GI system
A nurse is caring for a client who has been prescribed aluminum carbonate gel (Basaljel) for the relief of an acute peptic ulcer. Which of the following interventions should the nurse perform to promote an optimal response to therapy? A. Administer the drug hourly for the first 2 weeks B. Administer the drug early in the morning before breakfast C. Administer the drug with 40 mL of apple juice D. Administer the first dose by IV route and then orally
A. Administer the drug hourly for the first 2 weeks Feedback: The nurse should administer the drug hourly for the first 2 weeks when treating an acute peptic ulcer. The nurse instructs the client to administer the drug 1 to 2 hours after meals and at bedtime after the first 2 weeks. The nurse need not suggest to the client to administer the drug early in the morning before breakfast nor to administer it with apple juice. The drug is not given intravenously.
A nurse is caring for a client with intestinal stenosis who has been prescribed psyllium. During the course of the treatment, the client shows the signs of colon obstruction. What intervention should the nurse perform to avoid the occurrence of colon obstruction? A. Administer the drug with adequate fluid intake B. Give mineral oil to the client after meals C. Administer the drug after chilling it D. Provide foods high in bulk or roughage
A. Administer the drug with adequate fluid intake Feedback: The nurse should administer the drug with adequate fluid intake to avoid obstruction of the esophagus, stomach, small intestine, and colon in a client with intestinal stenosis. Mineral oil is given to the client as a laxative on an empty stomach in the evening. The nurse should provide foods high in bulk or roughage to avoid constipation in a client receiving laxatives. The nurse administers a laxative with an unpleasant or salty taste after chilling it to disguise its taste.
Which of the following antacids may produce constipation and should be used cautiously in clients who have chronic constipation? Select all that apply A. Calcium carbonate (Mylanta) B. Magnesium hydroxide (Milk of Magnesia) C. Magnesium oxide (Mag-Ox) D. Aluminum hydroxide (ALternaGEL) E. Sodium bicarbonate (Bell/ans)
A. Calcium carbonate (Mylanta) D. Aluminum hydroxide (ALternaGEL) Feedback: The aluminum- and calcium-containing antacids may produce constipation. Magnesium- and sodium-containing antacids tend to have a laxative effect.
A client's history reveals that the client is experiencing intestinal gas. Which of the following would the nurse expect the primary health care provider to prescribe? Select all that apply. A. Charcoal (Flatulex) B. Omeprazole (Prilosec) C. Ranitidine (Zantac) D. Odansetron (Zofran) E. Simethicone (Mylicon)
A. Charcoal (Flatulex) E. Simethicone (Mylicon) Feedback: Charcoal (Flatulex) and Simethicone (Mylicon) are antiflatulents used to help relieve gas in the intestinal tract of a client. Omeprazole and ranitidine are used to treat hyperacidity disorders. Odansetron is used to treat nausea and vomiting.
A client is prescribed an antidiarrheal drug. The nurse reviews the client's medical record for possible contraindications for use. Which of the following would alert the nurse to a possible contraindication? Select all that apply. A. Pseudomembranous colitis B. Type 1 diabetes C. Abdominal pain of unknown origin D. Liver disease E. Obstructive jaundice
A. Pseudomembranous colitis C. Abdominal pain of unknown origin E. Obstructive jaundice Feedback: Clients with pseudomembranous colitis, abdominal pain of unknown origin, and obstructive jaundice should not take antidiarrheals.
A nurse is caring for a client brought to the health care facility for a drug overdose. In which of the following cases can the client be administered an emetic? A. Client's mental status is intact B. Client has an existing condition of severe hypertension C. Client has a medical history of convulsions D. Client has an existing condition of hemorrhagic diathesis
A. Client's mental status is intact Feedback: The client can be administered an emetic only if the client does not have an altered mental status or is not comatose. A client who is comatose has an increased risk of aspiration of stomach contents. Clients with an existing condition of severe hypertension, a medical history of convulsions, or an existing condition of hemorrhagic diathesis should not be given an emetic as these conditions may be exacerbated by vomiting.
A nurse is teaching a client who is prescribed metoclopramide about signs and symptoms to report to the primary health care provider. The nurse determines that the teaching was successful when the client states which of the following? Select all that apply. A. Difficulty swallowing B. Uncontrolled tongue movements C. Muscle laxity D. Shuffling gait E. Diarrhea
A. Difficulty swallowing B. Uncontrolled tongue movements D. Shuffling gait Feedback: When taking metoclopramide, the client should immediately report any of the following signs: difficulty speaking or swallowing; mask-like face; shuffling gait; rigidity; tremors; uncontrolled movements of the mouth, face, or extremities; and uncontrolled chewing or unusual movements of the tongue. Diarrhea does not require the client to notify the health care provider.
After teaching a group of nursing students about laxatives, the instructor determines that the teaching was successful when the students identify which drug as producing the laxative effect by promoting water retention in the fecal mass and softening the stool? Select all that apply. A. Docusate sodium (Colace) B. Methylcellulose (Citrucel) C. Bisacodyl (Dulcolax) D. Lactulose (Chronulac)
A. Docusate sodium (Colace) Feedback: Stool softeners, like docusate sodium (Colace) and docusate calcium (Surfak), produce their laxative effect by promoting water retention in the fecal mass and softening the stool. Methylcellulose is a bulk-producing laxative. Bisacodyl is a stimulant laxative. Lactulose is a hyperosmolar laxative.
A client is prescribed Diphenoxylate. The nurse informs the client that he may experience which of the following effects? Select all that apply. A. Euphoric effects B. Analgesic effects C. Anti-inflammatory effects D. Sedative effects E. Slowed GI effects
A. Euphoric effects D. Sedative effects E. Slowed GI effects Feedback: Because diphenoxylate (Lomotil) is opioid related, it may have sedative, slowed GI, and euphoric effects but no analgesic or anti-inflammatory activity.
After administering diphenoxylate to a client, the nurse would assess the client closely for increased CNS depression if the client was also receiving which medication? Select all that apply. A. Fexofenadine (Allegra) B. Glyburide (DiaBeta) C. Sucralfate (Carafate) D. Zolpidem (Ambien) E. Temazepam (Restoril)
A. Fexofenadine (Allegra) D. Zolpidem (Ambien) E. Temazepam (Restoril) Feedback: The nurse should monitor a client closely for increased CNS depression when diphenoxylate (Lomotil) is given to a client taking antihistamines (fexofenadine), opioids, sedatives (zolpidem), and hypnotics (temazepam).
A client is taking ginger medicinally for motion sickness. The nurse would urge the client to use caution if the client has which medical condition? A. Gallstones B. Blood dyscrasia C. Parkinson's disease D. Severe liver disease
A. Gallstones Feedback: Ginger should be used with caution in clients with hypertension or gallstones and during pregnancy or lactation. Antiemetic Prochlorperazine is contraindicated in clients with blood dyscrasia, Parkinson's disease, and severe liver disease.
A physician has prescribed Simethicone to a client with postoperative abdominal distention. After administering the drug, the nurse would assess the client for the possibility of which of the following? A. Heartburn B. Vomiting C. Fainting D. Nausea
A. Heartburn Feedback: The nurse should monitor for heartburn, bloating, constipation, and diarrhea in the client after administering simethicone. Vomiting, fainting, and nausea are adverse reactions to methylcellulose, which is administered for the relief of constipation.
At a yearly physical examination, a client asks the nurse if it would be okay to take ginger to aid with digestion. Before telling the client it is okay to take ginger, which medical conditions should the nurse make sure the client does not have? Select all that apply. A. Hypertension B. Kidney stones C. Vitamin B12 deficiency D. Gallstones E. Liver disease
A. Hypertension D. Gallstones Feedback: Ginger should be used cautiously in clients with hypertension or gallstones and during pregnancy and lactation.
Which of the following drugs used to manage lower gastrointestinal disorders increase the risk of bleeding when administered to clients taking warfarin (Coumadin)? Select all that apply. A. Mesalamine (Asacol) B. Bisacodyl (Dulcolax) C. Psyllium (Metamucil) D. Polythylene glycol (MiraLAX) E. Olsalazine (Dipentum)
A. Mesalamine (Asacol) E. Olsalazine (Dipentum( Feedback: Aminosalicylates, like mesalamine (Asacol) and olsalazine (Dipentum), can increase the risk of bleeding in clients taking warfarin (Coumadin).
When describing the drugs used as treatment for clients with ulcerative colitis to a group of nursing students, the instructor discusses aspirin-like compounds with anti-inflammatory properties. Which of the following would the instructor most likely include? Select all that apply. A. Mesalamine (Asacol) B. Bisacodyl (Dulcolax) C. Magnesium oxide (Mag-Ox) D. Polyethylene glycol (MiraLAX) E. Olsalazine (Dipentum)
A. Mesalamine (Asacol) E. Olsalazine (Dipentum) Feedback: Aminosalicylates, like mesalamine (Asacol) and olsalazine (Dipentum), are aspirin-like compounds with anti-inflammatory properties used in the treatment of clients with ulcerative colitis.
A client is prescribed a laxative. Which of the following would the nurse include in the teaching plan for the client about possible adverse reactions? Select all that apply. A. Nausea B. Perianal irritation C. Bloating D. Constipation E. Cramps
A. Nausea B. Perianal irritation C. Bloating E. Cramps Feedback: Laxatives may cause diarrhea, loss of water and electrolytes, abdominal pain or discomfort, nausea, vomiting, perianal irritation, fainting, bloating, flatulence, cramps, and weakness.
A client is using chamomile tea as a remedy to treat gastrointestinal upset. When discussing the use of this herb, the nurse would alert the client that contact dermatitis is a possibility if the client has a hypersensitivity to which of the following plants? Select all that apply. A. Ragweed B. Fox glove C. Asters D. Lavender E. Chrysanthemums
A. Ragweed C. Asters E. Chrysanthemums Feedback: Although chamomile is generally safe and nontoxic, the tea is prepared from the pollen-filled flower heads and has resulted in symptoms ranging from contact dermatitis to severe anaphylactic reactions in individuals hypersensitive to ragweed, asters, and chrysanthemums.
A nurse educating a client on the antacid calcium carbonate (Mylanta) should warn the client of which of the following adverse reactions? Select all that apply. A. Rebound hyperacidity B. Anorexia C. Headache D. Dehydration E. Confusion
A. Rebound hyperacidity C. Headache E. Confusion Feedback: Adverse reactions of calcium carbonate (Mylanta) include rebound hyperacidity, metabolic alkalosis, hypercalcemia, vomiting, confusion, headache, renal calculi, and neurologic impairment.
A client is receiving an antiemetic. The nurse identifies a nursing diagnosis of Imbalanced Nutrition: Less Than Body Requirements. Which of the following would the nurse include in the client's plan of care? Select all that apply. A. Remove items with strong smells and odors B. Use mouthwash or frequent oral rinses C. Make the environment as pleasant as possible D. Explain that the drug may change the color of the stool E. Follow the medication with a small amount of water
A. Remove items with strong smells and odors B. Use mouthwash or frequent oral rinses C. Make the environment as pleasant as possible Feedback: When caring for a client receiving an antiemetic with a nursing diagnosis of Imbalanced Nutrition: Less Than Body Requirements, the nurse makes the environment as pleasant as possible to enhance the client's appetite and removes items with strong smells and odors. The nurse gives the client mouthwash or frequent oral rinses to remove the disagreeable taste that accompanies vomiting. Stool color is unaffected. Liquid antacids could be followed with a small amount of water.
A nurse in a health care facility if caring for a client who is receiving an antiemetic to control vomiting related to chemotherapy. Which of the following nursing diagnoses should the care plan for this client include? A. Risk for Imbalanced Fluid Volume B. Disturbed Sensory Perception C. Impaired Physical Mobility D. Ineffective Tissue Perfusion
A. Risk for Imbalanced Fluid Volume Feedback: The care plan should include Risk for Imbalanced Fluid Volume for the client receiving an antiemetic due to the possible fluid losses associated with vomiting as well as the possible decrease in fluid intake. Disturbed sensory perception, impaired physical mobility, and ineffective tissue perfusion are not applicable.
Which of the following produce their laxative effect by direct action on the intestine to increase peristalsis? Select all that apply. A. Sennosides (Senokot) B. Methylcellulose (Citrucel) C. Glycerin (Fleet Babylax) D. Bisacodyl (Dulcolax) E. Lactulose (Chronulac)
A. Sennosides (Senokot) D. Bisacodyl (Dulcolax) Feedback: Irritant or stimulant laxatives, like Sennosides (Senokot) and Bisacodyl (Dulcolax), produce their laxative effect by direct action on the intestine to increase peristalsis. Methylcellulose is a bulk-forming laxative. Glycerin and lactulose are hyperosmolar drugs.
A nurse would most likely expect a primary health care provider to prescribe psyllium (Metamucil) to a client who is experiencing constipation related to which drug? Select all that apply. A. Spironolactone (Aldactone) B. Clonidine (Catapres) C. Enalapril (Vasotec) D. Fexofenadine (Allegra) E. Amitriptyline (Elavil)
A. Spironolactone (Aldactone) B. Clonidine (Catapres) D. Fexofenadine (Allegra) E. Amitriptyline (Elavil) Feedback: The following drugs may cause constipation in clients and require the use of a laxative to relieve constipation: anticholinergics, antihistamines (fexofenadine), phenothiazines, tricyclic antidepressants (amitriptyline), opioids, non-potassium-sparing diuretics (spironolactone), iron preparations, barium, clonidine, and calcium- or aluminum-containing antacids.
A nurse is conducting a class for a community group. As part of the class, the nurse is explaining the use of syrup of ipecac. The nurse would emphasize that this drug is contraindicated in which of the following cases? Select all that apply. A. The client is comatose or has altered mental status B. The client has erosive esophagitis C. The client is having seizures D. The substance is a caustic or corrosive agent E. The substance is a low-viscosity petroleum distillate
A. The client is comatose or has altered mental status C. The client is having seizures D. The substance is a caustic or corrosive agent E. The substance is a low-viscosity petroleum distillate Feedback: The use of syrup of ipecac is contraindicated in the following cases: the client is comatose or has altered mental status, the client is having seizures, the substance is a caustic or corrosive agent, the substance is a low-viscosity petroleum distillate, or the substance is capable of also altered mental status or convulsions.
Before administering a prescribed emetic, which of the following would the nurse need to assess? Select all that apply. A. What chemicals or substances were ingested? B. What are the client's current medications? C. What time was the substance ingested? D. What is the client's blood pressure? E. What symptoms were noted before seeking medical treatment.
A. What chemicals or substances were ingested? C. What time was the substance ingested? E. What symptoms were noted before seeking treatment? Feedback: Before an emetic is given, it is extremely important to know the chemicals or substances that have been ingested, the time they were ingested, and what symptoms were noted before seeking medical treatment.
During a routine clinic visit, a client tells the nurse that he is taking an over-the-counter antidiarrheal agent for treatment of diarrhea. The nurse reviews the drug information with the client. Afterward, the nurse determines that the teaching was successful when the client states that he will contact his primary health care provider if the diarrhea is not resolved within which time frame? A. 24 hours B. 48 hours C. 72 hours D. 96 hours
B. 48 hours Feedback: If diarrhea persists for more than 2 days when over-the-counter (OTC) antidiarrheal drugs are being used, the client should discontinue use and seek treatment from the primary health care provider.
A nurse is caring for a client receiving bismuth subsalicylate for the relief of diarrhea. Which of the following interventions should the nurse perform to promote an optimal response to the prescribed drug therapy. A. Thoroughly mix and stir the drug before administering B. Administer the drug after each loose bowel movement C. Ensure the client receives adequate sunlight D. Encourage the client to lightly exercise on a daily basis
B. Administer the drug after each loose bowel movement Feedback: The nurse should administer the drug after each loose bowel movement to promote an optimal response to the prescribed drug therapy in the client with diarrhea. The nurse should inspect each bowel movement before making a decision to administer the drug. Laxatives that are in powder, flake, or granule form are mixed and stirred before being administered to the client with constipation. The nurse need not ensure that the client receives adequate sunlight or encourage the client to lightly exercise on a daily basis as these interventions will not help in promoting an optimal response to the prescribed drug therapy.
A nurse educating a client on the antacid aluminum hydroxide (ALternaGEL) should warn the client about which of the following adverse reactions? Select all that apply. A. Alopecia B. Anorexia C. Diarrhea D. Tremors E. Bone pain
B. Anorexia D. Tremors E. Bone pain Feedback: Adverse reactions of aluminum hydroxide (ALternaGEL) include constipation, intestinal impaction, anorexia, weakness, tremors, and bone pain.
A nurse is caring for a client with constipation. The physician prescribes cascara sagrada to the client. Which of the following effects should the nurse monitor for in the client after administration of the drug? A. Sudden increase in weight B. Brownish discoloration of urine C. Reduced sperm count D. Abdominal pain and cramping
B. Brownish discoloration of urine Feedback: The nurse should monitor for pink-red, red-violet, red-brown, yellow-brown, or black discoloration of urine after administration of cascara sagrada to the client. Reduced sperm count is the adverse effect of sulfasalazine. Abdominal pain and cramping are the adverse effects of Olsalazine. Cascara sagrada does not cause a sudden increase in the weight of the client.
A nursing student is preparing a presentation on antidiarrheal drugs. Which of the following drugs would the student include as being chemically related to opioid drugs and used to treat diarrhea by decreasing intestinal peristalsis? Select all that apply. A. Bisacodyl (Dulcolax) B. Difenoxin (Motofen) C. Alosetron (Lotronex) D. Diphenoxylate (Lomotil) E. Bismuth (Pepto-Bismol)
B. Difenoxin (Motofen) D. Diphenoxylate (Lomotil) Feedback: Difenoxin (Motofen) and Diphenoxylate (Lomotil) are chemically related to opioid drugs and treat diarrhea by decreasing intestinal peristalsis.
A nurse should monitor a client taking which of the following drugs for increased adverse effects and toxicity if omeprazole (Prilosec) therapy is initiated? Select all that apply. A. Phenobarbital (Luminal) B. Digoxin (Lanoxin) C. Diazepam (Valium) D. Warfarin (Coumadin) E. Ketoconazole (Nizoral)
B. Digoxin (Lanoxin) C. Diazepam (Valium) D. Warfarin (Coumadin) Feedback: The initiation of proton pump inhibitors, like omeprazole (Prilosec), can result in increased adverse reactions and toxicities of warfarin (Coumadin), benzodiazepines (diazepam), digoxin (Lanoxin), phenytoin (Dilantin), and clarithromycin (Biaxin).
A nurse educating a client on balsalazide (Colazal) should advise the client about possible adverse reactions not involving the gastrointestinal tract. Which of the following would the nurse include in the teaching plan? Select all that apply. A. Alopecia B. Headache C. Fever D. Tremors E. Bone pain
B. Headache C. Fever Feedback: Balsalazide (Colazal) is an aminosalicylate. Nongastrointestinal adverse effects of aminosalicylates include headache, dizziness, fever, and weakness.
A physician has prescribed Difenoxin with atropine to a client with acute diarrhea. The client informs the nurse that he is also taking MAOI antidepressants. The nurse would assess the client for which of the following that might result from the interaction of the two drugs? A. Decreased effect of Difenoxin B. Increased risk of hypertensive colitis C. Increased cholinergic blocking adverse reactions D. Increased risk of CNS depression
B. Increased risk of hypertensive crisis Feedback: The nurse should monitor the client for an increased risk of hypertensive crisis as an effect of the interaction between Difenoxin and atropine and MAOI antidepressants. When the client is administered antihistamines, opioids, sedatives, or hypnotics with antidiarrheal drugs, there will be increased wick of CNS depression. When the client is administered antihistamines and general antidepressants with antidiarrheal drugs, there will be increased cholinergic blocking adverse reactions. There will not be a decreased effect of Difenoxin when there is an interaction between Difenoxin and MAOI antidepressants.
A nurse should recognize that administering antacids to clients taking which of the following medications can result in decreased drug absorption and decreased drug effects? Select all that apply. A. Simvastatin (Zocor) B. Isoniazid (Nydrazid) C. Digoxin (Lanoxin) D. Phenytoin (Dilantin) E. Enalapril (Vasotec)
B. Isoniazid (Nydrazid) C. Digoxin (Lanoxin) D. Phenytoin (Dilantin) Feedback: Antacids decrease the absorption of digoxin, isoniazid, phenytoin, and chlorpromazine, leading to decreased effect of these drugs.
A client which a nasogastric tube is prescribed therapy to prevent ulcer development. Which of the following would be the best option for the drug? A. Tablet that can be crushed B. Liquid formulation C. Intravenous administration D. Intramuscular injection
B. Liquid formulation Feedback: The nurse should request the liquid form when administration is in a tube to decrease the chance of a clogged NG tube. Although it is appropriate to crush the tablet and mix it with apple juice, there is still a risk for clogging. Intravenous or intramuscular administration would be inappropriate. The IV route is typically preferred if the patient has an existing IV line, because these drugs are irritating, and IM injections need to be given deep into the muscular tissue to minimize harm.
Which of the following antacids may have a laxative effect and should be used cautiously in clients who have chronic diarrhea? Select all that apply. A. Calcium carbonate (Mylanta) B. Magnesium hydroxide (Milk of Magnesia) C. Magnesium oxidase (Mag-Ox) D. Aluminum hydroxide (ALtenaGEL) E. Sodium bicarbonate (Bell/ans)
B. Magnesium hydroxide (Milk of Magnesia) C. Magnesium oxidase (Mag-Ox) E. Sodium bicarbonate (Bell/ans) Feedback: The magnesium- and sodium-containing antacids may have a laxative effect and may produce diarrhea. Aluminum- and calcium-containing antacids tend to produce constipation.
The nurse is preparing to administer a laxative that adds bulk and water to the contents of the intestines, thereby stimulating intestinal peristalsis. Which of the following would the nurse be likely to administer? Select all that apply. A. Docusate (Colace) B. Methylcellulose (Citrucel) C. Polycarbophil (Fibercon) D. Bisacodyl (Docusate) E. Lactulose (Chronulac)
B. Methylcellulose (Citrucel) C. Polycarbophil (FiberCon) Feedback: Bulk-producing laxatives, like methylcellulose (Citrucel) and Polycarbophil (FiberCon), produce their laxative effect by adding bulk and water to the contents of the intestines, thereby stimulating intestinal peristalsis. Docusate is a stool softener. Bisacodyl is a stimulant laxative. Lactulose is a hyperosmotic agent.
A group of nursing students are reviewing information about upper gastrointestinal system drugs. The students demonstrate understanding of the material when they identify which of the following as a proton pump inhibitor? A. Nizatidine B. Omeprazole C. Esomeprazole D. Sucralfate E. Misoprostol
B. Omeprazole C. Esomeprazole Feedback: Omeprazole and esomeprazole are examples of proton pump inhibitors. Nizatidine is a histamine-2 receptor antagonist. Sucralfate and misoprostol are examples of miscellaneous acid reducers.
A client is diagnosed with an infection with H. pylori. Which of the following drugs are commonly used in combination with certain antibiotics in the treatment of this infection? Select all that apply. A. Metoclopramide (Reglan) B. Omeprazole (Prilosec) C. Ondansetron (Zofran) D. Lansoprazole (Prevacid) E. Promethazine (Phenergan)
B. Omeprazole (Prilosec) D. Lansoprazole (Prevacid) Feedback: The proton pump inhibitors, like omeprazole (Prilosec) and Lansoprazole (Prevacid), are commonly used in combination with certain antibiotics in the treatment of H. pylori.
A nurse follows a specific protocol when administering which of the following medications to prevent nausea induced by doxorubicin (Adriamcin) administration? Select all that apply. A. Lansoprazole (Prevacid) B. Ondansetron (Zofran) C. Metoclopramide (Reglan) D. Promethazine (Phenergan) E. Granisetron (Kytril)
B. Ondansetron (Zofran) E. Granisetron (Kytril) Feedback: 5-HT3 receptor antagonists, like Ondansetron (Zofran) and granisetron (Kytril), are used in the prevention of chemotherapy-induced nausea and vomiting.
The nurse should administer which of the following medications cautiously to clients with vitamin B12 deficiency as the prolonged use of these drugs decrease the body's ability to absorb vitamin B12? Select all that apply. A. Metoclopramide (Reglan) B. Rabeprazole (AcipHex) C. Sucralfate (Carafate) D. Pantoprazole (Protonix) E. Promethazine (Phenergan)
B. Rabeprazole (AcipHex) D. Pantoprazole (Protonix) Feedback: The nurse should administer proton pump inhibitors, like Rabeprazole (AcipHex) and pantoprazole (Protonix), cautiously to clients with vitamin B12 deficiency as the prolonged use of these drugs decreases the body's ability to absorb vitamin B12.
A nurse is caring for a client who is prescribed omeprazole for a duodenal ulcer. The client is also taking benzodiazepines for the management of a seizure disorder. The nurse would assess the client for which of the following? A. Decreased absorption of the proton pump inhibitor B. Risk for toxic level of benzodiazepines C. Increased risk of respiratory depression D. Increased risk of bleeding
B. Risk for toxic level of benzodiazepines Feedback: When the proton pump inhibitor is administered with benzodiazepines, there will be a risk for a toxic level of benzodiazepines. When the client is administered Sucralfate with the proton pump inhibitor, there will be a decrease in absorption of the proton pump inhibitor. When the client is administered an antacid with opioid analgesics, there will be an increased risk of respiratory depression. There will be an increased risk of bleeding when the client is taking oral anticoagulants with the proton pump inhibitor.
Antidiarrheals are contraindicated in clients whose diarrhea is associated with which of the following organisms that can harm the intestinal mucosa? Select all that apply. A. Staphylococcus B. Shigella C. Salmonella D. Streptococcus E. Escherichia coli
B. Shigella C. Salmonella E. Escherichia coli Feedback: Antidiarrheals are contraindicated in clients whose diarrhea is associated with Shigella, Salmonella, and Escherichia coli, which can harm the intestinal mucosa.
When reviewing a client's history, a nurse determines that the use of laxatives would be contraindicated if the client has a history of which of the following? Select all that apply. A. Chronic hepatitis B. Type 1 diabetes C. Acute appendicitis D. Intestinal obstruction E. Fecal impaction
C. Acute appendicitis D. Intestinal obstruction Feedback: Laxatives are contraindicated in clients with known hypersensitivity and those with persistent abdominal pain, nausea, vomiting, or pain or unknown cause or signs of acute appendicitis, fecal impaction, intestinal obstruction, or acute hepatitis.
A client is administered trimethobenzamide hydrochloride (Tigan) to control nausea and vomiting. The nurse would assess the client for which of the following? A. Acid rebound B. Neurotoxicity C. Blurred vision D. Bone softening
C. Blurred vision Feedback: The nurse should monitor the client for blurred vision as an adverse reaction to the trimethobenzamide hydrochloride (Tigan). The nurse need not monitor the client for acid rebound, neurotoxicity, and bone softening as they are not adverse reactions to trimethobenzamide hydrochloride (Tigan). Acid rebound is an adverse reaction to calcium carbonate. Neurotoxicity and bone softening are adverse reactions to aluminum carbonate gel.
A nurse is caring for an elderly client who has received cimetidine. Which of the following interventions should the nurse perform? A. Monitor the client for complaints of pain or sour taste B. Monitor the client for concentrated wine and restlessness C. Closely monitor the client for confusion and dizziness D. Report symptoms of tardive dyskinesia to the primary health care provider
C. Closely monitor the client for confusion and dizziness Feedback: The nurse should closely monitor the elderly client who has been administered cimetidine for confusion and dizziness. When the client is receiving an antiemetic, the nurse monitors the client frequently for continues complaints of pain, sour taste, spitting blood, or coffee-ground-colored emesis. When antacids are given to the client, the nurse should observe the client for concentrated urine and restlessness. When the client is administered prolonged doses of metoclopramide, the nurse reports any sign of tardive dyskinesia or extrapyramidal symptoms to the primary health care provider.
A nurse educating a client on the antacid magnesium oxide (Mag-Ox) should warn the client of which of the following adverse reactions? Select all that apply. A. Tremors B. Anorexia C. Diarrhea D. Dehydration E. Hypotension
C. Diarrhea D. Dehydration E. Hypotension Feedback: Adverse reactions of magnesium oxide (Mag-Ox) include severe diarrhea, dehydration, and hypermagnesemia (nausea, vomiting, hypotension, and decreased respirations.
A nurse is caring for a client with pseudomembranous colitis. The physician has prescribed loperamide. Which of the following would the nurse identify as indicative of effectiveness? A. Elevation in temperature is noted B. Rectal bleeding is noted C. Diarrhea is resolved D. Nausea and vomiting are resolved
C. Diarrhea is resolved Feedback: Loperamide is an antidiarrheal medication. The nurse will know that the medication is effective if the diarrhea is resolved in the client. The nurse should monitor the client for an elevation in body temperature, severe abdominal pain, abdominal rigidity, or distention because these are the indicators of intestinal perforation. The nurse should monitor for rectal bleeding when laxatives are administered.
The nurse is reviewing a client's history and finds that the client uses a laxative that produces its effects by dehydrating local tissues, which causes irritation and increased peristalsis, with consequent evacuation of the fecal mass. Which of the following would this be? Select all that apply. A. Docusate sodium (Colace) B. Methylcellulose (Citrucel) C. Glycerin (Fleet Babylax) D. Bisacodyl (Dulcolax) E. Lactulose (Chronulac)
C. Glycerin (Fleet Babylax) E. Lactulose (Chronulac) Feedback: Hyperosmotic agents, like glycerin (Fleet Babylax) and lactulose (Chronulac), produce their laxative effect by dehydrating local tissues, which causes irritation and increased peristalsis, with consequent evacuation of the fecal mass. Docusate is a stool softener. Methylcellulose is a bulk-forming laxative. Bisacodyl is an irritant laxative.
A client is prescribed ranitidine. A review of the client's medication history reveals that she also takes warfarin for treatment of deep vein thrombosis. The nurse would monitor the client for which of the following? A. Decreased white blood cell count B. Increased risk of respiratory depression C. Increased risk for bleeding D. Decreased seizure threshold
C. Increased risk for bleeding Feedback: Histamine-2 receptor antagonists when given with warfarin place the client at an increased risk for bleeding. A decreased white blood cell count occurs when histamine-2 receptor antagonists are given with carmustine. An increased risk of respiratory depression occurs when histamine-2 receptor antagonists are given with opioid analgesics. This class of drugs does not interact with any antiseizure medications.
The nurse is caring for a client who id prescribed mesalamine. The client is also taking warfarin. Which of the following interactions should the nurse monitor the client for when he is administered mesalamine with warfarin? A. Increased risk of immunosuppression B. Increased blood glucose level C. Increased risk of bleeding D. Increased risk of CNS depression
C. Increased risk for bleeding Feedback: The client administered mesalamine and warfarin is at an increased risk of bleeding. Warfarin is an anticoagulant used as a blood thinner; mesalamine is an aminosalicylate, which is an aspirin-like compound with anti-inflammatory action. The combination of mesalamine and warfarin does not increase the risk of immunosuppression, increase the blood glucose level, or increase the risk of CNS depression. There is an increased blood glucose level when oral hypoglycemic drugs interact with aminosalicylate. There is an increased risk of CNS depression when opioids are administered with aminosalicylates.
When describing the action of which drug would the nurse explain that it works to reduce gastric motility and decrease the amount of acid secreted by the stomach via blockade of cholinergic receptors? Select all that apply. A. Omeprazole (Prilosec) B. Ranitidine (Zantac) C. Propantheline (Pro-Banthine) D. Sucralfate (Carafate) E. Glycopyrrolate (Robinul)
C. Propantheline (Pro-Banthine) E. Glycopyrrolate (Robinul) Feedback: Propantheline (Pro-Banthine) and Glycopyrrolate (Robinul) are anticholinergic drugs used to reduce gastric motility and decrease the amount of acid secreted by the stomach via blockade of cholinergic receptors.
A nurse is caring for a client with irritable bowel syndrome. The physician has prescribed Polycarbophil to the client. The nurse would administer this drug cautiously if the client's history revealed which of the following? A. Abdominal pain B. Pseudomembranous colitis C. Rectal bleeding D. Intestinal obstruction
C. Rectal bleeding Feedback: The nurse should administer Polycarbophil with caution in clients with rectal bleeding, in pregnant women, and during lactation. Antidiarrheals are contraindications in clients with abdominal pain and pseudomembranous colitis. Aminosalicylates are contraindicated in client with intestinal obstruction.
A client is receiving a bowel evacuant in preparation for a colonoscopy. The client tells the nurse that he has been "going to the bathroom about every 30 to 45 minutes" since he started taking the drug and his stools are "like water." He reports that he is thirsty and his mouth feels dry. Which nursing diagnosis would the nurse most likely identify? A. Risk for Infection B. Risk for Injury C. Risk for Imbalanced Fluid Volume D. Deficient Knowledge
C. Risk for Imbalanced Fluid Volume Feedback: The client's report of frequent stools, which is a result of the drug therapy, along with complaints of feeling thirsty and dry mouth suggest the nursing diagnosis of Risk for Imbalanced Fluid Volume due to the large losses of fluid from the body from the drug. There is no evidence to support a risk for infection or deficient knowledge. Risk for Injury would be appropriate if the client was experiencing drowsiness or dizziness in conjunction with the fluid losses.
A client has been diagnosed with ulcerative colitis. The physician has prescribed sulfasalazine to the client. Based on the nurse's understanding of this condition, the nurse would monitor the client for which of the following? A. Mild symptoms of contact dermatitis B. Abdominal pain and distention C. Severe blood- and mucus-filled diarrhea D. Frequent loose or watery stools
C. Severe blood- and mucus-filled diarrhea Feedback: The nurse should monitor for severe blood-and mucus-filled diarrhea in the client with ulcerative colitis. Pain and fatigue also accompany this disorder. Abdominal pain and distention are clinical manifestations of Crohn's disease. When clients are hypersensitive to ragweed, asters, and chrysanthemums are administered the chamomile herb, mild symptoms of contact dermatitis are observed. Frequent loose or watery stools are not associated with ulcerative colitis.
A physician has prescribed Bisacodyl to a client with constipation. The client complains of epigastric pain and a burning sensation after taking the drug. Which of the following instructions should the nurse provide to the client? A. Immediately stop taking the drug B. Take antacids between meals C. Take the drug in powdered form D. Avoid milk before taking the drug
D. Avoid milk before taking the drug Feedback: The nurse should instruct the client to avoid milk, antacids, H2 antagonists, and proton pump inhibitors 1 to 2 hours before taking the Bisacodyl tablets because the enteric coating may dissolve early before reaching the intestinal tract, resulting in gastric lining irritation or dyspepsia and decreasing the laxative effect of the drug. The nurse need not instruct the client to immediately stop taking the drug, take the drug in powdered form, or take antacids between meals as there interventions will not help in preventing gastric lining irritation.
After teaching a group of nursing students about upper gastrointestinal system drugs, the instructor determines that the teaching was successful when the students identify which of the following as a gastrointestinal stimulant? A. Ranitidine (Zantac) B. Misoprostol (Cytotec) C. Omeprazole (Prilosec) D. Metoclopramide (Reglan)
D. Metoclopramide (Reglan) Feedback: Metoclopramide (Reglan) is classified as a gastrointestinal stimulant. Ranitidine is a histamine-2 receptor antagonist. Omeprazole is a proton pump inhibitor. Misoprostol is a miscellaneous acid reducer.
A nurse is preparing to administer sulfasalazine (Azulfidine) to a client with inflammatory bowel disease. The nurse checks the client's medical record for a history of hypersensitivities, understanding that the drug should not be administered to a client with hypersensitivity to which of the following drugs? Select all that apply. A. Enalapril (Vasotec) B. Doxycycline (Vibramycin) C. Azithromycin (Zithromax) D. Sulfamethoxazole/trimethoprim (Bactrim)
D. Sulfamethoxazole/trimethoprim (Bactrim) Feedback: Sulfasalazine (Azulfidine) is an aminosalicylate. The use of Aminosalicylates is contraindicated in clients with hypersensitivity to sulfonamides and sulfites, which includes sulfamethoxazole/trimethoprim (Bactrim).
A 30-year-old nonpregnant client is prescribed misoprostol. Which of the following should the nurse instruct the client as part of the teaching plan? A. Swallow the tablet 1 hour before eating B. Administer the drug 1 hour before travel C. Do not chew, open, or crush the tablet D. Use a reliable contraceptive method
D. Use a reliable contraceptive method Feedback: The nurse should instruct the client to use a reliable contraceptive method to avoid pregnancy during the course of treatment as it can cause spontaneous abortion. The nurse should instruct the client taking proton pump inhibitors not to chew, open, or crush the tablet and to swallow the tablet whole at least 1 hour before eating. The nurse needs to inform the client taking a drug for motion sickness to administer it about 1 hour before travel.