PHARM QUIZ 6 GI TRACT

A nurse is caring for an elderly patient who has been administered cimetidine. Which intervention should the nurse perform?

Closely monitor the patient for confusion and dizziness.

Most of the nutrients absorbed from the GI tract pass immediately into the portal venous system and are processed by the liver. This is possible because almost all absorption occurs through

the small intestine

T / F Pancrelipase would most likely be used to treat a patient with cystic fibrosis.

true

T / F Metoclopramide is classified as a nonphenothiazine antiemetic.

true

T / F : The stomach has three muscle layers, one running horizontally, one running circularly, and one running obliquely

true

A client, prescribed an antihistamine for nausea, should be monitored for which adverse effect of this classification of medication?

urianary retention

A client, prescribed an antihistamine for nausea, should be monitored for which adverse effect of this classification of medication?

urinary retention

why are PPI's better than H2 ?

stronger/faster healing, suppress acid more, last longer

Most antiemetics work with the CNS to decrease the activity of

the chemoreceptor trigger zone

A nurse is teaching a client about omeprazole, which has been prescribed as part of a regimen to treat an H. pylori infection. What statement, made by the client, suggests that the client understands proper use of the drug?

"I need to swallow this drug whole"

Which statement by a client leads the nurse to believe that the client understands how to safely and effectively use bulk-forming laxatives?

"I will mix the medication with around a cup of fluid and then drink the mixture."

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?

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

When considering the tendency of antiemetic agents to cross the placenta, which assessment question should the nurse initially ask every childbearing aged woman before initiating the therapy?

"are you pregnant ?"

After teaching a client who is receiving sucralfate about the drug, which statement indicates that the teaching has been successful?

"i should eat a high fiber diet"

A client is undergoing a course of radiotherapy for the treatment of leukemia. Treatments in the past have caused the client severe nausea and vomiting. The oncology nurse should normally administer antiemetics on what schedule?

30 to 60 minutes before the treatment

A nurse might expect an order for mineral oil for which patient?

A patient with hemorrhoids A patient with recent rectal surgery A child with encopresis

A nurse is caring for a patient with intestinal stenosis who has been prescribed psyllium. During the course of the treatment, the patient shows the signs of colon obstruction. What intervention should the nurse perform to avoid the occurrence of colon obstruction?

Administer the drug with adequate fluid intake.

Nursing interventions for the client receiving an antiemetic drug would include which of the following

Frequent mouth care Protection from falls or injury Fluids to guard against dehydration Protection from sun exposure Quiet environment and temperature control

Drugs that stimulate parasympathetic activity are used to increase GI activity and secretions. For which of the following would this group be most likely used?

Gastroesophageal reflux disease (GERD)

Which of the following instructions would be most appropriate to give to a patient to reduce the risk of photosensitivity related to the use of antiemetic agents?

Wear protective clothing when in the sun

A nurse taking care of a patient who is receiving a proton pump inhibitor should teach the patient to

swallow tablets or capsules whole.

After teaching a group of students about GI activity and constipation the instructor determines that the teaching was successful when the students state which of the following about constipation?

It can be artificially induced by increasing the volume of the large intestine.

The nurse anticipates that prochlorperazine (Compazine) would be the antiemetic of choice for which of the following?

Nausea and vomiting after anesthesia

Which H2 antagonist would the nurse expect to be ordered for a patient with known liver dysfunction?

Nizatidine

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?

Omeprazole prilosec

Acid production in the stomach is stimulated by what 4 things ?

Protein in the stomach Calcium products in the stomach Alcohol in the stomach Low levels of acid in the stomach H2 stimulation

A client is being sent home with orders for a laxative PRN. The nurse is conducting client teaching on the use of a laxative. What will the nurse inform the client is one of the most common adverse effects of a laxative?

abdonimal cramping

The CTZ in the brain is activated by what 5 things ?

Stretch of the uterus Stretch of the bladder Decreased GI activity Cell death Extreme pain

Patients who use antacids frequently can be expected to experience which of the following adverse effects?

Systemic alkalosis Electrolyte imbalances Hypokalemia Constipation or diarrhea Muscular weakness

Which intervention has priority when caring for an older adult client who has been prescribed a phenothiazine for reported nausea?

The client is identified as a possible falls risk

A nurse is preparing a teaching plan for a client who has been prescribed a laxative. The teaching plan should include which of the following?

The importance of proper diet and fluid intake The importance of exercise The need to take advantage of natural reflexes by providing privacy and time to allow them to work A patient with Crohn's disease

What would a nurse include when describing the action of H2 antagonists to a patient?

They selectively block specific histamine receptor sites, leading to a reduction in gastric acid secretion

what does gastrin do ?

stimulates acid secretion in the stomach

When explaining the actions of laxatives to a client the nurse would state that they can work by

acting as chemical stimulants. acting as lubricants of the intestinal bolus. acting to increase bulk of the intestinal bolus and stimulate movement.

A nurse is caring for a patient with intestinal stenosis who has been prescribed psyllium. During the course of the treatment, the patient shows the signs of colon obstruction. What intervention should the nurse perform to avoid the occurrence of colon obstruction?

administer the drug with adequate fluid intake

when taking meclizine, the patient should avoid..

alcohol

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

sulcrafate should be administered when ?

an hour before meals

How should the critical care nurse most accurately titrate the dose and frequency of administration of an intragastric drip of an antacid through a nasogastric tube?

aspirating stomach contents and measuring PH

An antacid has been added to the treatment regimen for a client on multiple medications. When is the best time for the nurse to administer the antacid?

at bedtime

A client is taking bisacodyl to treat constipation. The nurse suggests that the client take the drug at which time?

before going to bed

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?

bile

The drug of choice for treating/preventing traveler's diarrhea is

bisacodyl

The laxative of choice when mild stimulation is needed to prevent straining is

bisacodyl

Because of the possible adverse effects of long-term proton pump inhibitor (PPI) use, the nurse practitioner should focus on what assessment in a 72-year-old client?

bone density

The 5-HT3 receptor blockers, including ondansetron (Zofran) and granisetron (Kytril), are particularly effective in decreasing the nausea and vomiting associated with

cancer chemotherapy

The nurse would monitor a patient receiving IV cimetidine (generic) for an acute ulcer problem for

cardiac arrhythmias

When reviewing a newly admitted client's previous medication record, the nurse notes that the client has previously been treated with aprepitant. The nurse is justified in suspecting that this client's medical history includes which therapy/treatment?

chemotherapy

Cathartic dependence can occur when

chronic laxative use leads to a reliance on the intense stimulation of laxatives

An older adult's has been taking a calcium-based antacid on an increasingly frequent basis. When teaching this client, the nurse should include suggestions for the prevention of which adverse effect?

constipation

The nurse should warn a client taking aluminum- and calcium-containing antacids about which adverse effects?

constipation

The presence of fat in the duodenum causes

contraction of the gallbladder.

What is the benefit of adding proton pump inhibitors (PPIs) to the treatment regime treating an H. pylori bacterial infection?

decreased production of gastric secretions

The nurse explains that there is no "normal" number of daily stools because of differences in what contributing factor?

diet

When describing the drugs used to treat traveler's diarrhea, which would the nurse identify as the most common cause?

e coli

The nurse should prioritize what assessment when providing care for a client who has taken over-the-counter (OTC) bisacodyl daily for several months?

electrolyte levels

T / F saliva substitute is absorbed systemically

false

T / F : the Gi tract is sterile

false

When describing the action of pancreatic digestive enzymes in breaking down substances, which substances would the instructor include?

fats, proteins, sugars, lipids

A parent calls with concerns that a 2-year-old child ate a bottle full of baby aspirin. The nurse would advise the parent to

force fluids as the parent brings the child in for evaluation

A patient has mucus present throughout the gastrointestinal tract. Which disorder can occur when mucus is not secreted?

gastric ULCERATION

A client receiving cancer chemotherapy has been prescribed aprepitant for nausea. The nurse should instruct the client to avoid which liquid?

grapefruit juice

Which adverse effect is more likely to be caused by cimetidine than by other H2RAs?

gynecomastia

A nurse educating a client on the antacid calcium carbonate (Mylanta) should warn the client of which of the following adverse reactions ?

headache, confusion, rebound hyperacidity

The nurse should be aware that the combination of omeprazole and warfarin creates a risk of what adverse reaction?

hemorrhage

What type of laxative would be the first choice for a client diagnosed with hemorrhoids experiencing intense pain when straining to pass stools?

stool softener

what assessment contradicts the use of an antiemetic agent ?

history of chronic liver dysfunction

The nursing instructor is teaching students about proper administration of sucralfate. According to the instructor, sucralfate should be administered:

hour before meals

A client would experience what sign/symptom if their salivary glands were dysfunctional?

impaired swallowing

H2 receptors are found throughout the body, including

in the heart, CNS, and stomach.

Which adverse reaction of proton pump inhibitors is specific to menopausal women with osteoporosis?

increased fracture risk

Which would be most important for the nurse to do when administering a phenothiazine antiemetic to a patient?

institute safety precautions

what is the role of bile ?

it is essential for the breakdown and absorption of fats

A hospitalized client's request for a magnesium citrate "bisacodyl pill" every night to "keep regular" should alert the nurse to what potential health risk for the client?

laxative abuse

What is a common cause of diarrhea in older adults?

laxative overuse

What is the correct rationale for why the nurse would administer a laxative at a separate time from the client's other medications?

laxatives could reduce absorption of other drugs in the GI tract

When explaining the control of the activities of the GI tract—movement and secretion—the nurse would be most accurate to state that the GI is basically controlled by

local nerve reflexes of the GI nerve plexus.

Acid rebound is a condition that occurs when

lowering gastric acid to an alkaline level stimulates the release of gastric acid.

A client develops labyrinthitis. What would the nurse expect the health care provider to order?

meclizine antivert antihistamine and anticholinergic

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:

motion sickness

the structure that is responsible for initiation of the digestive system is the..

mouth

Which layer of the gastrointestinal (GI) tract provides its inner lining?

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?

mucus

what is the action of sodium bicarbonate ?

neutralize the acid bolus

In explaining the importance of the pancreas to a student nurse the instructor would explain that the pancreas does what..

neutralizes the hydrochloric acid secreted by the stomach.

What antiemetic is the most common first-line drug for the treatment of postoperative nausea and vomiting?

odansetron zofran

A client is diagnosed with peptic ulcer due to H. pylori. The nurse would anticipate administering which agent in conjunction with an antibiotic?

omeprazole

What drug would a nurse expect as most likely to be used in combination with antibiotics for treatment of Helicobacter pylori infection?

omeprazole prilosec

What substance is secreted into the small intestines to facilitate the digestion of sugars, proteins and fats

pancreatic enzyme

An older client has been prescribed a proton pump inhibitor. When addressing the medication's effect on nutrient absorption and the resulting risks, which medical condition should the nurse discuss with the client?

pernicious anemia

Misoprostol (Cytotec) is a prostaglandin that is used to

prevent NSAID-related gastric ulcers in patients at high risk

A client has a magnesium-based antacid prescribed for administration as needed. Which condition contraindicates the administration of this classification of medications?

renal dysfunction

Which substance is responsible for making the food bolus slippery?

saliva

_________ begins the digestive process

saliva

The basic type of movement that occurs in the small intestine is

segmentation.

A nurse caring for a patient receiving pancreatic enzymes as replacement therapy should be assessing the patient for

signs of GI irritation

The absorption of most nutrients occurs in which part of the digestive system?

small intestine

The large intestine absorbs mostly water and which electrolyte?

sodium

Laxatives are drugs that are used to

speed the passage of the intestinal contents through the GI tract.

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 what as a central reflex?

vomiting

What is the removal of possibly toxic substances triggered by the medulla called?

vomiting