Nursing practice questions with comprehensive rationales
NurseDive Free Nursing Practice Question
A client has been diagnosed with pancreatic insufficiency. Which treatment option does the nurse anticipate for this client?
A. Treatment with PPIs to decrease stomach acid
Treatment with PPIs to decrease stomach acid:Proton-pump inhibitors (PPIs) are used to decrease stomach acid production and are commonly prescribed for conditions such as gastroesophageal reflux disease (GERD) and peptic ulcers. However, they do not address the underlying cause of pancreatic insufficiency, which is the deficiency of pancreatic enzymes.
B. Treatment with stimulant laxatives
Treatment with stimulant laxatives:Stimulant laxatives are used to stimulate bowel movements and are not indicated for the treatment of pancreatic insufficiency. Pancreatic insufficiency primarily affects the digestion of nutrients rather than bowel motility.
C. Replacement therapy with pancreatic enzymes
Replacement therapy with pancreatic enzymes. Pancreatic insufficiency occurs when the pancreas does not produce enough digestive enzymes to properly digest food, leading to malabsorption of nutrients. Replacement therapy with pancreatic enzymes is the mainstay of treatment for pancreatic insufficiency. These enzymes, often prescribed in the form of pancreatic enzyme replacement therapy (PERT), help to supplement the deficient enzymes and aid in the digestion of fats, proteins, and carbohydrates.
D. Decrease food intake
Decrease food intake:Decreasing food intake is not an appropriate treatment for pancreatic insufficiency. In fact, individuals with pancreatic insufficiency may need to increase their food intake to compensate for malabsorption and ensure adequate nutrition. Restricting food intake would worsen nutritional deficiencies and symptoms associated with malabsorption.
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Full Explanation
A) Treatment with PPIs to decrease stomach acid:
Proton-pump inhibitors (PPIs) are used to decrease stomach acid production and are commonly prescribed for conditions such as gastroesophageal reflux disease (GERD) and peptic ulcers. However, they do not address the underlying cause of pancreatic insufficiency, which is the deficiency of pancreatic enzymes.
B) Treatment with stimulant laxatives:
Stimulant laxatives are used to stimulate bowel movements and are not indicated for the treatment of pancreatic insufficiency. Pancreatic insufficiency primarily affects the digestion of nutrients rather than bowel motility.
C) Replacement therapy with pancreatic enzymes.
Pancreatic insufficiency occurs when the pancreas does not produce enough digestive enzymes to properly digest food, leading to malabsorption of nutrients. Replacement therapy with pancreatic enzymes is the mainstay of treatment for pancreatic insufficiency. These enzymes, often prescribed in the form of pancreatic enzyme replacement therapy (PERT), help to supplement the deficient enzymes and aid in the digestion of fats, proteins, and carbohydrates.
D) Decrease food intake:
Decreasing food intake is not an appropriate treatment for pancreatic insufficiency. In fact, individuals with pancreatic insufficiency may need to increase their food intake to compensate for malabsorption and ensure adequate nutrition. Restricting food intake would worsen nutritional deficiencies and symptoms associated with malabsorption.
Similar Questions
A nurse is reinforcing teaching to a school-age child who has asthma. Which of the following medications should the nurse instruct the child to use to abort an ongoing attack?
A. Montelukast
Montelukast:Montelukast is a leukotriene receptor antagonist (LTRA) used as a controller or maintenance medication for asthma. It is not used for the immediate relief of asthma symptoms during an acute attack. Montelukast is taken regularly to prevent asthma symptoms and reduce the frequency of asthma attacks, but it does not provide rapid relief during an ongoing attack.
B. Fluticasone
Fluticasone:Fluticasone is an inhaled corticosteroid (ICS) used as a controller medication for asthma. It works by reducing airway inflammation and is taken regularly to control asthma symptoms and prevent exacerbations. Fluticasone is not used for the immediate relief of acute asthma symptoms and is not suitable for aborting an ongoing asthma attack.
C. Cromolyn
Cromolyn: Cromolyn is a mast cell stabilizer used as a controller medication for asthma. It helps prevent the release of inflammatory substances that contribute to asthma symptoms. Cromolyn is taken regularly to prevent asthma symptoms and reduce the frequency of asthma attacks but is not used for the immediate relief of acute asthma symptoms like albuterol.
D. Albuterol
Albuterol.Albuterol is a short-acting beta agonist (SABA) bronchodilator used for the quick relief of asthma symptoms during an acute asthma attack or exacerbation. It works rapidly to relax the smooth muscles in the airways, opening them up and relieving bronchoconstriction, which improves airflow and alleviates symptoms such as wheezing, shortness of breath, and chest tightness. Albuterol is typically administered via inhalation through a metered-dose inhaler (MDI) or a nebulizer.
Full Explanation
A) Montelukast:
Montelukast is a leukotriene receptor antagonist (LTRA) used as a controller or maintenance medication for asthma. It is not used for the immediate relief of asthma symptoms during an acute attack. Montelukast is taken regularly to prevent asthma symptoms and reduce the frequency of asthma attacks, but it does not provide rapid relief during an ongoing attack.
B) Fluticasone:
Fluticasone is an inhaled corticosteroid (ICS) used as a controller medication for asthma. It works by reducing airway inflammation and is taken regularly to control asthma symptoms and prevent exacerbations. Fluticasone is not used for the immediate relief of acute asthma symptoms and is not suitable for aborting an ongoing asthma attack.
C) Cromolyn:
Cromolyn is a mast cell stabilizer used as a controller medication for asthma. It helps prevent the release of inflammatory substances that contribute to asthma symptoms. Cromolyn is taken regularly to prevent asthma symptoms and reduce the frequency of asthma attacks but is not used for the immediate relief of acute asthma symptoms like albuterol.
D) Albuterol.
Albuterol is a short-acting beta agonist (SABA) bronchodilator used for the quick relief of asthma symptoms during an acute asthma attack or exacerbation. It works rapidly to relax the smooth muscles in the airways, opening them up and relieving bronchoconstriction, which improves airflow and alleviates symptoms such as wheezing, shortness of breath, and chest tightness. Albuterol is typically administered via inhalation through a metered-dose inhaler (MDI) or a nebulizer.
A nurse is caring for a client who has asthma. The client asks the nurse how albuterol helps his breathing. Which of the following information should the nurse include in the response? (Select all that apply.)
A. The medication will relieve wheezing.
The medication will relieve wheezing: Albuterol is a short-acting beta agonist bronchodilator that works by quickly relaxing the smooth muscles of the airways, leading to rapid bronchodilation. This helps relieve symptoms such as wheezing, shortness of breath, and chest tightness commonly associated with asthma exacerbations.
B. The medication will reduce inflammation.
The medication will reduce inflammation: Albuterol is not primarily indicated for reducing inflammation in asthma. While it can help alleviate symptoms of bronchospasm, it does not target the underlying inflammation associated with asthma.
C. The medication will increase the amount of mucus.
The medication will increase the amount of mucus: Albuterol does not increase mucus production. In fact, it is a bronchodilator medication that primarily targets airway smooth muscle relaxation and bronchodilation to improve airflow and relieve symptoms.
D. The medication will decrease coughing episodes.
The medication will decrease coughing episodes: Albuterol can help decrease coughing episodes by relieving bronchospasm and improving airflow. However, its primary mechanism of action is bronchodilation rather than directly targeting coughing.
E. The medication will open the airways.
The medication will open the airways: Albuterol works by stimulating beta-2 adrenergic receptors in the airway smooth muscles, resulting in relaxation of these muscles and dilation of the bronchial tubes. This action helps to open the airways, allowing for improved airflow and easier breathing.
Full Explanation
A. The medication will relieve wheezing: Albuterol is a short-acting beta agonist bronchodilator that works by quickly relaxing the smooth muscles of the airways, leading to rapid bronchodilation. This helps relieve symptoms such as wheezing, shortness of breath, and chest tightness commonly associated with asthma exacerbations.
B. The medication will reduce inflammation: Albuterol is not primarily indicated for reducing inflammation in asthma. While it can help alleviate symptoms of bronchospasm, it does not target the underlying inflammation associated with asthma.
C. The medication will increase the amount of mucus: Albuterol does not increase mucus production. In fact, it is a bronchodilator medication that primarily targets airway smooth muscle relaxation and bronchodilation to improve airflow and relieve symptoms.
D. The medication will decrease coughing episodes: Albuterol can help decrease coughing episodes by relieving bronchospasm and improving airflow. However, its primary mechanism of action is bronchodilation rather than directly targeting coughing.
E. The medication will open the airways: Albuterol works by stimulating beta-2 adrenergic receptors in the airway smooth muscles, resulting in relaxation of these muscles and dilation of the bronchial tubes. This action helps to open the airways, allowing for improved airflow and easier breathing.
The patient's family is asking questions about the medications used in the treatment for shock. The nurse explains that dopamine is one of the drugs being used and that it works:
(Select All that Apply.)
A. At high doses, to treat anaphylaxis.
At high doses, to treat anaphylaxis: Dopamine is not used to treat anaphylaxis. Anaphylaxis is typically managed with medications such as epinephrine, antihistamines, and corticosteroids.
B. At high doses, to increase cardiac output.
At high doses, to increase cardiac output: Dopamine is a medication commonly used in the treatment of shock, particularly in cases of hypotension. At higher doses, dopamine acts as a positive inotrope and increases cardiac contractility, thereby improving cardiac output and increasing blood pressure.
C. At low doses, to cause increased blood flow to the kidneys.
At low doses, to cause increased blood flow to the kidneys: At lower doses, dopamine primarily acts on dopaminergic receptors in the renal vasculature, leading to vasodilation of the renal blood vessels and increased renal perfusion. This can help improve renal blood flow and urine output, making it beneficial in cases of renal hypoperfusion or acute kidney injury.
D. At low doses, to treat anaphylaxis.
At low doses, to treat anaphylaxis: Dopamine is not used to treat anaphylaxis at any dose. Anaphylaxis is managed with medications such as epinephrine, which acts on multiple receptors to reverse the systemic effects of the allergic reaction.
E. To cause vasoconstriction and increase blood pressure.
To cause vasoconstriction and increase blood pressure: Dopamine can also cause vasoconstriction, particularly at higher doses. This effect is mediated through its action on alpha-adrenergic receptors, leading to peripheral vasoconstriction and an increase in systemic vascular resistance, which in turn helps increase blood pressure.
Full Explanation
A. At high doses, to treat anaphylaxis: Dopamine is not used to treat anaphylaxis. Anaphylaxis is typically managed with medications such as epinephrine, antihistamines, and corticosteroids.
B. At high doses, to increase cardiac output: Dopamine is a medication commonly used in the treatment of shock, particularly in cases of hypotension. At higher doses, dopamine acts as a positive inotrope and increases cardiac contractility, thereby improving cardiac output and increasing blood pressure.
C. At low doses, to cause increased blood flow to the kidneys: At lower doses, dopamine primarily acts on dopaminergic receptors in the renal vasculature, leading to vasodilation of the renal blood vessels and increased renal perfusion. This can help improve renal blood flow and urine output, making it beneficial in cases of renal hypoperfusion or acute kidney injury.
D. At low doses, to treat anaphylaxis: Dopamine is not used to treat anaphylaxis at any dose. Anaphylaxis is managed with medications such as epinephrine, which acts on multiple receptors to reverse the systemic effects of the allergic reaction.
E. To cause vasoconstriction and increase blood pressure: Dopamine can also cause vasoconstriction, particularly at higher doses. This effect is mediated through its action on alpha-adrenergic receptors, leading to peripheral vasoconstriction and an increase in systemic vascular resistance, which in turn helps increase blood pressure.