurse simply reinforces this guideline.

Correct Answer: Checking frequency and consistency of bowel movements

Crohn disease manifests with diarrhea and abdominal pain, and infliximab reduces inflammation in the colon, thereby reducing the diarrhea. Checking the frequency and consistency of bowel movements directly evaluates whether the medication is achieving its intended effect. Option b is incorrect because checking liver enzyme levels around infusion is appropriate monitoring for some safety concerns but does not evaluate effectiveness for Crohn disease. The intended effect appears in the bowel pattern, not in liver values. Option c is incorrect because monitoring the leukocyte count is appropriate for some safety reasons but does not evaluate infliximab effectiveness for Crohn disease. Bowel movement frequency and consistency directly reflect the inflammation reduction. Option d is incorrect because carrying out a hematest on gastric fluids does not match Crohn disease evaluation because gastric bleeding is not the principal manifestation. The medication targets bowel inflammation, and bow

Correct Answer: An episode of acute diarrhea

Loperamide is an antidiarrheal agent used to manage acute and chronic diarrhea in conditions like inflammatory bowel disease, and to reduce ileostomy drainage volume. It is given for an episode of diarrhea, not for pain or bleeding. Option a is incorrect because constipation is the opposite of what loperamide treats, since the drug decreases intestinal motility. Loperamide would worsen constipation and is only used for diarrhea episodes. Option b is incorrect because acute abdominal pain after eating is not a loperamide indication and requires a different evaluation. The medication targets diarrhea by reducing intestinal motility rather than addressing pain. Option c is incorrect because hematest-positive nasogastric drainage signals gastrointestinal bleeding and requires evaluation, not antidiarrheal therapy. Loperamide is given specifically for an episode of diarrhea, not for bleeding.

Correct Answer: Diarrhea after taking the medication

Magnesium hydroxide also acts as a saline laxative, so its most prominent side effect is diarrhea. It is contraindicated in intestinal obstruction, appendicitis, or undiagnosed abdominal pain, and magnesium can accumulate in clients with renal impairment, causing toxicity. Option a is incorrect because constipation is the most common side effect of aluminum and calcium antacids, not magnesium hydroxide. Magnesium compounds produce diarrhea because they act as saline laxatives. Option b is incorrect because acid rebound is characteristic of calcium carbonate antacids, not magnesium hydroxide. The defining magnesium side effect is diarrhea because the compound acts as a saline laxative. Option d is incorrect because flatulence with increased intra-abdominal pressure is characteristic of sodium bicarbonate because it liberates carbon dioxide. The most prominent magnesium hydroxide side effect is diarrhea.

Correct Answer: Increase fluid intake throughout the day

The client receiving a laxative must increase fluid intake to prevent dehydration, because laxatives shift water within the bowel and can pull water from circulation. Bulk-forming laxatives are usually taken with meals along with a full glass of water. Option a is incorrect because taking the laxative only at bedtime is not the chapter-directed safety priority and ignores the dehydration risk. Increased fluid intake throughout the day is the essential teaching point during laxative use. Option c is incorrect because discontinuing for any abdominal discomfort is not the chapter-directed primary teaching point and may not be necessary. The essential safety instruction is increasing fluids to prevent dehydration during therapy. Option d is incorrect because limiting physical activity is not part of laxative teaching and could actually worsen constipation. The priority safety instruction is increasing fluid intake throughout the day to prevent dehydration.

Correct Answer: Decreased serum ammonia level

Lactulose promotes increased peristalsis and bowel evacuation, expelling ammonia from the colon and thereby lowering the ammonia level. Normal ammonia is ten to eighty micrograms per deciliter, and the medication is given orally or rectally. Option a is incorrect because a decreased potassium value is not the targeted effect of lactulose, which addresses ammonia accumulation rather than electrolyte regulation. The intended therapeutic marker is reduced serum ammonia level. Option b is incorrect because a decreased platelet count is unrelated to lactulose effectiveness, which targets ammonia removal from the colon. The intended marker is a decreased serum ammonia level reflecting successful clearance. Option c is incorrect because an increased sodium value falls outside what this osmotic laxative actually changes during hepatic encephalopathy treatment. Effectiveness shows up as a downward shift in circulating ammonia once the bowel evacuation removes nitrogenous waste.