Custom: GI PHARM 6/15/20 ATI Practice Assessment

A nurse is reinforcing teaching with a client who reports taking bisacodyl daily. Which of the following information should the nurse include?

-"Excessive laxative use can cause an electrolyte imbalance." Chronic use of laxatives can lead to fluid and electrolyte imbalance.

A nurse is collecting data from a client who has been taking esomeprazole for several months. Which of the following client statements should the nurse identify as indicating effectiveness of the medication?

-"I don't have pain in my stomach anymore." Esomeprazole is a proton pump inhibitor that treats gastric ulcers, duodenal ulcers, and gastroesophageal reflux disease. Therefore, this statement indicates the medication is improving the client's condition.

A nurse is reinforcing teaching with a client who has a new prescription for docusate sodium. The nurse should recognize which of the following statements indicates the client understand the teaching?

-"I will have soft stools 1 to 3 days after starting this medication." The client should experience soft stools 1 to 3 days after treatment is begun. Docusate sodium is a stool softener and the therapeutic effect is soft stools each day.

A nurse is preparing to administer enteric-coated aspirin to an older adult client who had a cerebrovascular accident and has difficulty swallowing medications. The client asks the nurse if she will crush the medication to make it easier to swallow. Which of the following responses should the nurse make?

-"If I crush it you might experience a stomach ache or indigestion." The aspirin tablets have an enteric coating that prevents it from dissolving in the stomach but instead passes into the intestine where it dissolves and the client absorbs it. This prevents gastric irritation. Crushing the pill destroys that protection.

A nurse is reinforcing teaching with a client who is to start taking enteric-coated naproxen for rheumatoid arthritis. Which of the following client statements by the client indicates a need for further teaching?

-"It's okay to crush a tablet as long as I make sure it dissolves completely in water before swallowing it." The client should not crush an enteric-coated tablet, because this will interfere with the coating and allow the medication to dissolve in the stomach, resulting in gastric irritation.

A nurse is caring for a client who routinely drinks alcohol. Which of the following information should the nurse provide the client about alcohol consumption?

-"Medication is metabolized faster when alcohol is consumed regularly." Medication is metabolized faster when alcohol is consumed regularly due to alcohol-induced hepatic drug-metabolizing enzymes.

A nurse is reinforcing teaching for a client who has a duodenal ulcer and a new prescription for sucralfate. The client asks the nurse how sucralfate works. Which of the following statements should the nurse make?

-"This medication adheres to the ulcer and protects it from gastric acid." Sucralfate creates a protective coating over the ulcer that lasts about 6 hrs.

A nurse is collecting data from an older adult client who reports taking the herbal supplement flaxseed. Which of the following statements should the nurse make to the client?

-"You might experience abdominal bloating and discomfort while taking flaxseed." Flaxseed is an herbal supplement used, because of its fiber content, to relieve constipation and also to decrease total cholesterol levels. Flaxseed can cause gastrointestinal effects such as bloating, discomfort, and gas.

A nurse is reinforcing teaching with a client who has a duodenal ulcer and new prescription for cimetidine. Which of the following instructions should the nurse include?

-"You will need to continue taking this medication for up to 6 weeks." To heal a duodenal ulcer, the client should take the medication for 4 to 6 weeks.

A nurse is preparing to administer hydroxyzine HCL 50 mg PO. Available is hydroxyzine oral suspension 25 mg/5 mL. How many mL should the nurse administer? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)

-10 mL 50 mg x 5 mL = 250 250/50 = 10 mL

A nurse is collecting data from a client who has been taking omeprazole for the past 4 weeks. The nurse determines that the medication is effective when the client reports relief from which of the following symptoms?

-Acid indigestion Omeprazole, a proton pump inhibitor, reduces gastric acid secretion and treats duodenal and gastric ulcers, prolonged dyspepsia, gastrointestinal reflux disease, and erosive esophagitis.

When checking the medication administration records of four clients, a nurse notes that they all require oral medications that are prescribed to be administered once daily in the morning. Which of the following medications should the nurse administer first?

-Alendronate Alendronate is a bisphosphonate that prevents or slows weakening of bone. The nurse should administer this medication 30 min before the first food, beverage, or medication with a full glass (6 to 8 oz) of water; therefore, the nurse should administer this medication first, allowing the client the opportunity to eat when his breakfast tray arrives.

A nurse is collecting data from a client who has hypothyroidism and is to start taking levothyroxine. Which of the following over-the counter medications should the nurse instruct the client to separate taking by 4 hr?

-Calcium carbonate Taking calcium supplements concurrently with levothyroxine can decrease the absorption of the medication. The nurse should instruct the client to separate taking levothyroxine and calcium carbonate by 4 hr.

A nurse in a provider's office is caring for a client who has gastric ulcer caused by Helicobactor pylori. The nurse should anticipate that in addition to ranitidine and sucralfate, the provider will prescribe which of the following?

-Clarithromycin Treatment for a gastric ulcer caused by H. pylori includes a combination of medications, such as antibiotics, antisecretory agents (H2 receptor antagonists and proton pump inhibitors), mucosal protectants and antacids.

A nurse is reinforcing teaching with a client who has a new prescription for aluminum hydroxide to treat heartburn. Which of the following adverse effects of the medication should the nurse include in the teaching?

-Constipation An adverse effect of aluminum hydroxide is constipation; therefore, the nurse should instruct the client consume an adequate amount of fluid and fiber and to maintain an exercise program.

A nurse is reinforcing teaching with a client who has frequent urinary tract infections (UTIs). The nurse should identify that the client can use which of the following herbal supplements to help prevent UTIs?

-Cranberry juice ​Cranberry juice contains a group of compounds called proanthocyanidins, which prevent bacteria from attaching to the urinary tract wall. It does not affect bacteria that are already present so it does not treat UTIs nor does it acidify the urine.

A nurse is reinforcing teaching with a client who has cystic fibrosis ad is receiving pancrelipase. The nurse should tell the client that which of the following is an effect of this medication?

-Decreased fat in stools Clients who have cystic fibrosis supplement meals with oral pancreatic enzymes to reduce the fat content in their stools. Clients receiving pancreatic enzymes as a digestive aid should expect to have a reduction of fat in their stools.

A nurse is caring for a client who has cirrhosis and a prescription for lactulose. Following administration, the nurse should monitor the client for which of the following adverse effects?

-Diarrhea The nurse should monitor for diarrhea. Lactulose is a synthetic disaccharide that the small intestine cannot utilize. It causes diarrhea by lowering the pH, so the bacterial flora are changed in the bowel.

A nurse is reinforcing teaching with a client who reports motion sickness about using an herbal supplement. The nurse should identify that the client can use which of the following herbal supplements to help control nausea.

-Ginger root Clients can use ginger root to decrease nausea and vomiting resulting from motion sickness, morning sickness, and seasickness. This action might result from blocking serotonin receptors in the chemoreceptor trigger zone of the medulla and vagal neurons in the gastrointestinal tract.

A nurse is preparing a presentation for coworkers about the various herbal remedies clients might report using. Which of the following should she include as an herbal supplement clients might use to treat osteoarthritis of the knee, hip, and wrists?

-Glucosamine Clients who have osteoarthritis of the knee, hip, and wrists can use glucosamine to stimulate synthesis of cartilage and synovial fluid and decrease joint inflammation and degradation of cartilage.

A nurse is reinforcing teaching for the parent of a toddler who has iron deficiency anemia and a new prescription for liquid iron solution. Which of the following instructions by the nurse is the priority?

-Keep the iron solution stored in a locked cupboard. The greatest risk to this client is injury from iron toxicity which can be fatal in young children; therefore, the priority instruction the nurse should give is to keep the iron solution stored in a locked cupboard. The nurse should also instruct the parent to keep the medication in a child-proof container.

A nurse is reviewing medications for a client who has just been diagnosed with a small bowel obstruction. The nurse should withhold senna prescribed orally based on understanding of which of the following?

-Laxatives are contraindicated in clients who have a small bowel obstruction. Senna is a stimulant laxative and, like other laxatives, is contraindicated in clients who have fecal impaction, bowel obstruction, and acute abdominal surgery to prevent perforation. Because the bowel does not allow for any passage of stool with a complete small bowel obstruction, laxatives will cause increased abdominal cramping and discomfort and might cause perforation of the bowel.

A nurse is collecting data from a client who reports using long-term oral comfrey to promote wound healing. The nurse should realize that which of the following laboratory tests is appropriate to determine an adverse effect of oral comfrey?

-Liver function tests Oral comfrey has been shown to cause severe liver toxicity in humans. The nurse should expect that the provider will prescribe liver function testing to assess for liver damage.

A nurse is caring for a client who has metastatic cancer and has been taking morphine for several months to relieve severe pain. Which of the following prescriptions should the nurse expect when the client reports constipation unrelieved by laxative therapy?

-Methylnaltrexone Methylnaltrexone treats opioid-induced constipation that is no longer relieved by laxative therapy. Because it does not cross the blood-brain barrier, it does not reverse pain relief or cause opioid withdrawal.

A nurse is caring for an older adult client with a history of stroke who has been prescribed several medications and expresses reluctance to take them because of his difficulty swallowing. Which of the following actions is the nurse's priority?

-Observe for symmetry of the client's soft palate and uvula. An older client who has a history of stroke is at risk for choking and aspiration. If the client reports difficulty swallowing, data should be collected to determine the extent of dysphagia before feeding the client or administering medications. Checking the client's soft palate and uvula is a first step in data collection. A speech therapist might need to perform a swallowing evaluation for this client. The nurse should apply the safety and risk reduction priority-setting framework. This framework assigns priority to the factor or situation posing the greatest safety risk to the client. When there are several risks to client safety, the one posing the greatest threat is the highest priority. The nurse should use Maslow's hierarchy of needs, the ABC priority-setting framework, or nursing knowledge to identify which risk poses the greatest threat to the client.

A nurse is preparing to administer orlistat to a client for a treatment of obesity. For which of the following adverse effects should the nurse monitor?

-Oily fecal spotting Because the medication reduces the gastrointestinal tract's absorption of fat, oily fecal spotting is an adverse effect of orlistat.

A nurse is reinforcing teaching with a client who is to start taking atorvastatin. The nurse should instruct the client that she will need which of the following baseline examinations prior to starting therapy?

-Papanicolaou test Statins such as atorvastatin can cause liver damage and liver disease is a contraindication for taking the medication. The client should have baseline liver function testing before beginning therapy, then every 1 to 2 months, at 6 and 12 weeks, and then periodically throughout therapy.

A nurse is preparing to administer dimenhydrinate to a client. The nurse should explain to the client that the purpose of this medication is to do which of the following?

-Reduce nausea Dimenhydrinate is used to treat nausea because it blocks signals in the vomiting center of the brain. It is used to treat acute attacks of Meniere's disease and vertigo, as well as to reduce nausea and vomiting from radiation sickness.

A nurse is caring for an older client who has cancer and is receiving opioids for pain relief. The client has a new prescription for docusate PO daily. When collecting data from the client, which of the following therapeutic effects of docusate should the nurse expect?

-Relief from constipation Constipation is a serious adverse effect of opioid medications. The intended outcome of docusate therapy is to relieve constipation by producing stool that is softer in consistency and easier for the client to pass.

A nurse is caring for a client who has gastroesophageal disease and a prescription for metoclopramide. For which of the following adverse effects should the nurse monitor?

-Sedation The nurse should monitor the client for sedation, which is a common adverse effect of metoclopramide.

A nurse is reinforcing teaching a client who has peptic ulcer disease and is starting therapy with sucralfate. Which of the following instructions should the nurse include in the teaching?

-Take the medication 1 hr before meals. The nurse should instruct the client to take sucralfate on an empty stomach, 1 hr before meals, and at bedtime for maximum effectiveness.

A nurse is reinforcing teaching with a client who has a prescription for simvastatin. Which of the following instructions should the nurse provide?

-Take the medication in the evening hours. Statins are most effective if taken at bedtime or with the evening meal because this is when the peak production of cholesterol takes place.

A nurse is reinforcing teaching about cimetidine with a client who has peptic ulcer disease. Which of the following information should the nurse include in the teaching?

-Wait at least 1 hr after taking the medication before taking an antacid. The nurse should instruct the client to wait at least 1 hr after taking cimetidine before taking an antacid. These medications can decrease absorption of the medication

A nurse is collecting data from a client who has a prescription for oral clindamycin hydrochloride. Which of the following findings should the nurse immediately to the provider?

-Watery diarrhea The greatest risk to this client who is taking clindamycin hydrochloride is colitis, ranging from mild diarrhea to a severe, life-threatening condition called pseudomembranous colitis. Watery diarrhea might be a manifestation of pseudomembranous colitis; therefore, this is the priority finding to report to the provider.