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Chapter 34: Drugs Used to Treat Nausea and Vomiting My Nursing Test Banks Chapter 34: Drugs Used to Treat Nausea and Vomiting Test Bank MULTIPLE CHOICE 1. A patient is beginning the second round of high dose cisplatin. Severe, chemotherapy induced nausea and vomiting (CINV) occurred following the first treatment, requiring 72 hours of continuous IV hydration. In addition to her chemotherapy regimen, which medication would be best to administer? a. Prochlorperazine (Compazine) suppository daily, on the day of treatment and the next 3 days b. Anticholinergic agents, such as diphenhydramine or meclizine c. Parenteral ondansetron 1 hour before chemotherapy, with oral ondansetron to continue for the next 4 days d. Parenteral ondansetron during chemotherapy, with prochlorperazine suppositories daily for 1 week ANS: CPage 4 of 267 With the patients first treatment history and the emetogenic chemotherapy agent, cisplatin, ondansetron has shown to be the most effective for prevention of severe nausea and vomiting. Prochlorperazine and anticholinergic agents are not used for the treatment of CINV. The ondansetron should be administered 1 hour before the chemotherapy and continued for the next several days to prevent vomiting and dehydration associated with chemotherapy administration. DIF: Cognitive Level: Application REF: p. 538 | p. 541 OBJ: 5 TOP: Nursing Process Step: Implementation MSC: NCLEX Client Needs Category: Physiological Integrity 2. A patient expresses concerns about motion sickness. Which medication is most effective in preventing motion sickness? a. Serotonin antagonists b. Phenothiazines c. Corticosteroids d. Anticholinergics ANS: D Anticholinergic agents are used to treat motion sickness by counterbalancing the excessive amounts of acetylcholine present. Serotonin antagonists are used in the treatment of emesis associated with cancer chemotherapy, radiation therapy, and postoperative nausea and vomiting. Phenothiazines are used in the treatment of mild to moderate nausea and vomiting associated with anesthesia and surgery, radiationPage 5 of 267 therapy, and cancer chemotherapy. Corticosteroids are used in the treatment of nausea and vomiting related to pregnancy, postsurgical state, chemotherapy, radiation, and bowel obstruction. DIF: Cognitive Level: Knowledge REF: p. 538 OBJ: 1 | 3 TOP: Nursing Process Step: Implementation MSC: NCLEX Client Needs Category: Physiological Integrity 3. What is the purpose for the nurse administering metoclopramide (Reglan) IV postoperatively? a. Prolong the effects of anesthesia. b. Decrease the potential for thrombus formation. c. Prevent postoperative nausea and vomiting. d. Decrease postoperative pain. ANS: C Metoclopramide (Reglan) is an antiemetic and antagonist of dopamine and serotonin receptors. In addition to acting on receptor sites in the brain, metoclopramide increases sphincter tone in the gastrointestinal tract, which reduces nausea and vomiting. Metoclopramide does not affect anesthesia or the vascular system, and does not have analgesic effects. DIF: Cognitive Level: Comprehension REF: p. 537 OBJ: 1Page 6 of 267 TOP: Nursing Process Step: Implementation MSC: NCLEX Client Needs Category: Health Promotion and Maintenance 4. The nurse is assessing a patient with nausea and vomiting. Which additional autonomic symptoms that often accompany vomiting will the nurse observe? a. Bradycardia, diarrhea, and flushing b. Pallor, sweating, and tachycardia c. Urinary urgency, chills, and dizziness d. Fever, hyperventilation, and bradycardia ANS: B Autonomic symptoms of pallor, sweating, and tachycardia cause additional discomfort associated with vomiting. Bradycardia, diarrhea, flushing, urinary urgency, chills, dizziness, fever, and hyperventilation are not autonomic symptoms associated with vomiting. DIF: Cognitive Level: Knowledge REF: p. 534 OBJ: 5 TOP: Nursing Process Step: Assessment MSC: NCLEX Client Needs Category: Health Promotion and Maintenance 5. The nurse would expect to administer which drug when treating hyperemesis gravidarum?Page 7 of 267 a. THC (Marinol) b. Haloperidol (Haldol) c. Dexamethasone (Prednisone) d. Metoclopramide (Reglan) ANS: D Metoclopramide is the drug of choice when treating hyperemesis gravidarum because no teratogenic effects have been reported with the use of this drug. THC is used in the treatment of nausea and vomiting associated with cancer and cancer treatment. Haloperidol is used in the treatment of nausea associated with chemotherapy. Prednisone is used in the treatment of nausea associated with pregnancy, postsurgical state, chemotherapy, radiation, and bowel obstruction. DIF: Cognitive Level: Knowledge REF: p. 538 OBJ: 1 TOP: Nursing Process Step: Implementation MSC: NCLEX Client Needs Category: Health Promotion and Maintenance 6. Why does the nurse monitor daily weights prior to the administration of antiemetic medications to chemotherapy patients? a. Antiemetics are calculated according to body surface area. b. Antiemetics are toxic, and the minimal dosage should be administered.Page 8 of 267 c. Weight loss is a common adverse effect associated with chemotherapy, and dosages may need to be readjusted. d. Fluid overload is common, and antiemetic dosag