GI Drugs
. Mesalamine can be administered by which if the following: A. Oral B. SC C. IM D. Rectal
Answer: A & D, Mesalamine can be administered both orally and rectally.
A client has an as needed prescription for diphenoxylate. For which condition should the nurse administer this medication a) Constipation b) Abdominal pain c) An episode of diarrhea d) Hematest-positive nasogastric tube drainage
Answer: c) An episode of diarrhea Rationale: diphenoxylate is an antidiarrheal agent. It is used to manage acute diarrhea in conditions such as inflammatory bowel disease. It is not used for the conditions in options 1,2,4.
. Potential adverse effects of long-term or high dose magnesium hydroxide (MOM) therapy include: A. Headaches B. Sedation C. Electrolyte imbalance D. Peptic Ulcer
C
The nurse is planning to teach a client with gastroesophageal reflux disease (GERD) about substances to avoid. Which items should the nurse include on the list? Select all that apply a. Coffee b. Chocolate c. Peppermint d. Nonfat milk e. Fried chicken f. Scrambled eggs
Foods that decrease lower esophageal sphincter (LES) pressure and irritate the esophagus will increase reflux and exacerbate the symptoms of GERD and therefore should be avoided. Aggravating substances include coffee, chocolate,
The nurse is doing an admission assessment on a client with a history of duodenal ulcer. To determine whether the problem is currently active, the nurse should assess the client for which sign(s)/ symptoms of duodenal ulcers? a. Weight loss b. Nausea vomiting c. Pain relieved by food intake d. Pain radiating down the right arm
Rationale: A frequent symptom of duodenal ulcer is pain that is relieved by food intake. These clients generally describe the pain as a burning, heavy, sharp, or "hungry" pain that often localizes in the mid-epigastric area. The client with duodenal ulcer usually does not experience weight loss or nausea and vomiting. These symptoms are more typical in the client with gastric ulcer.
A physician has written an order for ranitidine (Zantac) once daily. The nurse schedules the medications for which of the following times? a. At bed time b. After lunch c. With supper d. Before breakfast
a
. John's physician prescribed him ranitidine (Zantac), a histamine-2 receptor antagonist, and an antacid to help treat and manage the symptoms of GERD. What statement by John needs further teaching by the nurse? a) I will avoid drinking alcohol while taking ranitidine. b) I should take my ranitidine and antacid at the same time. c) I will avoid lying down immediately after eating to help prevent acid reflux. d) I may experience diarrhea or constipation while taking these medications.
b
A client has been taking omeprazole (Prilosec) for 4 weeks. The nurse evaluates that the client is receiving the optimal intended effect of the medication if the client reports the absence of which symptom? a. Diarrhea b. Heartburn c. Flatulence d. Constipation
b
A patient taking alosetron (Lotronex) for IBS-D tells you they haven't had a bowel movement in a week. What do you recommend they do? a) tell them this is expected and to continue the medication as prescribed b) instruct the patient to discontinue the medication and contact their provider c) advise the client to skip today's dose and begin again the following day d) instruct the patient to take half of the prescribed dose
b
A patient with GERD for whom antacids have been prescribed asks the nurse how these drugs work. The nurse's response is based on which action of antacids? a. Gastric acid secretion is inhibited. b. Gastric acid is neutralized. c. There is increased thickness of the gastric mucus. d. Gastric mucosa is desensitized to the effects of acid.
b
. The pregnancy category for the antiflatulent drug simethicone is: a) category A b) category C c) category unknown d) category X
c
7. Which basic principle does the nurse consider when scheduling the administration of drugs used to treat patients with gastroesophageal reflux disease (GERD) or peptic ulcer disease (PUD)? a. These drugs are taken only in the presence of active symptomatology. b. Significant fluid and electrolyte imbalances are associated with these drugs. c. Individualized scheduling is required to avoid drug interactions. d. These drugs must be given with meals or snacks.
c
A charge nurse and a newly licensed nurse are providing care for a client who reports nausea and has a presciption for metoclopramide (Reglan) as an antiemetic. Which of the following statements by the newly licensed nurse indicates a correct understanding of the actions of the medication. "Metoclopramide": a. depresses vagal nerve activity b. decreases gastric acid secretions c. slows peristalsis d. promotes gastric emptying
d
A client has a PRN prescription for ondansetron (Zofran). For which condition should the nurse administer this medication to the postoperative client? a. Paralytic ileus b. Incisional pain c. Urinary retention d. Nausea and vomiting
d
The nurse is collecting assessment data from a client who has been taking omeprazole (Prilosec) as prescribed. The nurse determines that the medication is ineffective if the client continues to experience which symptom? A) Dizziness B) Heartburn C) Headaches D) Muscle pains
Ans: B. Feedback: Recall that the omeprazole is a gastric acid pump inhibitor (most medications names that end with the letters -zole are gastric acid pump inhibitors) will direct you to the option 2
Ranitidine (Zantac) is ordered for a 2 year old child with cystic fibrosis. Which of the following classifications accurately describes the drug? 1. Aluminum salt 2. Antacid 3. Anticholinergic 4. Histamine-2 receptor antagonist
Answer: 4. Ranitidine acts as an H-2 receptor antagonist. It helps decrease duodenal acidity and enhance pancreatic enzyme activity.
A 29-yr patient is prescribe mesalamine for ulcerative colitis. Which of the following should be included in patient teaching? Select all that apply. A.To prevent constipation drink plenty of fluid daily. B.Instruct patients to swallow capsule and tablets whole. C.Instruct the not to crush or chew oral form. D.All of the above.
D
A patient has been taking orlistat (Xenical) for several months as part of a weight loss program which also includes a low-fat diet. Which of these data obtained by the nurse indicate that a change in therapy may be needed? a. The patient complains of abdominal bloating after meals. b. The patient has lost 31 lb (14 kg) of the original 65 lb (30 kg) goal. c. The patient frequently has liquid stools. d. The patient is pale and has many bruises
D
A patient is taking Bethanechol (Urecholine) for treatment of GERD. This is known as what type of drug? a. Proton-pump inhibitor b. Histamine receptor blocker c. Prokinetic d. Mucosal Healing Agent
Rationale: The answer is C. This drug is known as a prokinetic drug. It prevents delayed gastric emptying by improving pressure in lower esophageal sphincter and improves peristalsis of the GI tract.
A nurse should teach a patient who takes alosetron [Lotronex] for diarrhea-prominent irritable bowel syndrome (IBS-D) to stop the medication immediately if the patient develops which condition? a. Blurred vision b. Heart palpitations c. Bruising d. Constipation
d
A health care provider prescribes ondasteron 2mg IV push every 4-6 hours PRN for nausea post chemotherapy. The medication label reads 4mg/2ml. The nurse prepares how many milliliters to administer one dose?
1ml
Pancrelipase may cause many side effects. Pain at what specific location is indicative of medication overdose? a) wrist b) knee c) ankle d) great toe
d
What is the appropriate time to infuse ondansetron? a) 1 minute b) 5 minutes c) 10 Minutes d) 15 minutes
d
Which of the following enzymes are mimicked in the drug pancrelipase? a) Amylase b) Lipase c) Protease d) all of the above
d
. A client with a history of GERD is taking Maalox. The nurse determines that the client is experiencing optimal effects of the medication if: A. Heartburn is relieved B. Muscle twitching stops C. Serum calcium levels rise D. Blood glucose levels decrease
A
. Your patient who was recently diagnosed with IBS is asking what kind of diet they should follow. You tell them: a. a diet high in fiber b. a diet high in protein c. a diet high in natural fats to promote peristalsis d. a diet low in fiber
A
A 35yr woman has been prescribed alosetron (Lotronex) for irritable bowel syndrome. The patient should be aware of which of the following adverse effect? A)Constipation B)Weight gain C)diarrhea D) Flatulence
A
A patient is receiving Morphine 4mg IV push for the past 6 days. Which other drug should the patient be on? a. docusate sodium b. magnesium hydroxide c. polyethylene glycol- electrolyte solution d. aldosterone
A
Mr. Hall, age 65, is admitted to the hospital for pneumonia. Since admission he has not had a bowel movement. The physician prescribes magnesium hydroxide. What would be a realistic outcome of this therapy? a. The patient will have a bowel movement after taking the drug b. The patient will not sustain injury from drug therapy c. Diarrhea will be controlled d. Within 2 to 3 hours of using drug, patient will have a decrease pain
A
Mr. Jackson is started on metoclopramide for the treatment of diabetic gastroparesis. Which adverse effect is specific to this drug therapy? a. Depression b. Anxiety c. Alcohol withdrawal d. CNS effects
A
Nursing management of the patient with chronic gastritis includes teaching the patient to: a. maintain a bland diet with six small meals a day b. take antacids before meals c. use NSAIDS instead of aspirin for pain relief d. eliminate alcohol and caffeine from diet
A
Omeprazole is prescribed for gastric reflux disorder. Which strategy would help minimize the risk of adverse effects? a. Divide daily dosage larger than 80 mg into smaller doses to be administered through the day b. Omeprazole suppresses early gastric acid production c. Omeprazole provides a protective coating of the stomach d. It decreases the secretion of gastric acid in stomach
A
The nurse is caring for a client with a history of a GI bleed and a recent MI. The provider prescribed daily enteric coated aspirin. Which of the following statements would require correction by the nurse? a. I can chew or swallow my aspirin whole b. I should never chew my apirin c. I should never give aspirin to my 1 year old child d. I should report coffee ground emesis or tarry stools.
A
The nurse is initiating client education about taking the medication Pancrelipase. Which of the following questions is most important to ask the client prior to administering Pancrelipase? A. "Do you have any known food allergies to pork products?" B. "Are you able to limit your fluid intake to avoid bloating?" C. "Do you have a way to crush your pills prior to mixing with food?" D. "Will you have difficulty eating only 3 main meals per day?"
A
What drug is used to prevent or control nausea, vomiting, and motion sickness associated with chemotherapy? a. Antiemetic b. Histamine 2 blockers c. Antacids d. Laxatives
A
What is a major adverse effect of metoclopramide? a) tardive dyskinesia b) excessive sweating c) MI d. Stroke
A
Which method is used to discourage the patient from taking an excessive dosage of diphenoxylate HCl? a. A small amount of atropine sulfate is combined with diphenoxylate HCl b. Treating like narcotics c. The drug is used for the upper GI tract HCl is used with atropine sulfate
A
Which statement is true about the pharmacokinetics of simethicone? a. The drug is inert and not absorbed from the GI tract b. The drug is systemically absorbed c. The drug works in the stomach to prevent gas d. The drug interferes with the mucosal membrane of the GI tract
A
Which nursing intervention is a priority before administering magnesium hydroxide? A) Assess renal function B) Order blood cultures C) Record baseline EKG D) Record baseline vital signs
Ans: A Feedback: Assessing renal function is a priority before administering magnesium hydroxide because the medication is excreted through the kidneys. Identifying the function of the kidneys is important to predict how the patient will respond to therapy. Adequate renal function is needed to excrete the excess magnesium and to decrease the likelihood of magnesium toxicity
The client has a new prescription for metoclopramide (Reglan). On review of the chart, the nurse identifies that this medication can be safely administered with which condition? A) Intestinal obstruction B) Vomiting following cancer chemotherapy C) Diverticulitis with perforation D) Peptic ulcer with melena
Ans: B. Feedback: Metoclopramide (Reglan) is a gastrointestinal stimulant and antiemetic. Because it is a gastrointestinal stimulant, it is contraindicated with gastrointestinal obstruction, hemorrhage, or perforation. It is used in the treatment of emesis after surgery, chemotherapy, and radiation.
A patient has a prescription for mesalamine rectal suppositories for distal ulcerative colitis symptoms. Which of the following statements is correct? A) The suppositories should be used four times daily and retained in the rectum for 8 hours. B) The suppository should be rolled between the hands into a point prior to insertion. C) The suppository should be used at night and kept in the rectum for 1-3 hours, or preferably overnight. D) Mesalamine is indicated for patients who have failed to achieve symptom control with infliximab.
Ans: C Feedback: Mesalamine suppositories work inside the intestines to reduce the inflammation and other symptoms of ulcerative colitis and proctosigmoiditis. Medication should be given once a day, at bedtime, and retained for at least 1 hour for proper distribution.
1. A nurse is administering simethicone to their patient who asks how the medication works to treat the discomfort that she is experiencing. Which response by the nurse would be appropriate? A) "It works to neutralize gastric pH." B) "It decreases gastric acid secretion resulting in less gas." C) "It changes the form of the gas bubbles in the intestine making them easier to pass." D) "It works on the intestine to prevent any future formation of gas."
Ans: C Feedback: Simethicone is a medication that is prescribed in order to relieve the discomfort associated with excess gas. However, it does not prevent the gas from being formed. Instead, it works by changing the surface tension of the gas bubbles to make them easier to expel. The patient should expect to pass more gas following ingestion of simethicone.
The nurse is preparing a patient for discharge with a prescription for sucralfate (Carafate) and teaches the patient to take the medication when? A) With meals B) With an antacid before breakfast C) 1 hour before or 2 hours after meals and at bedtime D) After each meal
Ans: C Feedback: Administer drug on an empty stomach, 1 hour before or 2 hours after meals and at bedtime, to ensure therapeutic effectiveness of the drug. Administer antacids, if ordered, between doses of sucralfate and not within 30 minutes of taking the drug. Options A, B, and D are not correct.
The nurse is providing education for a patient with peptic ulcer disease resulting from chronic nonsteroidal anti-inflammatory drug (NSAID) use who will begin a prescription of misoprostol (Cytotec). The nurse evaluates that the patient understands the actions of this drug when he or she says it does what? A) Reduces the stomach's volume of hydrochloric acid B) Increases the speed of gastric emptying C) Protects the stomach's lining D) Increases lower esophageal sphincter pressure
Ans: C Feedback: Misoprostol is a synthetic prostaglandin that, like physiologic prostaglandin, protects the gastric mucosa. NSAIDs decrease prostaglandin production and predispose the patient to peptic ulceration. Misoprostol does not reduce gastric acidity (option A), improve emptying of the stomach (option B), or increase lower esophageal sphincter pressure (option D).
1. Which of the following statements by a patient receiving diphenoxylate with atropine indicates effective teaching? A) "I need to be careful because the structure of the drug makes risk of addiction and dependence similar to those of a narcotic." B) "I should not be concerned if I experience side effects of dry mouth and fast heartbeat during drug therapy as these are expected." C) "I should decrease the amount of fluids that I drink while on this medication in order to promote absorption." D) I will notify my provider if my diarrhea doesn't get better within two days of taking the medication"
Ans: D Feedback: Answer A is incorrect because, although diphenoxylate does have similar structure to meperidine, it is a schedule V drug and does not have the same addictive qualities in the doses in which it is prescribed. Answer B is incorrect because dry mouth and tachycardia are rare side effects that usually occur from taking too much of the medication. Answer C is incorrect because patients should increase fluid intake while on this medication because of the dehydration that can result from diarrhea. Answer D is correct because this medication is prescribed for short-term use only; provider should be notified if symptoms don't resolve within two days.
A patient is prescribed a tumor necrosis factor (TNF) inhibitor for the treatment of Crohn's disease. Before beginning treatment, the healthcare provider will confirm the results of which of these diagnostic tests? A) Stool culture B) Sigmoidoscopy C) Erythrocyte sedimentation rate D) Tuberculin skin test
Ans: D Feedback: The use of anti-TNF drugs (infliximab, etanercept) have been linked to increase the risk of TB, therefore a TB test must be completed before starting therapy.
A client has a prescription to take magnesium citrate to prevent constipation after upper and lower gastrointestinal studies. The nurse tells the client that which is the best way to take this medication? A) With fruit juice only B) At room temperature C) With a warm glass of water D) Chilled with a full glass of water
Ans: D Feedback: Magnesium citrate is available as an oral solution. It is commonly used as a laxative after certain GI tract studies. It should be served chilled with a glass of water to mask the taste. Allowing the medication to stand would reduce the carbonation and make the solution even less palatable.
A client has been taking omeprazole (Prilosec) for 4 weeks. The ambulatory care nurse evaluates that the client is receiving the optimal intended effects of the medication if the client reports the absence of which symptom? 1. Diarrhea 2. Heartburn 3. Flatulence 4. Constipation
Answer: 2. Omeprazole is a PPI classified as an antiulcer agent. The intended effect of the medication is relief of pain from gastric irritation, often called heartburn by clients. Omeprazole is not used to treat the conditions identified in options 1,3, and 4.
The client has begun medication therapy with pancrelipase (Pancrease). The nurse evaluates that the medication is having the optimal intended benefit if which effect is observed? 1. Weight Loss 2. Relief of heartburn 3. Reduction of steatorrhea 4. Absence of abdominal pain
Answer: 3. Pancrelipase (Pancrease) is a pancreatic enzyme used in clients with pancreatitis as a digestive aid. The medication should reduce the amount of fatty stools (steatorrhea). Another intended effect could be improved nutritional status. It is not used to treat abdominal pain or heart burn. Its use could result in weight gain but should not result in weight loss if it is used in aiding digestion.
The client has a new prescription for metoclopramide (Reglan). On review of the chart, the nurse identifies that this medication can be safely administered with which condition? 1. Intestinal Obstruction 2. Peptic Ulcer with melena 3. Diverticulitis with perforation 4. Vomiting following cancer chemotherapy
Answer: 4. Metoclopramide is a gastric stimulant and antiemetic. Because it is a gastric stimulant, it is contraindicated with gastrointestinal obstruction, hemorrhage or perforation. It is used in the treatment of emesis after surgery, chemotherapy and radiation
A client with gastroesophageal reflux disease (GERD) is taking metoclopramide (Reglan) as prescribed. What client statement tells the nurse that the medication teaching session has been effective? a. "The purpose of this drug is to increase GI motility." b. "This drug decreases the tone of the lower esophageal sphincter." c. "This drug will prevent or stop diarrhea from occurring." d. "This drug kills the H.pylori organism that causes peptic ulcer disease."
Answer: A Metoclopramide is a GI stimulant, increasing motility of the GI tract, shortening gastric emptying time, and thus reducing the risk of the esophagus being exposed to gastric contents.
Omeprazole (Prilosec), cimetidine (Tagamet), and Maalox are ordered for an adult. When should the nurse plan to administer these drugs? a. Give omeprazole (Prilosec) before meals, cimetidine (Tagamet) with meals, and Maalox after meals. b. Give omeprazole (Prilosec) with meals, cimetidine (Tagamet) after meals, and Maalox before meals. c. Give omeprazole (Prilosec) after meals, cimetidine (Tagamet) before meals, and Maalox with meals. d. Give all of the drugs after meals.
Answer: A Omeprazole (Prilosec) should be taken 1 hour before meals. Cimetidine (Tagamet) should be taken with meals or at bedtime. Aluminum hydroxide with magnesium hydroxide (Maalox) should be taken 2 hours after other drugs and 1 hour after meals and at bedtime.
A patient is to start taking liquid aluminum hydroxide with magnesium hydroxide to treat recurrent esophageal reflux. To maximize the therapeutic effect of drug therapy, the nurse should teach the patient to: a. Shake the bottle well before measuring the dose b. Administer the drug one hour before meals c. Mix the drug with water before administration d. All of the above e. None of the above
Answer: A Shaking the bottle will disperse the drug evenly in the suspension. Administer the drug one hour after a meal for maximum effectiveness. Do not mix the drug with water. When given in tablet form, they should be chewed thoroughly and then followed with water to promote dissolving.
. A patient was prescribed Xenical by their primary health care provider. An important patient education instruction would be: A. Do not take Xenical if the meal does not contain fat B. GI symptoms are serious adverse effects C. The patient does not need to make any dietary changes as long as the patient is on Xenical D. Overdosing on Xenical can cause lethal symptoms
Answer: A, Xenical must be taken with food that contains fat
A new nurse is providing patient teaching on omeprazole, the nurse manager intervenes when the new nurse says which of the following statements: A. Take omeprazole 1 hour after meals and continue therapy for the duration prescribed. B. Daily dosages larger than 80 mg should be divided in two doses. C. This drug should not be crushed or chewed, because doing so alters absorption and effectiveness. D. This drug is usually well tolerated, however, the most common side effects are headache and diarrhea.
Answer: A. This is an incorrect statement by the new nurse. This drug should be taken 30 minutes-1 hour before meals
Which of the following patients would be most likely to benefit from treatment with ondansetron (Zofran)? A. A woman who is receiving chemotherapy for the treatment of colon cancer B. A child who experienced a greenstick fracture of his humerus in a playground accident C. A woman who is recovering from a bilateral mastectomy and breast reconstruction D. A man who has been diagnosed with chronic renal failure secondary to poorly controlled diabetes Incisional pain is decreased
Answer: A. woman who is receiving chemotherapy for the treatment of colon cancer. Ondansetron is used to prevent nausea and vomiting associated with cancer chemotherapy and radiotherapy, and in postoperative states when expectation is high that nausea or vomiting will occur or when nausea and vomiting must be avoided. It is less likely to be used in postsurgical care, though this may be the case. Renal failure and skeletal fractures are not indications for the use of ondansetron.
Diphenoxylate HCl with Atropine Sulfate (Lomotil) is prescribed for the client with ulcerative colitis. Which of the nursing observations indicates that the drug is having a therapeutic effect? a. There is an absence of peristalsis b. The number of diarrhea stools decreases c. Cramping in the abdomen had increased d. Abdominal girth size increases
Answer: B Desired effect of Diphenoxylate HCl with Atropine Sulfate (Lomotil), is to decrease GI motility and the number of diarrhea stools.
34-year-old postoperative patient is prescribed ondansetron (Zofran) to prevent nausea and vomiting. The nurse should observe the patient for the following adverse effects except: A. Constipation B. Hypertension C. Hypotension D. Headache
Answer: B Hypertension is not an adverse effect of ondansetron. Constipation and headache are common adverse effects and hypotension is a serious adverse effect of ondansetron.
A patient has been prescribed orlistat (Xenical) for weight reduction. After educating the patient about its use, the nurse determines that the teaching was successful when the patient states: A. "I will make sure to take a multivitamin 1 hour apart from the administration of orlistat." B. "The multivitamin I take should include fat-soluble vitamins (vitamins A, D, E, and beta-carotene)." C. "Most of my daily fat intake should be eaten during meals earlier in the day." D. "I will limit my dietary fat to 20% of my calories."
Answer: B Multivitamins should contain fat-soluble vitamins and be administered 2 hours apart from orlistat. Daily fat intake should be divided evenly between meals. Dietary fat should be limited to 30% of the patient's calories.
A client is complaining of gas pains after surgery and requests medication. The nurse reviews the medication prescription sheet to see if which medication is prescribed for the relief of gas pains? a. Droperidol (Inapsine) b. Simethicone (Mylicon) c. Acetaminophen (Tylenol) d. Magnesium hydroxide (MOM)
Answer: B Simethicone is an anti-flatulent used in the relief of pain caused by excessive gas in the gastrointestinal tract.
A patient has just been prescribed Simethicone and the nurse is providing the patient education on their new medication. The patient asks the nurse how does their medication work. Which response by the nurse is correct? A. Antiflatulents work by decreasing the amount of air swallowing during food intake. B. Simethicone works by facilitating an antifoaming action, changing the surface tension of gas bubbles, causing them to coalesce and pass more easily through belching and flatus. C. Antiflatulents decrease the amount of gas produced. D. Simethicone works as an antacid and flatus reducer
Answer: B, Simethicone works by facilitating an antifoaming action, changing the surface tension of gas bubbles, causing them to coalesce and pass more easily through belching and flatus
The patient who is admitted with a diagnosis of diverticulitis and a history of irritable bowel disease and gastroesophageal reflux disease (GERD) has received a dose of Mylanta 30 mL PO. The nurse should evaluate its effectiveness by questioning the patient as to whether which symptom has been resolved. a. Diarrhea b. Heartburn c. Constipation d. Lower abdominal pain
Answer: B. Mylanta is an antacid that contains both aluminum and magnesium. It is indicated for the relief of GI discomfort, such as heartburn associated with GERD. Mylanta can cause both diarrhea and constipation as a side effect. Mylanta does not affect lower abdominal pain.
A postoperative client requests medication for flatulence (gas pains). Which medication from the following PRN list should the nurse administer to this client? A. Ondansetron (Zofran) B. Simethicone (Mylicon) C. Acetaminophen (Tylenol) D. Magnesium hydroxide (milk of magnesia, MOM)
Answer: B. Simethicone is an antiflatulent used in the relief of pain caused by excessive gas in the gastrointestinal tract. Ondansetron is used to treat postoperative nausea and vomiting. Acetaminophen is a nonopioid analgesic. Magnesium hydroxide is an antacid and laxative
A 25 year old client, admitted to the hospital with an exacerbation of ulcerative colitis is placed on mesalamine (Asacol), which is to be administered rectally via enema. The client finds this procedure distasteful and asks the nurse why the medication is not given orally. Which is the best response by the nurse? a. "It can be given orally. I'll contact the doctor and see if the change can be made." b. "Rectal administration delivers the medication directly to the affected area." c. "Oral administration will not be as effective for the disease condition." d. "It can be given orally, I'll make the change and we'll tell the doctor in the morning."
Answer: B. Treatment of inflammatory bowel disease often involves topical application of medication directly to the tissue involved. Rectal application of mesalamine decreases the side effects of the medication. Initially, the nurse should explain this to the cliet. If the client still desires a change in medication route, the HCP should be contacted as nurses cannot order medications and cannot change medication routes.
Which of the following patients should refrain from metoclopramide (Reglan) therapy? a. Jason, with hypertension b. Billy, with GERD c. Alex, with seizure disorder d. Bob, with asthma
Answer: C Seizures may increase with the use of metoclopramide.
A patient has been taking alosetron (Lotronex) for the past 2 weeks for irritable bowel syndrome. Today she calls the clinic to report that she has been experiencing constipation. The nurse will expect which priority action to be taken? A. The dosing will be increased by 1 mg B. The patient will be told to take a bulk-forming laxative C. The patient will be given Milk of Magnesia to relieve the constipation quickly D. The drug will be discontinued immediately
Answer: D Constipation is a major contraindication to alosetron.
Pancrelipase utilized in the treatment of many conditions. It is contraindicated for which of the following patients? A. 27-year-old male with cystic fibrosis B. 45-year-old female pancreatic insufficiency C. 38-year-old female ductal obstruction caused by pancreatic cancer D. 25-year-old male acute pancreatitis
Answer: D Pancrelipase is used in the treatment of cystic fibrosis, pancreatic insufficiency, and ductal obstruction caused by pancreatic cancer. It is contraindicated in patients with acute pancreatitis.
A patient has been taking alosetron (Lotronex) for 3 weeks as part of treatment for irritable bowel syndrome. Today she calls the clinic to report that she has been experiencing constipation. The nurse will expect with priority action to be taken? a. The dose will be increased by 1 mg. b. The patient will be told to take a bulk-forming laxative. c. The patient will be given Milk of Magnesia to relieve the constipation quickly. d. The drug will be discontinued immediately.
Answer: D. Constipation can be severe in some patients and major complications can include obstruction, perforation, impaction, and toxic megacolon. If constipation develops, the drug should be discontinued and reported to the healthcare provider immediately
The nurse determines the client needs further instruction on cimetidine if which statements were made? Select all that apply a) I will take the cimetidine with my meals b) I'll know the medication is working if my diarrhea stops c) My episodes of heartburn will decrease if the medication is effective d) Taking the cimetidine with an antacid will increase its effectiveness e) I will notify my health care provider if I become depressed or anxious f) Some of my blood levels will need to be monitored closely since i also take warfarin for atrial fibrillation
Answer: a, b, d Rationale: cimetidine, a histamine receptor antagonist helps to alleviate the symptom of heartburn, not diarrhea. Because cimetidine crosses the blood brain barrier, central nervous system side and adverse effects such as mental confusion, agitation, depression, and anxiety, can occur. Food reduced the rate of absorption, so if cimetidine is taken with meals, absorption will be slowed. Antacids decrease the absorption of cimetidine and should be taken at least 1 hour apart. If cimetidine is concomitantly administered with warfarin therapy, warfarin doses may need to be reduced, so prothrombin and international normalized ratio results must be followed.
A client with Crohn's disease is scheduled to receive an infusion of infliximab. What intervention by the nurse will determine the effectiveness by treatment? a) Monitoring the leukocyte count for 2 days after the infusion b) Checking the frequency and consistency of bowel movements c) Checking the serum liver enzyme levels before and after the infusion d) Carrying out a hematest on gastric fluids after the infusion is completed
Answer: b) Checking the frequency and consistency of bowel movements Rationale: the principle manifestations of Crohn's disease are diarrhea and abdominal pain. Infliximab is an immunomodulator that reduces the degree of inflammation in the colon, thereby reducing the diarrhea. Options 1,3,4 are unrelated.
A client has been taking omeprazole for 4 weeks. The ambulatory care nurse evaluates that the client is receiving the optimal intended effect of the medication if the client reports the absence of which symptom? a) Diarrhea b) Heartburn c) Flatulence d) Constipation
Answer: b) Heartburn Rationale: Omeprazole is a protein pump inhibitor classified an as antiulcer agent. The intended effect of the medication is relief of pain from gastric irritation, often called heartburn by clients. Omeprazole is not used to treat the conditions identified in options 1,3, and 4.
A client who uses nonsteroidal anti inflammatory drugs (NSADs) has been taking misoprostol. The nurse determines that the misoprostol is having the intended therapeutic effect if which is noted? a) Resolved diarrhea b) Relief of epigastric pain c) Decreased platelet count d) Decreased white blood cell count
Answer: b) Relief of epigastric pain Rationale: the client who uses NSAIDs is prone to gastric mucosal injury. Misoprostol is a gastric protectant and is given specifically to prevent the occurrence in clients taking NSAIDs frequently. Diarrhea can be a side effect of the medication but is not an intended effect. Options 3 and 4 are unrelated to the purpose of misoprostol.
The nurse is caring for an adult who is receiving diphenoxylate hydrochloride with atropine sulfate (Lomotil) qid. What nursing assessment is essential while the client is receiving this medication? a. Monitor blood pressure hourly b. Assess respirations before administering drug c. Measure hourly urine output d. Do neuro checks every two hours
Answer: b. Lomotil is a schedule V opioid. Opioids depress respirations. The nurse must monitor respirations before administering Lomotil. It is not necessary to take blood pressure or measure urine output hourly. Neuro checks are not necessary
The nurse should administer an as-needed dose of magnesium hydroxide (MOM) after noting what information while reviewing a patient's medical record? a. Abdominal pain and bloating b. No bowel movement for 3 days c. A decrease in appetite by 50% over 24 hours d. Muscle tremors and other signs of hypomagnesemia
Answer: b. No bowel movement for 3 days. MOM is an saline laxative that produces a soft, semisolid stool usually within 15 minutes to 3 hours. This medication would benefit the patient who has not had a bowel movement for 3 days. MOM would not be given for abdominal pain and bloating, decreased appetite, or signs of hypomagnesemia
A client has begun medication therapy with pancrelipase. The nurse evaluates that the medication is having the optimal intended benefit if which effect is observed? a) Weight loss b) Relief of heartburn c) Reduction of steatorrhea d) Absence of abdominal pain
Answer: c) Reduction of steatorrhea Rationale: pancrelipase is a pancreatic enzyme used in clients with pancreatitis as a digestive aid. The medications should reduce the amount of fatty stools (steatorrhea). Another intended effect could be improved nutritional status/ it is not used to treat abdominal pain or heartburn. Its use could result in weight gain but should not result in weight loss if it is aiding in digestion.
A client with peptic ulcer is diagnosed with a H. pylori infection. The nurse is teaching the client about the medications prescribed, including clarithromycin, esomeprazole, and amoxicillin. Which statement by the client indicates the best understanding of the medication regime a) My ulcer will heal because these medications will kill the bacteria b) These medications are only taken when I have pain from my ulcer c) The medications will kill the bacteria and stop the acid production d) These medications will coat the ulcer and decrease the acid production in my stomach
Answer: c) The medications will kill the bacteria and stop the acid production Rationale: triple therapy for H. pylori infection usually includes 2 antibacterial medications and a proton pump inhibitor. Clarithromycin and amoxicillin are antibacterials. Esomeprazole is a proton pump inhibitor. These medications will kill the bacteria and decrease acid production.
A client has an as needed prescription for ondansetron. For which condition should the nurse administer this medication? a) Paralytic ileus b) Incisional pain c) Urinary retention d) Nausea and vomiting
Answer: d) Nausea and vomiting Rationale: ondansetron is an antiemetic used to treat postoperative nausea and vomiting, as well as nausea and vomiting associated with chemotherapy. The other options are incorrect reasons for administering this medication.
A client with a gastric ulcer has a prescription for sucralfate 1 gram by mouth 4 times daily. The nurse should schedule the medication for which times? a) With meals and at bedtime b) Every 6 hours around the clock c) One hours after meals and at bedtime d) One hour before meals and at bedtime
Answer: d) One hour before meals and at bedtime Rationale: sucralfate is a gastric protectant. The medication should be scheduled for administration 1 hour before meals and at bedtime. The medication is timed to allow it to form a protective coating over the ulcer before food intake stimulates gastric acid production and mechanical irritation. The other options are incorrect.
A client has a new prescription for metoclopramide. On review of the chart, the nurse identifies that this medication can be safely administered with which condition? a) Intestinal obstruction b) Peptic ulcer with melena c) Diverticulitis with perforation d) Vomiting following cancer chemotherapy
Answer: d) Vomiting following cancer chemotherapy Rationale: Metoclopramide is a gastrointestinal stimulant and antiemetic. Because it is a gastrointestinal stimulant, it is contraindicated with gastrointestinal obstruction, hemorrhage, or perforation. It is used in the treatment of vomiting after surgery, chemotherapy or radiation.
. Mesalamine is contraindicated for the following patient a. patients with crohn's disease b. Patient with active peptic ulcer disease c. Patient with hypersensitivity to acetaminophen d. Patient with ulcerative colitis
B
A client complains of constipation and requires a laxative. In providing teaching to the client, the nurse reviews the common causes of constipation, including which cause? a. Motion sickness b. Lack of exercise c. Food intolerance d. Bacteria (Escherichia coli)
B
A client has nausea and is taking ondansetron (Zofran). The nurse explains that the action of this drug is what? a. Stimulate the CTZ b. Block serotonin receptors in the CTZ c. Block dopamine receptors in the CTZ d. Coat the wall of the GI tract and absorb bacteria
B
A client is starting cisplatin therapy for cancer. What intervention is appropriate for this client? a. Administer granisetron (Kytril) 60 minutes before therapy and for several days after surgery. b. Administer ondansetron HCL (Zofran) 30 minutes before therapy and two doses after therapy. c. Administer palonosetron (Aloxi) IV push. d. Administer metoclopramide (Reglan) PO
B
A patient has recently been prescribed Maalox (aluminum hydroxide with magnesium hydroxide) for her GERD symptoms, which statement made by the patient requires further teaching? A. I am taking this medication in combination with aluminum hydroxide and magnesium hydroxide to lessen the adverse effects of either constipation or diarrhea from taking either one alone. B. Maalox will help me with my GERD symptoms because it will coat the lining of my stomach. C.I will contact my doctor immediately if I have abdominal pain, tarry stools, or coffee-ground emesis. D. To minimize drug interactions, I will wait 2 hours after taking my other medications to take Maalox
B
Alosetron is a pregnancy category a. X b. B c. C d. D
B
Because Irritable Bowel Syndrome, IBS, can be triggered by stress. IBS can be identified as the following: a. A personality disorder b. A psychological disorder c. a digestive disorder d. a renal disorder
B
Ms. Law has been taking omeprazole for the last 10 years. What is the risk to the patient from long term use? a. Loss of stomach acid production b. Increased risk of gastric cancer c. Erosion of the esophagus d. Decreased function of the lower esophagus
B
The client has been taking omeprazole for 4 weeks. The ambulatory care nurse evaluates that the client is receiving optimal intended effect of the medication if the client reports the absence of which symptoms? a. diarrhea b. heartburn c. constipation d. flatulence
B
When administering mesalamine, to minimize adverse effects, it is important to: a) take with milk or food b) not to crush or chew medication c) take at bedtime d. Take PRN
B
Which of the following patients would have a high risk for atropine toxicity when taking diphenoxylate (Lomotil)? a. Annie, with a history of migraine headache b. Jennifer, with Down syndrome c. Bill, with ulcerative colitis d. Jack, with peptic ulcer disease
B
Which of the following statements concerning the potential adverse effects of ondansetron (Zofran) is accurate? A. There are only a few potential adverse side effects and they are all serious B. There are many potential adverse effects, and a few are serious. C. There are only a few potential adverse effects, and they are minor. D. There are many potential adverse effects, and they are minor.
B
. Which assessment is most important for the client who is taking stimulant laxatives? a. Monitor bowel elimination daily. b. Monitor intake and output. c. Monitor signs and symptoms of fluid and electrolyte imbalance. d. Monitor heart rate and blood pressure every 4 hours
C
A nurse performing an initial admission taking metoclopramide (Reglan) for a prolonged period. The nurse should immediately call the health care provider if which sigs/symptoms were then noted by the nurse? a. Anxiety and Irritability b. Excessive drowsiness c. Tardive dyskinesia d. Dry mouth relieved with the use of sugar free hard candy
C
An obese patient asks the nurse about using orlistat (Xenical) for weight reduction. The nurse advises the patient that a. this drug can cause serious depletion of fat-soluble vitamins and should be used for only several weeks. b. weight-reduction drugs of any type are used for only those who do not have the willpower to reduce their intake of food. c. drugs may be helpful in weight loss, but weight gain is likely to recur unless changes in diet and exercise are maintained. d. the long-term effect of orlistat is not known, and the drug may cause serious side effects such as heart valve problems
C
Before administering a stimulant laxative to a client, which nursing intervention is the priority? a. Obtain a history of constipation and causes. b. Record baseline vital signs. c. Evaluate renal function. d. Assess fluid and electrolyte balance.
C
Following administration of a dose of metoclopramide (Reglan) to the patient, the nurse determines that the medication has been effective when which of the following is noted? A) Decreased blood pressure B) Absence of muscle tremors C) Relief of nausea and vomiting D) No further episodes of diarrhea
C
Jennifer, the nurse caring for Carrie is explaining how she will administer a suppository of mesalamine in order to maximum effectiveness of the medication. How should she administer the medication? a. Assist in prone position b. Warm the suppository in hot water c. Position Carrie in a left side lying position d. Administer the suppository after cleaning enema
C
Ms. Johnson begins taking ondansetron for nausea. What recommendation is appropriate for the administration of ondansetron in the form of an oral disintegrating tablet? a. Dissolve under the tongue b. Swallow the pill whole c. Remove the tablet by peeling back the foil d. Break the pill in half
C
The nurse teaches a patient with GERD to control her symptoms by: a. drinking 10-12oz of water with each meal b. spacing 6 small meals per day c. sleeping with the head of the bed elevated 4-6 inches d. performing daily exercises
C
When metoclopramide (Reglan) is given for nausea, the client is cautioned to avoid which substance? a. Milk b. MAOIs c. Alcohol d. Carbonated beverages
C
Which of the following medications should the nurse expect the physician to order for a client at risk for peptic ulcers after a severe traumatic injury? a. loperamide b. ondansetron c. pantoprazole d. sucralfate
C
A client is taking ranitidine (Zantac). The nurse who is teaching the client about this drug should include which information. (Select all that apply.) a. Drug induced impotence is irreversible b. The drug must be administered 30 minutes before meals c. The drug must be administered separate from an antacid by at least 2 hours d. The drug must always be administered with magnesium hydroxide e. Smoking should be avoided while taking this drug
C&E
. A client is taking ranitidine (Zantac). The nurse who is teaching the client about this drug should include which information? (Select all that apply.) a. Drug-induced impotence is irreversible b. The drug must be administered 30 minutes before meals c. The drug must be administered separate from an antacid by at least 1 hour d. The drug must always be administered with magnesium hydroxide e. Smoking should be avoided while taking this drug f. Foods high in vitamin B12 should be increased in diet
C, E, F
A patient is taking delayed-release omeprazole (Prilosec) capsules for the treatment of gastroesophageal reflux disease (GERD). Which statement will the nurse include in the teaching plan about this medication? A. "Take this medication once a day after breakfast." B. "You will only have to be on this medication for 2 weeks for a life long treatment of the reflux disease." C. "The medication may be dissolved in a liquid for better absorption." D. "The entire capsule should be taken whole, not crushed, chewed, or opened."
D
Carter, age 2, has cystic fibrosis. The physician places him on pancrelipase. What would be the most appropriate nursing diagnosis for Carter related to his medication regimen? a. Risk for Injury related to side effects of drug b. Alterations in elimination related to disease process c. Alteration in comforted related to the drug therapy and adverse effect of headache d. Imbalanced nutrition: less than body requirements, related to impaired digestion secondary to insufficient pancreatic enzymes
D
How should the patient be instructed to take Antacid tablets? A. Take tablet 30 minutes before meals B. Crush tablet and mix with orange juice C. Take 1 hour after meals D. Chew thoroughly and take with a full glass of water
D
Most common adverse effects of Diphenoxylate HCL include all but: a. dry mouth b. drowsiness c. dizziness d. orange urine
D
Mr. Palmer is scheduled to receive ranitidine at 9:00 am. What is the correct explanation of the pharmacodynamics of ranitidine? a. It has effects on prolactin levels b. It affects pepsin effects c. It has effects on fasting d. It inhibits both daytime and nocturnal basal gastric secretions as well as gastric acid
D
What is true about the mechanism of action of the IBS medication Alosetron? A. Alosetron is a 5-HT agonist B. Alosetron is a 5-HT antagonist C. Alosetron is a 5-HT3 agonist D. Alosetron is a 5-HT3 antagonist
D
When administering milk of magnesia it is important to remember to do all of the following EXCEPT: a. administer other drugs within 2 hours of administering milk of mag b. Check age of patient c. encourage increasing fluids and fiber in diet prior d. Encourage your patient to take medication everyday for the rest of their LIFE
D
Zofran is prescribed for a patient with cancer chemo induced vomiting. The nurse understands this drug: a. is a derivative of cannabis b. has a strong antihistamine effect that provides sedation and sleep c. is used only when other therapies are ineffective d. relieves vomiting centrally by action in the vomiting center and peripherally by promoting gastric emptying
D
Which of the following conditions can you safely administer Metoclopramide (Reglan) ? a. Patient with bowel obstruction b. Patient with gastrointestinal hemorrhage c. Patient undergoing radiation d. Patients with pheochromocytoma
Metoclopramide can be safely administered to patients having vomiting episodes following radiation, chemotherapy, and surgery. Options A and B: It is contraindicated in patients with conditions where stimulation of gastrointestinal motility might be harmful, such as mechanical bowel obstruction, bowel perforation, or gastrointestinal hemorrhage. Option D: Hypertensive crises may occur in patients with pheochromocytoma due to induction of catecholamine release from the tumor.
What is the priority nursing intervention for a client receiving an antiemetic? a. Monitor intake and output. b. Keep items far away from the bed. c. Give the client privacy by letting him walking around the room. d. Keep bed in low position with side rails up.
Rationale: Antiemetics can cause drowsiness; hence the priority nursing intervention is to protect the client from injury such as raising the side rails and keeping the bed in low position.Option A is not the most priority intervention.Options B and C will risk the client for fall.
A patient with Chron's disease is receiving an infusion therapy of Infliximab (Remicade). Which of the following should the nurse do while the patient is on this medication? a. Monitoring liver function test prior the infusion. b. Monitoring the vomiting episodes. c. Monitoring the frequency and consistency of bowel movements. d. Monitoring urine output and orientation.
Rationale: Crohn's disease is a condition in which the body attacks the lining of the digestive tract, causing pain, diarrhea, weight loss, and fever. Infliximab works by reducing the inflammation in the colon, thereby decreasing diarrhea.Options A, B, and D are not related to this medication.
The nurse is providing discharge teaching for a client with newly diagnosed Crohn's disease about dietary measures to implement during exacerbation episodes. Which statement made by the client indicates a need for further instruction? a. "I should increase the fiber in my diet" b. "I will need to avoid caffeinated beverages" c. "I'm going to learn some stress reduction techniques" d. "I can have exacerbations and remissions with Crohn's disease"
Rationale: Crohn's disease is an inflammatory disease that can occur anywhere in the gastrointestinal tract but most often affects the terminal ileum and leads to thickening and scarring, a narrowed lumen, fistulas, ulcerations, and abscesses. It is characterized by exacerbations and remissions. If stress increases the symptoms of the disease, the client is taught stress management techniques and may require additional counseling. The client is taught to avoid gastrointestinal stimulants containing caffeine and to follow high-caloric and high-containing caffeine and to follow a high calorie and high protein diet. A low-fiber diet may be prescribed, especially during periods of exacerbation.
A client has been given Loperamide hydrochloride (Imodium). Which of the following situation is the medication indicated to? a. Abdominal pain. b. Patients with an ileostomy. c. Bloody diarrhea. d. Acute dysentery.
Rationale: Loperamide hydrochloride is an antidiarrheal agent. It can also be used to reduce the volume of drainage from an ileostomy. Options A, C, and D: It is contraindicated in patients with abdominal pain in the absence of
Which of the following condition can you safely administer Metoclopramide (Reglan)? a. Patient with bowel obstruction. b. Patient with gastrointestinal hemorrhage c. Patient undergoing radiation. d. Patients with pheochromocytoma.
Rationale: Metoclopramide can be safely administered to patients having vomiting episodes following radiation, chemotherapy, and surgery.Options A and B: It is contraindicated in patients with conditions where stimulation of gastrointestinal motility might be harmful, such as mechanical bowel obstruction, bowel perforation, or gastrointestinal hemorrhage. Option D: Hypertensive crises may occur in patients with pheochromocytoma due to induction of catecholamine release from the tumor.
A client has been taking Ibuprofen for some quite time and was given Misoprostol (Cytotec). Which of the following is exhibiting the therapeutic effect of Cytotec? a. Relief of gastric ulcer. b. Relief of diarrhea. c. Relief of vomiting. d. Relief of constipation.
Rationale: Misoprostol (Cytotec) is a synthetic (man-made) prostaglandin that is used to reduce the risk of stomach ulcers in patients treated with nonsteroidal antiinflammatory drugs (NSAIDs, for example, aspirin, ibuprofen, etc.).Option B: Although a side effect, but it is not the intended therapeutic effect. Options C and D are not related to the medication.
A client is prescribed with Omeprazole (Prilosec). The nurse determines that the client is receiving its therapeutic effect if which of the following is stated by the client: a. Relief of nausea and vomiting b. Decrease diarrheal episodes c. The absence of constipation d. Relief from GERD
Rationale: Omeprazole is used to treat symptoms of gastroesophageal reflux disease (GERD) and other conditions caused by excess stomach acid. It is also used to promote healing of erosive esophagitis (damage to your esophagus caused by stomach acid). Options B, C, and D are not related to this medication.
A client is prescribed with Omeprazole (Prilosec). The nurse determines that the client is receiving its therapeutic effect if which of the following is stated by the client: a. Relief of nausea and vomiting. b. Decrease diarrheal episodes. c. The absence of constipation. d. Relief from GERD.
Rationale: Omeprazole is used to treat symptoms of gastroesophageal reflux disease (GERD) and other conditions caused by excess stomach acid. It is also used to promote healing of erosive esophagitis (damage to your esophagus caused by stomach acid).Options B, C, and D are not related to this medication.
4. A client has been given Ondansetron (Zofran). For which condition should the nurse administer this medication to the postoperative patient? a. Vomiting. b. Incisional pain. c. Abdominal infection. d. Atelectasis
Rationale: Ondansetron is used to prevent nausea and vomiting that may be caused by surgery or by medicine to treat cancer (chemotherapy or radiation). Options B, C, and D, are not related to this medication.
A client has been prescribed with Pancrelipase (Pancrease). Which of the following symptoms would prompt the nurse that the medication is having its therapeutic effect if which of the following is noted? a. Negative abdominal pain. b. An absence of constipation. c. An absence of diarrhea. d. Reduction of excess fat in feces.
Rationale: Pancrelipase is used to help improve food digestion in certain conditions (cystic fibrosis, pancreatitis) where the pancreas is not working properly. This medicine minimizes the amount of steatorrhea (fatty stools).Options A, B, and C are not related to this medication.
A client has been prescribed with Pancrelipase (Pancrease). Which of the following symptoms would prompt the nurse that the medication is having its therapeutic effect if which of the following is noted? a. Negative abdominal pain. b. An absence of constipation. c. An absence of diarrhea. d. Reduction of excess fat in feces.
Rationale: Pancrelipase is used to help improve food digestion in certain conditions (cystic fibrosis. pancreatitis) where the pancreas is not working properly. This medicine minimizes the amount of steatorrhea (fatty stools).Options A. B. and C are not related to this medication.
The nurse is monitoring a client with a diagnosis of peptic ulcer. Which assessment finding would most likely indicate proliferation of the ulcer? a. Bradycardia b. Numbness in the legs c. Nauseas and vomiting d. A rigid, boardlike abdomen
Rationale: Perforation of an ulcer is a surgical emergency and is characterized by sudden, sharp, intolerable severe pain beginning in the mid-epigastric area and spreading over the abdomen, which becomes rigid and boardlike. Nausea and vomiting may occur. Tachycardia may occur as hypovolemic shock develops. Numbness in the legs is not an associated finding.
A client has been prescribed with Sucralfate (Carafate) for the treatment of gastric ulcer. The nurse instruct the client that this medication is taken? a. 1 hour before meals. b. 1 hour after meals. c. At the same time with an antacid. d. Lunch time
Rationale: Sucralfate is a gastric protective agent. It works by forming a protective layer on the ulcer to serve as a barrier against acid, bile salts, and enzymes in the stomach. Taken by mouth on an empty stomach at least 1 hour before or 2 hours after eating.Options B and D are incorrect. Option C: Do not take an antacid for at least 30 minutes before or after taking sucralfate.
A client with a duodenal ulcer is diagnosed with H. pylori infection. The physician prescribed Amoxicillin (Wymox), Pantoprazole (Prevacid), and Clarithromycin (Biaxin). Which statement made by the nurse correctly explains the purpose of these medications? a. "These medicines will minimize acid production and will coat the ulcer". b. "These medicines will stop the acid production and will kill the bacteria" c. "The ulcer will heal because the medications will kill the bacteria". d. "These medicines will control the ulcer and motion sickness".
Rationale: The triple therapy treatment of H-pylori infection includes 2 antibiotics (Clarithromycin and Amoxicillin) and one proton pump inhibitor such as omeprazole, lansoprazole, pantoprazole, or esomeprazole.
A client with history of chest pain is admitted to irritable bowel syndrome. As a nurse, which of the following medicines will you least expect to be a part of the medical management? a. Alosetron (Lotronex). b. Tegaserod (Zelnorm). c. Lubiprostone (Amitiza). d. Loperamide (Immodium).
Rationale: The use of tegaserod is restricted to patients with IBS due to the serious cardiovascular adverse effect that may happen such as heart attack and stroke.
1. You're collecting a patient's medication history that has GERD. Which medication below is NOT typically used to treat GERD? a. Colesevelam (Welchol) b. Omeprazole (Prilosec) c. Metoclopramide (Reglan) d. Ranitidine HCL (Zantac)
The answer is A. Options B is a proton-pump Inhibitors (PPIs) and it decreases stomach acid and helps the esophagus heal. Option C is a type of prokinetic drug and prevents delayed gastric emptying by improving pressure in lower esophageal sphincter and it improves peristalsis of the GI tract. Option D is a histamine receptor blocker and it blocks histamine. When histamine is released it causes the parietal cells to release HCL but this response will be blocked so gastric acid secretion will be decreased. Option A is a drug used in gallbladder disease.
The nurse should administer antidiarrheal drugs... a) after each loose bowel movement b) hourly until diarrhea ceases c) with food d) BID, in the AM and at bedtime
a
What is an absolute contraindication to the use of mesalamine (Asacol, Pentasa, Lialda)? a) aspirin allergy b) history of colon cancer c) concurrent use of SSRIs d) COPD
a
Which principle guides care planning for a patient with recurrent nausea and vomiting? a. Antiemetics are more effective when given before the onset of nausea. b. Antiemetics are ineffective in cases of anticipatory vomiting. c. Tolerance to antiemetics develops rapidly. d. Administer one type of antiemetic at a time.
a
A client has begun medication therapy with pancrelipase (Pancrease MT). the nurse evaluates the medication is having the optimal intended benefit if which effect is observed? a. Weight loss b. Relief of heartburn c. Reduction of steatorrhea d. Absence of abdominal pain
c
In which patient would the use of alosetron (Lotronex) be contraindicated? a) a 68-year old woman with a history of GERD b) a 51 year old with heart failure c) a 33 year old with signs of constipation d) a 72 year old with a history of asthma
c
The patient asks how laxatives relieve constipation. Which of the following would be the best response by the nurse? Laxatives relieve constipation by: a) stimulating the walls of the intestine b) promoting the retention of sodium in the fecal mass c) promoting the retention of water in the fecal mass d) lubricating the intestinal walls
c
Which of the following drugs would patient most likely be prescribed if he suffers from only nausea and vomiting? a) omeprazole (Prilosec) b) metoclopramide (Reglan) c) ondansetron (Zofran) d) ranitidine (Zantac)
c
A client has a new prescription for metoclopramide (Reglan). On review of the chart, the nurse identifies that this medication can be safely administered with which condition? a. Intestinal obstruction b. Peptic ulcer with melena c. Diverticulitis with perforation d. Vomiting following cancer chemotherapy
d
