Karch Chapter 56-59

You are teaching your 47-year-old client about omeprazole, which the physician has prescribed as part of a regimen to treat an H. pylori infection. What statement, made by the client, suggests that he understands proper use of the drug?

"I need to swallow the drug whole."

You have finished client education with someone who is going home on bulk-forming laxatives. What statement by your client leads you to believe that he has understood how to use his medication? a) "I will use milk of magnesia in conjunction with this medication until I am having daily bowel movements." b) "I will mix the dry medication with applesauce." c) "I will mix the medication with 4 to 8 ounces of liquid and follow it by an additional 4 to 8 ounces." d) "I will decrease the roughage in my diet while I am using this medication."

"I will mix the medication with 4 to 8 ounces of liquid and follow it by an additional 4 to 8 ounces."

A 60-year-old man has scheduled a follow-up appointment with his primary care provider stating that the omeprazole (Prilosec) which he was recently prescribed is ineffective. The patient states, "I take it as soon as I feel heartburn coming on, but it doesn't seem to help at all." How should the nurse best respond to this patient's statement? a) "Prilosec won't really decrease the sensation of heartburn, but it is still minimizing the damage to your throat and stomach that can be caused by the problem." b) "A better strategy is to take a dose of Prilosec 15 to 30 minutes before meals or drinks that cause you to get heartburn." c) "It could be that Prilosec isn't the right drug for you, so it would be best to talk this over with your care provider." d) "Prilosec will help your heartburn but it's not designed to provide immediate relief of specific episodes of heartburn."

"Prilosec will help your heartburn but it's not designed to provide immediate relief of specific episodes of heartburn."

A 73-year-old woman has scheduled an appointment with her nurse practitioner to discuss her recurrent constipation. The woman states that she experiences constipation despite the fact that she takes docusate on a daily basis and performs cleansing enemas several times weekly. How should the nurse best respond to this patient's statements? a) "Because we become more prone to constipation as we age, you'll likely need to increase the number of stool softeners you take." b) "Taking too many laxatives can make your bowels dependent on them, making you more susceptible to constipation." c) "Try using a different over-the-counter laxative and see that if you resolves your problem." d) "I'll refer you to a specialist because it could be that you have a disease affecting your bowels or stomach."

"Taking too many laxatives can make your bowels dependent on them, making you more susceptible to constipation."

A patient has GERD and is taking ranitidine (Zantac). She continues to have gastric discomfort and asks whether she can take an antacid. Which of the following is an appropriate response by the nurse? a) "I wouldn't advise it. You may experience severe constipation." b) "No, the two drugs will work against each other." c) "Yes, but be sure to wait at least 2 hours to take the antacid after you take the ranitidine." d) "Sure, you may take an antacid with ranitidine."

"Yes, but be sure to wait at least 2 hours to take the antacid after you take the ranitidine."

A client is to start receiving chemotherapy at 10:00 AM. The client has an order for intravenous metoclopramide. The nurse would expect to give the drug at which time? a) 10:15 AM b) 9:00 AM c) 9:30 AM d) 11:00 AM

9:30 AM

Most digestive processes occur in the small intestine. The nurse is reviewing with a client who has had gastrointestinal surgery that these intestinal enzymes are proteins that act as catalysts, which promote and speed up chemical reactions. Based on this information, which enzyme would be the best response from the client about the enzymes that are responsible for facilitating the formation of proteins into amino acids? 1. Pepsin 2. Trypsin 3. Maltase 4. Lactose a) 1, 4 b) 1, 2 c) 2, 3 d) 3, 4

1, 2

The nurse is reviewing with a client the digestive pathway. The steps involved in the digestive pathway are in random order. The nurse asks the client to place them in the correct sequence. Which does the client say are the correct sequences of steps involved in the digestive pathway? 1. The physical breakdown of food is accomplished by the process of mastication 2. The chemical breakdown of food occurs by the release of various enzymes 3. The process of churning the food takes place in the pylorus of the stomach 4. Absorption of the dissolved molecules occurs in the small intestine. The molecules are then taken into circulation 5. Dilution of the food entering the digestive tract is accomplished by water and various enzymes. a) 4, 2, 5, 1, 3 b) 3, 5, 2, 1, 4 c) 2, 4, 3, 5, 1 d) 1, 3, 2, 5, 4

1, 3, 2, 5, 4

The nurse is caring for a client with a hepatic impairment. The nurse knows that the dose of ondansetron should not exceed what amount? a) 12 mg b) 10 mg c) 6 mg d) 8 mg

8 mg

Mr. Tan is a 69-year-old man who prides himself in maintaining an active lifestyle and a healthy diet that includes adequate fluid intake. However, Mr. Tan states that he has experienced occasional constipation in recent months. What remedy should be the nurse's first suggestion? a) Bismuth subsalicylate b) A stimulant laxative c) A bulk-forming (fiber) laxative d) A hyperosmotic laxative

A bulk-forming (fiber) laxative

While discussing the use of laxatives a student asks the nursing instructor what the best indication of normal bowel elimination is. What would be the best response by the instructor? a) "One bowel movement daily after dinner." b) "One bowel movement daily in the morning." c) "A semi-formed stool." d) "A soft formed stool."

A soft formed stool."

Your patient is being sent home with orders for a laxative PRN. You are doing patient teaching on the use of a laxative. What will you inform the patient is one of the most common adverse effects of a laxative? a) Dizziness b) Abdominal cramping c) Headache d) Weakness

Abdominal cramping

When administering a bulk laxative to a client, which of the following actions is important for the nurse to take? a) Administer an anti-diarrheal medication simultaneously. b) Immediately place the client on a bedpan or commode. c) Administer the laxative with a full glass of water or juice. d) Other than standard safety measures, no additional actions are needed.

Administer the laxative with a full glass of water or juice.

A 21-year-old female client has been prescribed metoclopramide for treatment of nausea and vomiting associated with migraines. Which of the following substances should the nurse instruct the client to avoid? a) Folic acid supplements b) Fluids c) Alcohol d) Caffeine

Alcohol

A client is receiving meclizine. The nurse would caution the client to avoid which of the following? a) Aged cheese b) Chocolate c) Alcohol d) Caffeine

Alcohol

Your patient has been a patient on your floor for the past week undergoing diagnostics to determine the cause of his GI disorder. In what ways could his GI condition alter his medications? a) All of these b) Dissolution of medications c) Ingestion of medications d) Metabolism of medications.

All of these

The nurse assists and educates clients about the structure and function of the digestive system. The nurse is reviewing the processes involved during digestion. What is the best explanation the nurse can give the client about the process of peristalsis? a) Alternate contraction and relaxation of muscles that sends food down through the digestive tube b) Process of transferring broken-down food elements into the circulation for transport c) Act of chewing d) Process of swallowing

Alternate contraction and relaxation of muscles that sends food down through the digestive tube

After reviewing the process of secretion, a group of students demonstrate understanding when they identify which pancreatic enzyme as being secreted to break down sugars?

Amylase

Of the following enzymes, which one is responsible for the breakdown of starch? a) Trypsin b) Pepsin c) Amylase d) Lipase

Amylase

Drugs used to treat digestive disorders act on what aspect of the gastrointestinal system? a) Secretion b) Motility c) Absorption d) Any of the above

Any of the above

A nurse is preparing to administer dolasetron orally to a child who is unable to swallow the tablet. The nurse would expect to mix the solution with which of the following? a) Orange juice b) Apple juice c) Grapefruit juice d) Cranberry juice

Apple juice

The anatomy and physiology instructor is discussing the digestion of nutrients. According to the instructor, what substance is required for digestion and absorption of fats and fat-soluble vitamins? a) Saliva b) Bile c) Mucus d) Amylase

Bile

You are teaching a 31-year-old patient about lansoprazole, which the physician has prescribed for treatment of gastric ulcer. By what mechanism of action does lansoprazole help treat the disease? a) By healing damaged cells b) By increasing mucus secretion c) By exerting an antibiotic effect d) By inhibiting acid secretion

By inhibiting acid secretion

A client is receiving a phenothiazine antiemetic. The nurse instructs the client to use the call light if he needs to get out of bed to go to the bathroom based on the understanding that this group of drugs is associated with which of the following? a) Urinary abnormalities b) Central nervous system effects c) Endocrine effects d) Gastrointestinal overstimulation

Central nervous system effects

A nurse is caring for an elderly patient who has been administered cimetidine. Which of the following interventions should the nurse perform? a) Closely monitor the patient for confusion and dizziness. b) Monitor the patient for concentrated urine and restlessness. c) Inform the PHCP if the patient exhibits tardive dyskinesia symptoms. d) Monitor the patient for complaints of pain or sour taste.

Closely monitor the patient for confusion and dizziness.

The nurse is conducting a pre-colonoscopy class and knows that polyethylene glycol- electrolyte solution will be contraindicated for the client with which condition? a) Chronic constipation b) Gastroesophageal reflux disease c) Oral stomatitis d) Colitis

Colitis

A 29-year-old woman has been prescribed alosetron (Lotronex) for irritable bowel syndrome. Before starting the drug therapy, the nurse will advise the patient about which of the following adverse effect(s)? a) Hyperthyroidism b) Breathlessness and hypotension c) Impaired cardiac function d) Constipation

Constipation

The nurse should warn a patient taking aluminum and calcium containing antacids about which of the following adverse effects? (Choose one) a) Constipation b) Dehydration c) Flatulence d) Diarrhea

Constipation

A pediatric patient is receiving chemotherapy. What is the recommended treatment of nausea and vomiting with pediatric chemotherapy agents? a) Prokinetic agents and antihistamines b) Corticosteroids and 5-HT3 receptor antagonists c) Phenothiazines and benzodiazepines d) Proton pump inhibitors and antacids

Corticosteroids and 5-HT3 receptor antagonists

The nurse would expect a client with motion sickness to receive which of the following? a) Perphenazine b) Cyclizine c) Promethazine d) Dolasetron

Cyclizine

You are preparing to administer a stimulant cathartic to your client. What adverse effect of this medication would you inform your client of? a) Vomiting b) Rectal bleeding c) Nausea d) Diarrhea

Diarrhea

A nurse is caring for a patient with pseudomembranous colitis. The physician has prescribed loperamide HCl to the patient. How does the nurse know that the drug has been effective? a) Diarrhea is resolved. b) Nausea and vomiting are resolved. c) Rectal bleeding is noted. d) Elevation in temperature is noted.

Diarrhea is resolved.

Which of the following processes breaks up food into absorbable nutrients? a) Secretion b) Digestion c) Motility d) Absorption

Digestion

The nurse may advise a patient to get which of the following after a myocardial infarction to prevent straining during defecation? (Choose one) a) Lactulose (Cephulac) b) Lubiprostone (Amitiza) c) Psyllium (Metamucil) d) Docusate (Colace)

Docusate (Colace)

When describing the drugs used to treat traveler's diarrhea, which of the following would the nurse identify as the most common cause? a) C. difficile b) E. coli c) Pseudomonas d) Staphylococcus aureus

E. coli

The nurse is conducting a class on nonpharmacologic treatment for occasional constipation. Which treatments will the nurse recommend? (Select all that apply.) a) Use of prebiotics b) Decrease the amount of daily exercise c) Decrease fluid intake d) Use of probiotics e) Eat more high-fiber foods

Eat more high-fiber foods • Use of prebiotics • Use of probiotics

A nurse is providing health education regarding the role of the accessory organs of the digestive system. What is the best explanation by the nurse of the action of bile released by the gallbladder? a) Emulsification of fat b) Synthesis of immunoglobulin c) Breakdown of protein d) Formation of urea

Emulsification of fat

The gastrointestinal system is sterile. a) True b) False

False

Mucus is present throughout the gastrointestinal tract. Which of the following disorders can occur when mucus is not secreted?

Gastric ulceration

High levels of acid in the gastrointestinal (GI) tract decrease the secretion of which of the following enzymes? a) Gastrin b) Trypsin c) Lipase d) Pancrease

Gastrin

Upon stimulation of the chemoreceptor trigger zone, which of the following occurs next? a) Increased salivation b) Decreased acid production c) Increased sweating d) Increased production of mucus

Increased salivation

A male patient is taking cimetidine (Tagamet). Which adverse effect is more likely to occur with cimetidine than with other histamine2 receptor antagonists? a) Seizures b) Gynecomastia c) Hypoxia d) Hypertension

Gynecomastia

The physician has prescribed ranitidine for a patient in your unit. Prior to administering the drug for the first time, which of the following adverse effects should you mention to the patient? a) Headache b) Visual disturbances c) Tremor d) Anxiety

Headache

The nurse is caring for a client who has just had an episode of vomiting. What is the first intervention that the nurse would complete after the client has finished vomiting? a) Go prepare an IM injection of an antiemetic. b) Weigh the client. c) Help the client rinse his mouth. d) Take vital signs.

Help the client rinse his mouth.

Carter, age 2, is diagnosed with cystic fibrosis; the physician places him on pancrelipase. What would be the most appropriate diagnosis for Carter related to his medication regimen? a) Imbalanced nutrition: less than body requirements, related to impaired digestion secondary to insufficient pancreatic enzymes b) Alteration in comfort related to the drug therapy and the adverse effect of a headache c) Alterations in elimination related to the disease process d) Risk for injury related to the side effects of the drug therapy

Imbalanced nutrition: less than body requirements, related to impaired digestion secondary to insufficient pancreatic enzymes

Which adverse reaction of proton pump inhibitors is specific to menopausal women with osteoporosis? a) Abdominal pain b) Diarrhea c) Headache d) Increased fracture risk

Increased fracture risk

The nurse is preparing to administer dexpanthenol to a client based on the understanding that this drug acts in which manner? a) Acting directly on the muscles of the GI tract b) Increasing acetylcholine levels c) Blocking dopamine receptors d) Exerting an osmotic pull on fluids

Increasing acetylcholine levels

In pharmacology class the students are learning about the mechanism of action of different laxatives. What would the students learn about the mechanism of action of psyllium hydrophilic mucilloid? a) Reducing the surface tension of bowel contents b) Irritating the intestinal mucosa, thus increasing intestinal motility c) Increasing mass and water content of stool, promoting evacuation d) Creating a barrier between the colon wall and feces

Increasing mass and water content of stool, promoting evacuation

A 25-year-old patient arrives at the walk-in clinic complaining of vomiting and a burning sensation in the midepigastric region. The nurse suspects that the patient has peptic ulcer disease. Which of the following is a potential cause of peptic ulcer disease? a) Infection with H. pylori b) Excessive worrying c) Decreased stomach acid secretion d) Overconsumption of spicy foods

Infection with H. pylori

A patient is using psyllium hydrophilic mucilloid (Metamucil) to promote evacuation of stool. What is the action of this bulk-forming laxative? a) It irritates the intestinal mucosa, thus increasing intestinal motility. b) It reduces the surface tension of bowel contents. c) It creates a barrier between the colon wall and feces. d) It increases mass and water content of stool, promoting evacuation.

It increases mass and water content of stool, promoting evacuation.

Which of the following best reflects the gastrointestinal system? a) It is one of only a few body systems open to the external environment. b) . c) It plays a major role in waste excretion. d) It is comprised of one continuous, long tube. e) It is subject to high levels of friction with movement.

It is comprised of one continuous, long tube.

You are interviewing the latest admission to your GI floor. The patient requests a magnesium citrate "cocktail" every night to "keep her regular." Her request is evidence of potential: a) Anorexia. b) Laxative abuse. c) Constipation. d) Normal colon function.

Laxative abuse.

Which of the following is a common cause of diarrhea in older adults? a) Glaucoma b) The normal aging process c) Laxative overuse d) Poor muscle tone

Laxative overuse

Which of the following is the correct rationale for why the nurse would administer a laxative at a separate time from the client's other medications? a) They often taste bad and clients are less likely to take other medications. b) Often laxatives make the client nauseated, which interferes with the ability to take medications. c) Because a laxative may stimulate a bowel movement, it can interfere with medication administration. d) Laxatives may reduce absorption of other drugs present in the GI tract.

Laxatives may reduce absorption of other drugs present in the GI tract.

The vomiting reflex is stimulated by two centers in which structure of the brain? a) Reticular activating system (RAS) b) Medulla c) Pons d) Limbic system

Medulla

Which part of the brain is responsible for autonomic functioning such as ventilation, cardiac conduction, and vomiting? a) Tegmentum b) Pituitary gland c) Medulla oblongata d) Pineal gland e) Hypothalamus

Medulla oblongata

Different medications are used to treat the differing causes of nausea and vomiting. Antihistamines may be effective in the treatment of nausea and vomiting created by: a) Drugs. b) Motion sickness. c) Radiation therapy. d) Surgery.

Motion sickness.

Which structure would be identified as being responsible for the initiation of digestion? a) Mouth b) Small intestine c) Stomach d) Pancreas

Mouth

Which of the following layers of the gastrointestinal (GI) tract has an epithelial component and a connective tissue component? a) Nerve plexus b) Mucosal c) Adventitia d) Muscularis mucosa

Mucosal

Which layer of the gastrointestinal tract is innermost? a) Mucosal layer b) Adventitia c) Muscularis layer d) Nerve plexus layer

Mucosal layer

A patient has been diagnosed with a gastric ulcer. Within the gastrointestinal tract, what secretion protects the esophagus from the development of ulcerations? a) Hydrochloric acid b) Gastrin c) Pepsin d) Mucus

Mucus

Ingesting prescribed medication can result in allergic reactions and adverse effects. What are the most common adverse effects of drug therapy? a) Elevated temperature and rash b) Nausea and elevated temperature c) Elevated temperature and vomiting d) Nausea and vomiting

Nausea and vomiting

Which of the following best describes the action of sodium bicarbonate? a) Facilitate swallowing b) Stomach muscle contraction c) Neutralize the acid bolus d) Breakdown of proteins

Neutralize the acid bolus

A nurse is reviewing information about proton pump inhibitors. The nurse recognizes that which of the following is available as an over-the-counter agent? a) Lansoprazole b) Rabeprazole c) Omeprazole d) Esomeprazole

Omeprazole

After teaching a group of students about proton pump inhibitors, the instructor determines that the students have understood the information when they identify which agent as the prototype proton pump inhibitor? a) Lansoprazole b) Pantoprazole c) Esomeprazole d) Omeprazole

Omeprazole

The nurse is preparing to administer cascara to a client. The nurse anticipates administering this drug by which route? a) Oral b) Rectal, via suppository c) Intramuscular d) Rectal, via enema

Oral

Your patient, a 35-year-old man who works on the stock exchange, is at his follow-up visit for GERD. Antacids have not been effective for his reflux, and the physician is prescribing a proton pump inhibitor. Why might he prescribe a PPI, rather than an H2RA? a) None of these b) PPIs suppress acid more gently and for a longer time. c) PPIs suppress acid more strongly and for a shorter time. d) PPIs suppress acid more strongly and for a longer time.

PPIs suppress acid more strongly and for a longer time.

A 22-year-old male exercises by swimming laps. Which organ secretes enzymes responsible for the digestion of carbohydrates to provide energy?

Pancreas

A nursing student is very nervous before her final nursing examination. She states that her stomach is burning. What body system is responsible for this physiological response?

Parasympathetic nervous system

Which substance is secreted by the chief cells of the stomach? a) Hydrochloric acid b) Bile c) Gastrin d) Pepsin

Pepsin

A patient is taking nonsteroidal anti-inflammatory agents for arthritis of the knees and hips. Which of the following diseases is a result of cellular destruction of the gastrointestinal tract from this medication? a) Liver cancer b) Esophageal cancer c) Bowel obstruction d) Peptic ulcer disease

Peptic ulcer disease

When describing the process used by the esophagus for motility, which of the following would the nurse include? a) Churning b) Segmentation c) Peristalsis d) Mass movement

Peristalsis

A patient who has been experiencing liquid stools is prescribed polycarbophil (FiberCon). What is the reason for administering a bulk-forming laxative? a) Polycarbophil absorbs large amounts of water and decreases fluidity of stools. b) Polycarbophil will provide pain relief and decrease cramping and bloating. c) Polycarbophil will diminish the absorption of intestinal fiber and water. d) Polycarbophil will increase bile and diminish bacterial flora in the intestines.

Polycarbophil absorbs large amounts of water and decreases fluidity of stools.

Your client is scheduled for a colonoscopy in the morning. What laxative would you expect to be prescribed the evening before the procedure? a) Psyllium b) Polyethylene glycol-electrolyte solution c) Castor oil d) Lactulose

Polyethylene glycol-electrolyte solution

Each end of the esophagus acts as a sphincter. What is the function of the lower esophageal sphincter?

Preventing gastric reflux Explanation: The lower esophageal sphincter prevents reflux of acidic gastric contents into the esophagus. The upper esophageal sphincter prevents air from entering the esophagus during inspira... Reference: Karch, A.M. Focus on Nursing Pharmacology, 6th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2013, Chapter 56: Introduction to the Gastrointestinal System, p. 952. Karch, A.M. Focus on Nursing Pharmacology, 5th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2011, Chapter 56: Introduction to the Gastrointestinal System, p. 908.

A postoperative pediatric patient is experiencing nausea and vomiting. What is the antiemetic drug of choice in children? a) Buclizine (Bucladin-S) b) Cyclizine (Marezine) c) Benzquinamide (Emete-Con) d) Promethazine (Phenergan)

Promethazine (Phenergan)

Although excessive mucus secretion can be problematic, mucus is secreted by glands in every part of the GI tract. Which of the following are functions of mucus? Select all that apply. a) Increase secretion of acids and bases b) Protect GI tract lining from digestive fluids c) Decrease adherence of fecal mass d) Promote adherence of fecal mass

Promote adherence of fecal mass Protect GI tract lining from digestive fluids

An 85-year-old patient is administered an antiemetic agent. Which of the following is an important nursing intervention? a) Protect from injury b) Have the patient void after administration c) Force fluids with this patient d) Maintain IV access

Protect from injury

When describing the action of saliva, which of the following would be included? a) Stimulation of the cephalic phase of digestion b) Protection of the oral mucous membranes c) Early absorption of nutrients d) Increase the secretion of gastrin

Protection of the oral mucous membranes

Which of the following best reflects the rationale for using histamine-2 receptor antagonists for stress ulcer prophylaxis? a) Decreases the acid being regurgitated into the esophagus b) Reduces the overall acid level, promoting healing and comfort c) Protects the stomach lining via acid blockage d) Blocks the overproduction of hydrochloric acid

Protects the stomach lining via acid blockage

A female client presents to the physician's office with increasing stomach acidity. She self-administers calcium antacids. She notes that she seems to be having more issues with stomach acid, so she has been taking the calcium antacids more frequently. The nurse suspects that this may have caused what to occur in this client? a) Hyperactive gastric mucosa b) Rebound acidity c) Gastric reflux d) Hypocalcemia

Rebound acidity

Ranitidine is a histamine2 receptor antagonist (H2RA) prescribed for treatment of peptic ulcer disease and gastric reflux. Dosage of ranitidine must be reduced in patients with what condition? a) Migraine headaches b) Renal disease c) Diabetes mellitus d) Pulmonary disease

Renal disease

The patient has Maalox ordered for administration before meals. Which of the following conditions is contraindicated with the administration of Maalox? a) Renal dysfunction b) Hypertension c) Heart rate of 68 d) Stress ulcer

Renal dysfunction

A nurse is caring for a patient who is prescribed omeprazole for a duodenal ulcer. The patient is also taking benzodiazepines for the management of a seizure disorder. Which of the following should be the effect of the interaction between these two drugs? a) Increased risk of respiratory depression b) Decreased absorption of the proton pump inhibitor c) Risk for toxic level of benzodiazepines d) Increased risk of bleeding

Risk for toxic level of benzodiazepines

Which of the following begins the digestive process? a) Esophagus b) Stomach c) Saliva d) Tongue

Saliva

A female client is going on a cruise to Nova Scotia with her husband to celebrate their 15th wedding anniversary. She is concerned because she has experienced severe, debilitating seasickness in the past. What would the nurse expect the physician to order? a) Palonosetron b) Dexamethasone c) Ondansetron d) Scopolamine

Scopolamine

Which of the following would the nurse anticipate to be used for the prevention of nausea from motion sickness? Select the best answer. a) Scopolamine (Transderm Scop) b) Phosphorated carbohydrate solution (Emetrol) c) Dronabinol (Marinol) d) Benzodiazepines

Scopolamine (Transderm Scop)

To be able to provide optimal care to clients with problems involving digestion, a nurse needs to understand the functions performed by various organs of the digestive system. What is a function of the pancreas that the nurse needs to know to help explain the pathology of the pancreas to a client? a) Stores fat-soluble vitamins (vitamins A, D, E, K) and iron b) Stores glucose as glycogen c) Secretes the hormones insulin, glucagon, and somatostatin into the bloodstream d) Forms vitamin A; stores vitamin B complex

Secretes the hormones insulin, glucagon, and somatostatin into the bloodstream

The nurse is tracing the digestive pathway for a group of nursing students. The nurse educator is reviewing the major organs of the gastrointestinal tract and the function of each. Based on information provided, what is the correct response by the student nurse of the function of the salivary gland of the gastrointestinal tract? a) It senses the temperature and texture of food and is also involved with the mixing of food with saliva b) Contraction results in continuation of the act of swallowing and pushes the food into the esophagus c) Secretion helps in moistening the food, making it easier to swallow and preventing oral infections d) Food is mixed with gastric juices and churned until it is in a semiliquid form called chyme

Secretion helps in moistening the food, making it easier to swallow and preventing oral infections

Ondansetron (Zofran) belongs to which pharmacological category of medications? a) Selective 5-HT3 receptor antagonist b) Prokinetic c) Anticholinergic d) Dopamine receptor antagonist

Selective 5-HT3 receptor antagonist

Your patient arrives at his sick call reporting chronic abdominal pain. Having a 40-pack year history, he reports his smoking has decreased to approximately ½ pack/day. The physician, after thorough assessment and evaluation and labs, prescribes a treatment regimen for duodenal ulcer. What important teaching would you include in relation to treatment? a) General health dangers of smoking b) Only take the medication when experiencing stomach pain c) Smoking's effects on healing d) Take the medication until feeling better

Smoking's effects on healing

The large intestine absorbs most water and which electrolyte? a) Potassium b) Sodium c) Calcium d) Magnesium

Sodium

Throughout the GI tract, various mechanisms protect mucosal linings from the digestive properties of gastric juices. What substance protects the pancreas? a) Secretin b) Sodium bicarbonate c) Pepsin d) Gastrin

Sodium bicarbonate

Which of the following occurs first when pressure receptors in the back of the throat and pharynx send impulses to the medulla to stimulate nerves? a) Soft palate elevates b) Larynx rises c) Pharyngeal constrictor muscles contract d) Glottis closes

Soft palate elevates

A hospice patient is receiving opioids for treatment of cancer pain. Which laxative will assist in the prevention of constipation? a) Lactulose (Cephulac) b) Saline c) Stimulant d) Bulk-forming

Stimulant

When describing the reflexes of the GI tract, which of the following would be identified as a central reflex?

Swallowing

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) Diarrhea will be controlled through the use of the drug. b) Within 2 to 3 hours of using the drug, the patient will experience a decrease in abdominal pain and distention. c) The patient will have a bowel movement after taking the drug. d) The patient will not sustain injury from drug therapy.

The patient will have a bowel movement after taking the drug.

In which of the following scenarios would the nurse question the order for ondansetron (Zofran)? a) Prevention of nausea and vomiting from chemotherapy b) Treatment of nausea and vomiting as a result of chemotherapy c) Treatment of gastroesophageal reflux d) Prevention of postoperative nausea or vomiting

Treatment of gastroesophageal reflux

The gastrointestinal system is responsible for a fairly small part of waste excretion. a) False b) True

True

The peritoneum lines the abdominal wall and viscera. a) True b) False

True

The use of calcium carbonate is associated with the development of acid rebound. a) True b) False

True

A patient is administered an antihistamine for nausea. Which of the following is an adverse effect of this classification of medication? a) Inverted T wave b) Urinary retention c) Prolonged QRS complex d) Urinary incontinence

Urinary retention

The nurse is caring for a male client who has benign prostatic hypertrophy. The nurse would be alert for what complication if this client is given promethazine for treatment of nausea? a) Urinary retention b) Hematuria c) Dysuria d) Polyuria

Urinary retention

A 30-year-old nonpregnant patient is prescribed misoprostol. Which of the following should the nurse instruct the patient as part of the teaching plan? a) Use a reliable contraceptive. b) Swallow the tablet one hour before eating. c) Administer the drug one hour before travel. d) Do not chew, open, or crush the tablet.

Use a reliable contraceptive.

A 23-year-old female patient is prescribed misoprostol (Cytotec). Which of the following patient teaching interventions is most important? a) Supplement therapy with magnesium antacids b) Report postmenopausal bleeding c) Administer the drug one time per day d) Use effective contraceptive measures

Use effective contraceptive measures

Which of the following would facilitate the swallowing reflex? a) Applying heat to the tongue b) Providing foods of similar temperature c) Turning the head to one side d) Using different textured foods

Using different textured foods

After teaching a group of students about the reflexes involved in the gastrointestinal tract, the instructor determines that the teaching has been successful when the students identify which of the following as a central reflex? a) Gastroenteric b) Ileogastric c) Somatointestinal d) Vomiting

Vomiting

You are teaching your 57-year-old client about metoclopramide, which the physician has prescribed to control nausea. What statement, made by your client, suggests that he understands what you have taught? a) "I shouldn't drink alcohol while I'm taking this medication." b) "I should take this medication only after I start to feel nauseated." c) "I should adjust my dose based on how nauseated I feel." d) All the above statements suggest appropriate understanding.

a) "I shouldn't drink alcohol while I'm taking this medication."

A major physiologic function of the gastrointestinal system is to: a) act as a conduit for the passage of food from the pharynx to the stomach b) produce the factors needed for blood clotting c) absorb nutrients into the bloodstream d) serve as a food storage reservoir

absorb nutrients into the bloodstream

The nursing instructor is teaching students about proper administration of sucralfate. According to the instructor, sucralfate should be administered a) with an antacid. b) with meals. c) an hour before meals. d) immediately after each meal.

an hour before meals.

A patient has been administered metoclopramide (Reglan) for nausea. Which of the following statements indicates that she has understood the teaching provided by the nurse? a) "I should eat before I take this medication." b) "When I have episodes of nausea, I will drink clear liquids." c) "I may experience drowsiness with this medication." d) "I will need to take potassium with this medication."

c) "I may experience drowsiness with this medication."

A client receiving chemotherapy has begun receiving aprepitant. The client also takes oral contraceptives. What should the nurse tell the client in regard to birth control? a) "There is no need to do anything; your oral contraceptive will continue to be effective." b) "You should practice abstinence because the aprepitant will cause severe sores in the vagina." c) "Use alternative means of birth control for 1 month after taking aprepitant." d) "Double the dose of the oral contraceptive while you are taking aprepitant."

c) "Use alternative means of birth control for 1 month after taking aprepitant."

A patient is scheduled for a colonoscopy in the morning. Which laxative is most likely prescribed the evening before the colonoscopy? a) Psyllium (Metamucil) b) Castor oil c) Lactulose (Cephulac) d) Polyethylene glycol-electrolyte solution (NuLYTELY)

d) Polyethylene glycol-electrolyte solution (NuLYTELY)

Ranitidine and cimetidine are both H2RAs used in the treatment of peptic ulcer disease. Of the two, ranitidine is preferred in critically ill clients because it is less likely to a) cause diarrhea. b) cause macular rash and cough. c) interfere with the metabolism of other drugs. d) result in hypotension.

interfere with the metabolism of other drugs.

When auscultating bowel sounds on a client who has had abdominal surgery, the nurse finds that they are absent. The nurse interprets this as indicating a disruption in which of the following?

intestinal-intestinal reflex

Your 32-year-old patient tells you that he takes antacid tablets several times each day. Knowing that the brand of antacid he uses contains calcium carbonate, you caution the patient that overuse could place him at risk for a) hypercholesterolemia. b) metabolic acidosis. c) metabolic alkalosis. d) hypocalcemia.

metabolic alkalosis.

A 52-year-old man is suffering from a deficiency of exocrine pancreatic secretions and is prescribed pancrelipase (Pancrease MT). Before the medication therapy begins, the nurse will assess for allergies related to a) pollen. b) ragweed. c) shellfish. d) pork.

pork

Metoclopramide is classified as a nonphenothiazine antiemetic. a) False b) True

true

Pancrelipase would most likely be used to treat a patient with cystic fibrosis. a) True b) False

true

Choice Multiple question - Select all answer choices that apply. Which of the following are activities of the gastrointestinal (GI) system? Select all that apply. a) Digestion b) Absorption c) Respiration d) Motility e) Secretion

• Absorption • Digestion • Motility • Secretion Correct

The nurse is aware that critically ill clients are more at risk for constipation for what reasons? (Select all that apply.) a) Increased access to a high-fiber diet b) Decreased activity c) Decrease in the amount of family interaction d) Use of opioid medications e) Change in bowel routines

• Decreased activity • Use of opioid medications • Change in bowel routines

A patient develops significant nausea and vomiting related to antineoplastic chemotherapy. Which of the following agents would be most appropriate to use in this situation? Select all that apply. a) Hydroxyzine b) Aprepitant c) Nabilone d) Dolasetron e) Granisetron

• Dolasetron • Granisetron • Aprepitant • Nabilone

Which of the following should be included in client teaching as a means of avoiding constipation? Select all that apply. a) Eat foods high in bulk or roughage. b) Avoid defecating when the urge occurs. c) Drink plenty of fluids. d) Be active and exercise daily. e) Take an opioid pain medication daily.

• Eat foods high in bulk or roughage. • Drink plenty of fluids. • Be active and exercise daily.

An instructor is preparing a teaching plan for a group of students about the structures of the GI tract. Which of the following would the instructor include as an accessory organ? Select all that apply. a) Esophagus b) Liver c) Small intestine d) Pancreas e) Gall bladder

• Pancreas • Liver • Gall bladder

Choice Multiple question - Select all answer choices that apply. An instructor is describing the action of pancreatic enzymes on substances. Which of the following would the instructor include as being acted on by these enzymes? Select all that apply. a) Sugars b) Proteins c) Fats d) Acids e) Calcium

• Sugars • Proteins • Fats

Which substances are primarily absorbed by the large intestine? (Select all that apply.) a) Vitamins b) Water c) Sodium d) Alcohol e) Drugs

• Water • Sodium