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CHAPTER 15

1. Which of the following disorders would the nurse suspect a client suffers from if lithium is noted ona client's drug history upon admission?

A. Bipolar disorder

B. Absence seizures

C. Obsessivecompulsive disorder

D. Paranoid schizophreniaLithium is the drug of choice to treat manic episodes associated with bipolar disorders.

2. Which of the following best describes the function of selective serotonin reuptake inhibitors (SSRIs)and tricyclic antidepressants (TCAs)?

A. Increasing the placebo effect

B. Increasing alertness levels in the brainC. Blocking the reuptake of neurotransmitters at nerve endings

D. Decreasing levels of epinephrine and serotonin at nerveendings

SSRIs block the reuptake of serotonin. TCAs block the reuptake of norepinephrine and serotonin.

3. A child is noted to be taking imipramine, but the parents deny a history of depression. Which of thefollowing diagnoses would this child suffer from?

A. Manic episodes

B. Absence seizures

C. Nocturnal enuresis

D. Obsessive-compulsivedisorder

Imipramine causes urinary retention and delayed micturition, side effects that make it useful to treatnocturnal enuresis (bedwetting) in children.

4. Which of the following should the nurse emphasize when teaching a client about TCAs?

A. The drugs are often given with monoamine oxidase (MAO) inhibitors for synergistic effect

B. Dietary restrictions of beer and chocolate are needed to prevent a hypertensive crisis

C. The client should notify the healthcare provider if therapeutic effects are not noted within 10days

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D. Common side effects can be relieved by increasing fluid and fibre intake as well as sucking onhard candy

TCAs cause anticholinergic side effects, including constipation and dry mouth.

5. A client is being switched from amitriptyline to citalopram. Which of the following statements madeby the client reflects understanding of client education?

A. I can just stop taking my amitriptyline and start taking citalopram as ordered.

B. I can expect fewer cardiovascular side effects such as orthostatic hypotension with citalopram.

C. The doctor is switching me to this medication because it is less expensive but just as effective.

D. I will need to limit my intake of cheese when taking citalopram to prevent a rise in myblood pressure.

Citalopram, an SSRI, produces minimal anticholinergic and cardiovascular side effects.

6. Which of the following should the client be cautioned against while taking an MAO inhibitor?

A. Eating aged cheese

B. Sunbathing at the pool

C. Participating in a bowling league

D. Smoking a low-nicotinecigarette

Eating foods high in tyramine, including aged cheese, can cause a hypertensive crisis in clients takingMAO inhibitors.

7. Which of the following is bupropion, a second-generation antidepressant, also used for?

A. Aiding in smoking cessation

B. Treating orthostatic hypotensionC. Treating nocturnal enuresis in children

D. Increasing appetite in clients undergoingchemotherapy

A sustained-released form of bupropion is useful in helping clients quit smoking.

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8. Which of the following is the rationale for clients taking antipsychotic medications periodically beingprescribed a "drug-free holiday"? To prevent

A. Noncompliance due to side effects

B. Higher costs by decreasing amount of drug used

C. Destructive behaviours by allowing client to regain control

D. Tardive dyskinesia and other extrapyramidal reactions

Drug-free holidays are recommended to attempt to prevent tardive dyskinesia in clients who are

taking phenothiazines.

9. Which of the following statements made by a client demonstrates a lack of understanding of clientteaching regarding phenothiazine drug therapy?

A. I need to change positions slowly to prevent dizziness.

B. I will need to wear sunscreen and protective clothing when outdoors.

C. It is okay to take this drug with a small glass of wine to help me relax.

D. I should call my doctor if I notice any uncontrollable movements of mytongue.

Drinking alcohol with phenothiazines puts the client at risk for increased CNS depression.

10. Which of the following laboratory tests should be monitored frequently to assess for a potential

life-threatening adverse reaction to clozapine?

A. Renal panel

B. Liver function tests

C. Complete blood count

D. Immunoglobulinlevels

Clients taking clozapine must be monitored for the life-threatening side effect of agranulocytosis,evidenced by a severe reduction in the number of white blood cells.

11. Which of the following extrapyramidal side effects should the nurse monitor for in a client takingan antipsychotic medication?

A. Dystonia

B. Orthostatic hypotension

C. Dry mouth and constipation

D. Neuroleptic malignant

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syndrome

Dystonia, an impairment of muscle tone, is the only extrapyramidal side effect listed. The other sideeffects also occur but are not extrapyramidal effects.

12. Which of the following is an atypical antipsychotic medication useful for treatment ofschizophrenia?

A. amoxapine

B. phenelzine

C. risperidone

D. trazodone

Risperidone is effective against both negative and positive symptoms of schizophrenia. The othermedications listed are antidepressants.

CHAPTER 30

1. Which of the following statements demonstrates understanding of discharge medications for aclient receiving levothyroxine?

A. I will double my dose if I gain more than 0.45 kg per day.

B. I can expect to see relief of my symptoms within 1 week.

C. It is best to take the medication with food to prevent GI upset.

D. I will take this medication in the morning so as not to interfere with sleep.

Levothyroxine increases basal metabolism and thus wakefulness.

2. With which of the following manifestations would the nurse suspect excessive thyroid replacementin a client taking levothyroxine?

A. Irritability

B. Bradycardia

C. Weight gain

D. Intolerance to

cold

Irritability is a symptom of hyperthyroidism. The other choices are signs of hypothyroidism.

3. Clients taking levothyroxine and warfarin should be monitored for which of the following?

A. Cardiac arrhythmias

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B. Excessive weight loss

C. Increased risk of bleeding

D. Increased risk of deep veinthrombosis

Levothyroxine can compete with protein-binding sites of warfarin, allowing more warfarin to beunbound or free, thus increasing effects of warfarin and risk of bleeding.

4. Which of the following would be the nurse's best response to a client receiving propylthiouracil(PTU) who asks the nurse how this medication will help relieve his symptoms? Propylthiouracil:

A. Helps your thyroid gland use iodine and synthesize hormones better.

B. Inhibits the formation of new thyroid hormone, thus gradually returning your metabolism tonormal.

C. Inactivates any circulating thyroid hormone, thus decreasing signs and symptoms of

hyperthyroidism.D. Stimulates the pituitary gland to secrete thyroid-stimulating hormone (TSH), which inhibits

the production of hormones by the thyroid gland.

Propylthiouracil is an antithyroid medication used to treat hyperthyroidism. It works by inhibiting thesynthesis of new thyroid hormone. It does not inactivate present hormone.

5. Which of the following foods high in iodine should the nurse teach clients taking antithyroidmedications to avoid?

A. Milk

B. Eggs

C. Seafood

D. Chicken

Seafood contains high amounts of iodine. The other choices do not.

6. Which of the following statements demonstrates client understanding of radioactive iodine (I-131)therapy?

A. I will need to take this drug on a daily basis for at least 1 year.

B. This drug will help decrease my cold intolerance and weight gain.

C. I will have to isolate myself from my family for 1 week so as not to expose them to radiation.

D. This drug will be taken up by the thyroid gland and destroy the cells to reduce myhyperthyroidism.

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Radioactive iodine is an antithyroid medication that is administered orally for one or two doses only. Itconcentrates in the thyroid gland, enabling the radiation to destroy the hyperplastic cells.

CHAPTER 32

1. With knowledge of which of the following facts about glucocortcoids does the nurse planadministration of prednisone? Glucocorticoids:

A. Should be administered with food to diminish the risk of gastric irritation

B. Are usually administered on a strict, unchanging schedule in order to prevent adverse reactions

C. Should not be administered intravenously secondary to the risk of hypotension when givenparenterally

D. Are usually administered early in the evening to coincide with the natural secretion patternof the adrenal cortex

Glucocorticoids can cause GI distress and should be administered with food. The normal circadiansecretion of the adrenal cortex is early morning to wake the person up, not early evening. These

medications should be tapered off slowly to prevent adrenal crisis and can be administeredintravenously.

2. Which of the following statements about glucocorticoids is most accurate? Glucocorticoids:

A. decrease serum sodium and glucose levels.

B.influence carbohydrate, lipid, and protein metabolism.C. are produced in decreased amounts during times of stress.

D. stimulate defense mechanisms to produce immunity.

Glucocorticoids play a major role in carbohydrate, lipid, and protein metabolism within the body. Theysuppress the immune system, increase sodium and glucose levels, and are produced in increasingamounts during stress.

3. For a client with which of the following conditions would the nurse question an order for steroids?

A. Septic shock

B. COPD exacerbation

C. Rheumatoid arthritis

D. Uncontrolled diabetes mellitus

A common side effect of steroid therapy is hyperglycemia.

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4. Which of the following signs and symptoms would the nurse monitor for when assessing forpotential side effects of fludrocortisone?

A. Hyponatremia

B. Hypercalcemia

C. Hypokalemia

D. Hypovolemia

Fludrocortisone has mineralocorticoid properties, resulting in sodium and fluid retention along withpotassium excretion.

5. Discharge teaching for a client receiving glucocorticoids should include the preferred use of whichof the following medications for pain management?

A. aspirin

B. ibuprofen

C. acetaminophen

D. naproxensodium

Acetaminophen does not cause GI distress as does aspirin, ibuprofen, naproxen sodium, andglucocorticoids.

6. For which of the following conditions would aromatase inhibitors be recommended?

A. Addisons disease

B. Adrenal malignancy

C. Cushings syndrome

D. Hormone receptor-positive breast cancer.

Hormone receptor-positive breast cancer. Based on evidence-based practice, aromatase inhibitors,

particularly anastrozole or letrozole, are recommended as standard adjuvant therapy for post-menopausal women with hormone receptor-positive breast cancer. Tamoxifen is still considered therecommended standard of care for women with hormone receptor-positive breast cancer.

CHAPTER 29

1. In which of the following conditions is somatropin contraindicated? In clients with:

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A. Dwarfism

B. Acromegaly

C. Hypopituitarism

D. Addisons disease

Somatropin is a synthetic form of growth hormone. Acromegaly is caused by excessive growthhormone, and thus this drug would be contraindicated,

2. Which of the following would be a priority nursing diagnosis for a client receiving desmopressin(DDAVP)?

A. Potential for injury

B. Alteration in comfort

C. Alteration in fluid volume

D. Knowledge deficit

Desmopressin is a form of antidiuretic hormone, which increases sodium and water retention, leadingto an alteration in fluid volume. Although the other nursing diagnoses may be appropriate they are nota priority using Maslow's hierarchy of needs.

3. Which of the following points would the nurse include when teaching a client regarding the correctadministration of desmopressin (DDAVP)?

A. Rotate nostrils daily to prevent irritation.

B. Take in the morning to prevent nocturia.

C. The dose is based upon your chemstick results.

D. Weigh yourself daily and take if you gain more than 0.45 kg perday.

Desmopressin works to decrease urine output; thus the client would retain fluid and gain weight. Itshould be taken at night if used to treat nocturnal enuresis. Because it is administered intranasally, itcan be irritating; thus nostrils should be rotated.

4. Which of the following would the nurse monitor to assess the therapeutic effectiveness ofvasopressin?

A. Relief of pain

B. Serum albumin levels

C. Urine specific gravity

D. Adrenocorticotropic hormone (ACTH)

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levels

Vasopressin causes decreased water excretion in the renal tubule, thus increasing urine specificgravity. It is used to treat diabetes insipidus, which presents with a low urine specific gravity.

5. The nurse admitting a client with acromegaly anticipates administering which of the followingmedications?

A. octreotide

B. somatropin

C. corticotropin

D. desmopressin

Octreotide suppresses growth hormone, the culprit of acromegaly.

6. Which of the following side effects would the nurse monitor for after administering corticotropin?(choose all that apply)

A. Glucose levels

B. Intake and output

C. Peripheral edema

D. Serum sodium levels

Corticotropin stimulates the release of adrenal hormones, which can lead to sodium and fluidretention as well as hyperglycemia.

CHAPTER 34

1. Which of the following dosage forms for testosterone allows for the highest hepatic first-passeffect?

A. Oral

B. BuccalC. Transdermal

D. Subcutaneous

Transdermal, subcutaneous, and buccal absorption all cause the drug to enter the bloodstream afterportal circulation. Oral administration results in gastric or intestinal absorption, which takes themedication through the liver before it reaches its target organ.

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2. For which of the following laboratory values would the nurse question the administration oftestosterone?

A. Hypocalcemia

B. Hyponatremia

C. Hyperkalemia

D. HypovolemiaTestosterone can cause increased serum potassium levels.

3. Discharge teaching for a client receiving finasteride would include which of the following commonside effects?

A. Hair loss

B. Increased libidoC. Muscle weakness

D. Ejaculatory dysfunction

Common side effects of finasteride include impotence, decreased libido, and decreased volume ofejaculate. It is also used to treat male pattern baldness and thus would cause hair growth, not hairloss.

4. With which of the following drugs would clients prescribed sildenafil be instructed regarding apotential fatal drug interaction?

A. aspirin

B. nitroglycerin

C. acetaminophen

D. anticoagulants

When taken in conjunction with nitroglycerin, sildenafil can cause severe hypotension unresponsiveto treatment.

CHAPTER 33

1. Which of the following statements, made by the client, indicates understanding of dischargeteaching regarding alendronate?

A. I need to decrease my intake of dairy products to prevent hypercalcemia.

B. I need to take this medication with food to prevent damage to my esophagus.

C. This medication will help relieve the bone pain I have from my osteoporosis.

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D. I will take the medication first thing in the morning on an empty stomach and remain upright for30 minutes.

Alendronate can cause erosive esophagitis. To prevent this side effect it is important to take themedication first thing in the morning on an empty stomach without any other medications andmaintain an upright position for 30 minutes. These actions facilitate rapid absorption and preventreflux into the esophagus.

2. For which of the following cancers is the risk reduced with the addition of continuous administrationof progestin to an estrogen regimen?

A. Breast cancer

B. Vaginal cancer

C. Ovarian cancer

D. Endometrial cancer

Estrogen, given alone, has been associated with an increased risk of endometrial hyperplasia, whichcan lead to endometrial cancer. Progestin reduces the incidence of endometrial hyperplasia.

3. For a client with which of the following conditions would the nurse question the order for estrogenreplacement therapy?

A. Weight loss

B. DysmenorrheaC. Vaginal bleeding

D. Deep vein thrombosis

Increased coagulation and risk of deep vein thrombosis is a side effect of hormone replacementtherapy.

4. During postpartum assessment the nurse notes a boggy uterus and increased vaginal bleeding.Which of the following drugs would the nurse anticipate to administer based upon this assessmentand standing physician orders?

A. oxytocin

B. terbutaline

C. clomiphene

D. prostaglandinE

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Oxytocin is a uterine stimulant, causing uterine contractions, which would decrease the vaginalbleeding.

CHAPTER 51

1. Which of the following actions makes metoclopramide useful to treat post-operative nausea andvomiting? Metoclopramide:

A. Decreases chemoreceptor stimulation

B. Decreases mobility in the entire GI tract

C. Promotes motility in the small intestine

D. Improves the bodys response to analgesicmedication

Metoclopramide works by increasing GI motility in the small intestine, thus minimizing gastricdistention and accompanying stimulation of the vomiting centre.

2. Which of the following is important for the nurse to know when planning administration of anti-emetic medications to a client? Combination therapy is preferred because:

A. The risk of constipation is decreased

B. Lower doses of medication are cost-effective

C. Different vomiting pathways are blocked

D. Increased sedation is achieved by higher doses of

medicationCombining anti-emetic agents from various categories allows the blocking of the vomiting centre andchemoreceptor trigger zone through different pathways, thus enhancing the anti-emetic effect.

3. In developing a plan of care for a client receiving an antihistamine anti-emetic agent, which of thefollowing nursing diagnoses would be of highest priority?

A. Knowledge deficit regarding medication administrationB. Fluid volume deficit related to nausea and vomiting

C. Risk for injury related to side effects of medication

D. Alteration in comfort related to nausea andvomiting

Although all of the options are appropriate nursing diagnoses, fluid volume deficit is the highestpriority because it has the highest associated mortality rate. Although a fall or injury could also provefatal, this diagnosis is a potential; actual nursing diagnoses have priority over potential diagnoses.

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4. A client receiving an anticholinergic agent to treat nausea and vomiting should be taught to expectwhich of the following side effects?

A. Diarrhea

B. Lacrimation

C. Dry mouth

D. Bradycardia

Anticholinergic agents block the parasympathetic nervous system, which causes the body to "rest anddigest." Blocking of these effects leads to constipation, urinary retention, and decreased secretions(dry mouth).

5. Which of the following agents works by blocking serotonin in the GI tract, vomiting centre, andchemoreceptor trigger zone (CTZ)?

A. meclizine

B. droperidol

C. ondansetron

D. metoclopramide

Ondansetron is a serotonin blocker. Metoclopramide is a prokinetic agent, meclizine is anantihistamine, and droperidol is a neuroleptic agent.

6. Which of the following would the nurse assess the client for before administering the anticholinergicagent scopolamine? A history of:

A. Glaucoma

B. Hyperthyroidism

C. Rheumatoid arthritis

D. Gastroenteritis

Anticholinergic agents are contraindicated in clients with glaucoma. These agents can cause pupillarydilation, which can obstruct the flow of aqueous humor and increase intra-ocular pressure.

7. Which of the following actions does the nurse plan when administering 50 mg diphenhydramine

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intravenously?

A. Undiluted over 1 minute

B. Undiluted over 2 minutes

C. Diluted in 100 mL D5W over 20 minutes

D. Diluted in 50 mL normal saline over 30minutes

Diphenhydramine should be administered undiluted at a rate of 25 mg/min.

8. The nurse would expect to teach a client about which of the following anti-emetics commonly usedto prevent motion sickness?

A. droperidol

B. scopolamine

C. prochlorperazine

D. metoclopramide

Scopolamine blocks the binding of acetylcholine with cholinergic receptors in the inner ear, animbalance of which is a common cause of motion sickness.

9. Which of the following is a neuroleptic-like agent used for both anxiety and nausea and vomitingassociated with surgical procedures?

A. droperidol

B. scopolamine

C. prochlorperazine

D. metoclopramide

Droperidol is actually classified as an anaesthetic agent that has both neuroleptic (antianxiety) andanti-emetic properties, thus making it an effective agent to use as an adjunct during surgery.

10. The nurse would anticipate administering which of the following medications to a client sufferingfrom nausea and vomiting not relieved by first-line anti-emetic drugs?

A. dronabinol

B. dimenhydrinate

C. metoclopramide

D. prochlorperazine

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Dronabinol is the active ingredient of marijuana. It has been approved by Health Canada as asecond-line agent to treat nausea and vomiting related to cancer chemotherapy.

11. Which of the following is the nurse aware of when planning to administer metoclopramide?Metoclopramide must be given:

A. With food to decrease GI upset

B. Every 6 hours around the clock

C. 30 minutes before meals and at bedtime

D. With a full glass of water first thing in themorning

Metoclopramide should be administered 30 minutes before meals and at bedtime. Administering themedication before meals allows time for onset to increase GI motility before food ingestion, thusdecreasing stomach distention and resulting nausea and vomiting.

12. Which of the following statements regarding anti-emetic medications, if made by the client,indicate the need for further client teaching?

A. I may take Tylenol to treat the headache caused by ondansetron.

B. I will apply the scopolamine patches to rotating sites on my arms.

C. I will not drive while I am taking these medications because they may cause drowsiness.

D. I should take my prescribed anti-emetic before receiving my chemotherapy dose.Transdermal scopolamine patches should be applied to nonirritated areas behind the ear, not on thearms.

CHAPTER 49

1. Which of the following would the nurse teach clients about the effectiveness of antacids in thetreatment of hyperacidity? Antacids:

A. Decrease gastric pHB. Neutralize gastric acid

C. Decrease duodenal pH

D. Decrease stomachmotility

Antacids work by neutralizing gastric acid, which would cause an increase in pH. They do not affectgastric motility.

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2. The nurse would monitor for which of the following adverse reactions to aluminum-containingantacids such as aluminum hydroxide?

A. Diarrhea

B. GI upset

C. Constipation

D. Fluidretention

Aluminum- and calcium-containing antacids cause constipation, magnesium-containing antacidscause diarrhea, and sodium-containing antacids cause sodium and fluid retention.

3. The nurse would question an order for which type of antacid in clients with chronic renal failure?

A. Aluminum-containing antacids

B. Calcium-containing antacids

C. Magnesium-containing antacids

D. All of the above

Magnesium-containing antacids can cause hypermagnesemia in clients with chronic renal failure.Aluminum-containing antacids may be used as a phosphate binder in clients with chronic renalfailure. Calcium-containing antacids are also appropriate because these clients may behypocalcemic.

4. Which of the following signs and symptoms would the nurse monitor in a client using sodiumbicarbonate to treat gastric hyperacidity?

A. Hyperkalemia

B. Hypercalcemia

C. Metabolic alkalosis

D. Metabolic acidosisSolutions containing sodium bicarbonate (a base) can cause metabolic alkalosis. Serum K and serumcalcium would decrease with alkalosis, not increase.

5. Which of the following nursing diagnoses is appropriate for a client receiving famotidine?

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A. Increased risk for infection related to immunosuppression

B. Potential risk for bleeding related to thrombocytopenia

C. Alteration in urinary elimination related to retention

D. Alteration in tissue perfusion related to hypertension

A serious side effect of famotidine is thrombocytopenia, which is manifested by a decrease in plateletcount and an increased risk of bleeding.

6. Which of the following is the action of histamine2-receptor antagonists?

A. Cause a decrease in stomach pH

B. Irreversibly bind to H+/K+ATPase

C. Compete with histamine for binding sites on the parietal cells

D. Decrease signs and symptoms of allergies related to histaminerelease

Histamine receptor blocking agents decrease gastric acid by competing with histamine for bindingsites on the parietal cells.

7. Which of the following statements demonstrates understanding of client teaching regarding the useof histamine2-receptor antagonist?

A. I should decrease bulk and fluids in my diet to prevent diarrhea.

B. Since I am taking this medication, it is OK for me to eat spicy foods.

C. Smoking decreases the effects of this medication, so I should look into cessation programs.

D. I should take this medication 1 hour after each meal in order to maximally decreasegastric acidity.

Clients taking histamine2-receptor blocking agents should avoid spicy foods, extremes intemperatures, alcohol, and smoking. They should also increase bulk and fluids in diet to preventconstipation.

8. Which of the following is an action of proton pump inhibitors? Proton pump inhibitors:

A. Cause a decrease in stomach pH

B. Irreversibly bind to H+/K+ATPase

C. Cannot be used to treat erosive esophagitis

D. Compete with histamine for binding sites on the parietalcells

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Proton pump inhibitors work to block the final step in the acid-secreting mechanisms of the protonpump. They do this by irreversibly binding to H+/K+ATPase, the enzyme for this step.

9. Which of the following adverse effects can result because proton pump inhibitors have the ability toalmost totally inhibit gastric acid secretion?

A. GERD

B. Achlorhydria

C. Diverticulosis

D. Gastric ulcerformation

Because the proton pump inhibitors stop the final step of acid secretion, they can block up to 90% ofacid secretion, leading to achlorhydria (without acid).

10. A client unable to tolerate oral medications may be prescribed which of the following proton pumpinhibitors to be administered intravenously?

A. lansoprazole

B. omeprazole

C. pantoprazole

D. esomeprazole

Pantoprazole is the only proton pump inhibitor that is available for intravenous administration. Theother medications in this category may only be administered orally.

11. Which of the following points about medication administration is important when administeringsucralfate to a client with a nasogastric tube?

A. Administer with a bolus tube feeding

B. Administer with an antacid for maximum benefit

C. Allow the tablet to dissolve in water before administering

D. Crush the tablet into a fine powder before mixing withwater

It is important to give sucralfate on an empty stomach so that it may dissolve and form a protectivebarrier over the gastric mucosa. The tablet form will not dissolve in water when crushed; it must beleft whole and allowed to dissolve. Crushing the medication so that it will not dissolve could lead toclogging of the nasogastric tube and decreased effectiveness of the drug.

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D. Anorexia

Side effects associated with loperamide include CNS fatigue and dizziness, epigastric pain,abdominal cramps, nausea, dry mouth, vomiting, and anorexia. Diarrhea is an indication, not a sideeffect.

4. Which of the following is the mechanism of action of diphenoxylate?

A. An increase in intestinal motility

B. An increase in intestinal excretion of water

C. A decrease in peristalsis in the intestinal wall

D. A decrease in the reabsorption of water in thebowel

Diphenoxylate acts on the smooth muscle of the intestinal tract to inhibit GI motility and excessivepropulsion of the GI tract (peristalsis).

5. Which of the following actions explains how Milk of Magnesia alleviates constipation?

A. Lubricating the passage of stool

B. Increasing bulk within the colon

C. Increasing water absorption into the colon

D. Stimulating nerves that regulate

defecation

Milk of Magnesia is a saline laxative that increases osmotic pressure to draw water into the colon.

6. Which of the following additional functions does lactulose, a hyperosmotic laxative, have?

A. Decrease peripheral edema

B. Correct sodium imbalancesC. Reduce ammonia levels

D. Alleviate galactoseintolerance

Lactulose reduces blood ammonia levels by forcing ammonia from the blood into the colon. It isuseful in treating clients with hepatic encephalopathy.