ATI The Gastrointestinal System Test

When administering sulfasalazine (Azulfindine) to a patient, the health care professional should check which of the following to help identify an adverse effect of the drug?

-Skin integrity (Sulfasalazine, a 5-aminosalicylate, is unlikely to affect level of consciousness. Metoclopramide, a dopamine antagonist, is a GI-system drug that can cause sedation.) -Temperature (Sulfasalazine can cause a fever, so the nurse should check the client's temperature and treat fever with an antipyretic.) -CBC (Sulfasalazine can cause hematologic disorders, such as agranulocytosis and hemolytic and macrocytic anemia. The nurse should check the client's CBC periodically during therapy and tell the client to report sore throat or fatigue.)

A health care professional should question the use of misoprostol (Cytotec) for a patient who has which of the following?

A positive pregnancy test (Misoprostol, a prostaglandin E1 analog, is a teratogenic drug. It can cause uterine contractions and induce spontaneous abortion; therefore, providers must confirm that clients are not pregnant before prescribing the drug; and clients who take misoprostol must use contraception.)

A nurse is caring for a client who is taking allopurinol to treat gout and has a new prescription for Azathioprine to treat ulcerative colitis. For which of the following reasons should the nurse clarify these prescriptions with the provider?

Allopurinol delays the conversion of azathioprine and can lead to toxicity. (Allopurinol delays the conversion of azathioprine to an inactive form and can lead to toxicity. If used concurrently, the dose of azathioprine must be reduced.)

which of the following drugs has protocols that require patients to meet specific risk management criteria and sign a treatment agreement before the health care professional can administer the drug?

Alosetron (Lotronex) (Clients who take alosetron, a serotonin 5-HT3 receptor antagonist, can develop severe constipation that can lead to impaction, bowel obstruction, perforation, and potentially fatal ischemic colitis. Because of these risks, nurses must inform clients of the benefits and risks of the drug therapy, and clients must sign a treatment agreement.)

A primary care provider who is considering the various pharmacologic options for a patient who has peptic ulcer disease should understand that which of the following drugs require monitoring of the patients phosphorus levels?

Aluminum hydroxide (Amphoral) (Antacids that contain aluminum, such as aluminum hydroxide, can cause hypophosphatemia because of aluminum's ability to bind with phosphate and decrease its absorption. The nurse should monitor the client's phosphorus levels while administering this drug.)

A health care professional should question the use of dimenhydrinate for a patient who has which of the following disorders?

Angle-closure glaucoma

A health care professional is caring for a patient who is about to begin taking ranitidine (Zanatac) to treat GERD. The health care professional should tell the patient to take certain precautions like to wait 1 hour between taking ranitidine and which of the following over the counter drugs?

Antacids (Antacids can decrease the absorption of ranitidine, a histamine2-receptor antagonist. The nurse should instruct the client to wait at least 1 hr between taking ranitidine and taking an antacid.)

The nurse is talking with a patient about taking loperamide (Imodium) the health care professional should include which of the following instructions?

Avoid activities that require alertness (Loperamide, an opioid agonist, can cause sedation and dizziness. The nurse should instruct the client to avoid taking it before activities that require alertness.)

A nurse is planning teaching for a client who has been prescribed loperamide to treat diarrhea. Which of the following statements should the nurse plan to include?

Avoid driving or activities requiring alertness. (Loperamide can cause drowsiness and dizziness. The client should avoid driving or activities requiring alertness while taking the drug.)

A health care professional is caring for a patient who is about to begin taking azathioprine (Imran) to treat inflammatory bowel disease. The health care professional should tell the patient to report which of the following adverse effects ?

Bruising Jaundice Sore throat Nausea

Which talking with a patient about taking metoclopramide (Raglan) to treat GERD, the health care professional should include which of the following instructions?

Chew gum or suck on hard candy

When talking with a patient about taking lubiprostone (Amitiza) the health care professional should tell the patient not to take the drug if he has which of the following?

Diarrhea

A health care professional should question the use of metoclopramide (Raglan) for a patient who is taking which of the following drugs?

Digoxin (Lanolin)

A health care professional is assessing a client who was administered ondansetron (Zoran) IV 1 hr ago. Which of the following findings is an adverse effect of this drug?

Dizziness

A nurse is caring for a client who is taking allopurinol to treat gout. The nurse should monitor the client for which of the following manifestations of hypersensitivity syndrome?

Fever

A nurse is teaching a client who has a new prescription for methotrexate. The nurse should instruct the client to monitor for manifestations of which of the following conditions?

Gout (An adverse effect of methotrexate is hyperuricemia, which causes gout. The nurse should instruct the client to drink plenty of fluids to minimize this effect, and to report edema or pain in the joints.)

A health care professional should question the use of diphenoxylate/atropine (Lomotil) for a patient who has which of the following disorders?

Inflammatory bowel disease (Diphenoxylate is an opioid, which can cause the severe complication of toxic megacolon in clients who have inflammatory bowel disease. The nurse should have the client monitor the consistency and frequency of stools throughout therapy.)

A health care professional is about to administer ondansetron (Zoran) to a patient who is receiving chemotherapy. Which of the following actions should the health care professional take?

Infuse the drug 30 min prior to chemotherapy (The nurse should administer IV ondansetron, a serotonin antagonist, 30 min prior to chemotherapy to prevent chemotherapy-induced nausea and vomiting. When treating radiation-induced nausea and vomiting, the nurse should give the drug orally 1 to 2 hr prior to radiation therapy and again every 8 hr.) Infuse the drug slowly over 15 minutes (The nurse should infuse ondansetron slowly over 15 min to prevent chemotherapy-induced nausea.) Repeat the dose 4 hr after chemotherapy (For maximum effectiveness, the nurse should administer ondansetron 4 hr after chemotherapy, and again 8 hr after chemotherapy. When treating anesthesia-induced nausea and vomiting, the nurse can give the drug 1 hr before anesthesia induction.)

A health Care professional is reviewing the medical record of a patient who is to begin taking ranitidine ( Zantac) Which of the following medications interacts with ranitidine?

Ketoconazole (Ranitidine reduces the absorption of ketoconazole)

A health care professional is caring for an older adult patient who is about to begin taking cimetidine (Tagamet) to treat a duodenal ulcer. The health care professional should tell the patient to report which of the following adverse reactions?

Lethargy (Cimetidine, a histamine2 receptor antagonist, can cause CNS effects, such as lethargy, depression, confusion, and seizures, especially in older adults. The nurse should instruct the client to report these manifestations. If they persist, the provider may prefer to prescribe ranitidine for the client.)

A nurse is caring for a client who is taking lubiprostone. The nurse should tell the client that lubiprostone can cause which of the following adverse drug reactions?

Nausea (Lubiprostone, a chloride channel activator, can cause nausea. Clients who develop this effect do not need to discontinue the drug but should take it with food and water to minimize GI upset.)

When talking with a patient about taking omeprazole (Prilosec) to treat a duodenal ulcer, the health care professional should include which of the following instructions?

Swallow the capsule whole (Omeprazole, a proton pump inhibitor, is unstable in stomach acid. The nurse should tell the client to swallow the capsules or tablets whole and not chew the delayed-release tablets.)

A health care professional is caring for a patient who is about to begin using dimenhydrinate to prevent motion sickness. which of the following instructions should the health care professional include when talking with the patient about taking the drug?

Take the drug 30-60 minutes before activities that trigger nausea (The nurse should instruct the client to take dimenhydrinate 30 to 60 min before activities that trigger nausea, and again before meals and at bedtime.) Avoid activities that require alertness (Dimenhydrinate can cause sedation. The nurse should instruct the client to avoid activities that require alertness) Increase fluid and fiber intake (Dimenhydrinate can cause anticholinergic effects, such as dry mouth and constipation. The nurse should instruct the client to increase activity level, and fluid and fiber intake.)

When taking with a patient about taking psyllium (Metamucil) to treat constipation, the health care professional should include which of the following instructions?

Take the drug with at least 8 oz of fluids Increase fluid and fiber intake

A nurse is caring for a male client asked the nurse about taking alosetron for irritable bowel syndrome with diarrhea (IBS-D) lasting three months. Which of the following information should the nurse provide the clients about alosetron?

The drug is prescribed to female clients who have IBS-D lasting more than six months (Alosetron is approved only to be prescribed to females who have IBS-D lasting 6 months or longer that has not been controlled by conventional treatment.)

Side effect of dimenhydrinate is

Urinary retention (Dimenhydrinate, an antihistamine, is a GI-system drug that can cause urinary retention.)

A nurse is teaching a client who has a new prescription for sulfasalazine which of the following statements should the nurse make

Use sunscreen and protective clothing while taking sulfasalazine to prevent sunburn. (Photosensitivity is a possible adverse effect of sulfasalazine that makes the skin sensitive to light. The nurse should instruct the client to wear sunscreen and protective clothing when outdoors to prevent burning.)

A health care professional is caring for a patient who is about to begin taking alosetron (Lotronex) to treat irritable bowel syndrome. The health care professional should tell the patient to report which of the following adverse effects?

abdominal pain (Alosetron, a serotonin 5-HT3 receptor antagonist, can cause ischemic colitis. The nurse should tell the client to report abdominal pain, bloody diarrhea, or rectal bleeding, and to stop taking the drug if these manifestations occur.)

A primary care provider should use caution when prescribing bisacodyl (Dulcolax) for a patient who has

anorexia nervosa

A primary care provider should use caution when prescribing sulfasalazine (Azulfidine) for a patient who has?

aspirin sensitivity (Any sensitivity to salicylates, sulfonamides, or trimethoprim is a contraindication for the use of sulfasalazine, a 5-aminosalicylate. This is because intestinal bacteria metabolize the drug into 5-aminosalicylic acid, a salicylate. Aspirin is also a salicylate.)

A health care professional should conclude that alosetron (Lotronex) therapy is effective when a patient who is taking it reports which of the following?

one formed stool per day (Alosetron, a serotonin 5-HT3 receptor antagonist, treats the diarrhea and pain of severe irritable bowel syndrome. One formed stool per day indicates effective therapy.)

A health care professional is caring for a patient who has recently had a myocardial infarction and is about to begin taking docusate sodium (Colace). The health care professional should explain that decussate sodium will have which of the following therapeutic effects.

prevents straining (Docusate sodium, a stool softener, prevents straining during defecation and prevents the elevation in blood pressure that can result from straining. It also helps relieve constipation and reduces the painful elimination of hard stools.)

A health care professional is caring for a patient who takes phenytoin ( Dilantin) for a seizure disorder and is about to begin sucralfate (Carafate) therapy to treat a duodenal ulcer. The health care professional should tell the patient to take the drug at least 2 hrs apart because

sucralfate interferes with the absorption of phenytoin (Sucralfate decreases the absorption of phenytoin because it creates a coating in the stomach. The nurse should instruct the client to allow at least 2 hr between taking the two drugs and should monitor the client's phenytoin levels which are vital to prevent seizures.)