Ch. 58 - Quiz - Drugs Affecting Gastrointestinal Motility

The nurse is teaching a client who is to be discharged with an order to use chemical stimulant laxatives PRN. The nurse should caution the client about what potential adverse effect? a. Abdominal cramping b. Rectal bleeding c. Confusion d. Gastroesophageal reflux

a. Abdominal cramping

The nurse administers metoclopramide to the client with what condition? a. Chronic diabetic gastroparesis b. Impaction c. Encopresis d. Clients requiring diagnostic procedures

a. Chronic diabetic gastroparesis

The nurse administers loperamide to decrease the number and liquidity of stool by what mechanism? a. Decreasing intestinal motility b. Absorbing toxins c. Binding with fecal material to increase bulk d. Blocking the chemoreceptor trigger zone (CTZ)

a. Decreasing intestinal motility

The client had surgery 2 days ago and bowel motility has not returned. What drug might the nurse administer to prevent the loss of intestinal muscle tone? a. Dexpanthenol b. Docusate c. Psyllium (Metamucil) d. Senna

a. Dexpanthenol

The nurse collects a stool culture from a client diagnosed with traveler's diarrhea. What bacterium does the nurse expect the culture to grow? a. Escherichia coli b. Staphylococcus aureus c. Streptococcus type B d. Pseudomonas

a. Escherichia coli

The hospice nurse is caring for a client diagnosed with bone cancer who is receiving large doses of opioids. The client has used other laxatives in the past to treat opioid-induced constipation but nothing is working now. What drug would the nurse request the provider to order for this client? a. Methylnaltrexone b. Castor oil c. Paregoric d. Mineral oil

a. Methylnaltrexone

The family brings a client to the emergency department saying he has been hallucinating and falls so deeply asleep he stops breathing when not stimulated. The nurse learns the client has been self-treating diarrhea and suspects the client was taking what medication? a. Paregoric b. Bismuth subsalicylate c. Loperamide d. Colace

a. Paregoric

The nurse administers lubiprostone (Amitiza) to the client with irritable bowel syndrome and anticipates what therapeutic action from the drug? a. Secretion of chloride-rich intestinal fluid leading to increased motility b. Adding bulk to the fecal matter to ease the process of stooling c. Irritation of the inner lining of the bowel to increase bowel motility d. Stimulate the bowel by increasing innervation

a. Secretion of chloride-rich intestinal fluid leading to increased motility

A hospital client with a long history of constipation has been prescribed cascara. What aspect of the client's current health status should the nurse address before administering the medication? a. The client is immobile and has cognitive deficits. b. Most of the client's meals are brought in by family members. c. The client's preferred beverage is diet soda and the client is slightly obese. d. The client has type 2 diabetes and takes metformin.

a. The client is immobile and has cognitive deficits.

A man with irritable bowel syndrome reports ongoing diarrhea and asks for a prescription for alosetron, which was helpful for his coworker who recently started taking the drug. What is the nurse's best response? a. This drug is only approved for use in women. b. This drug is used as a laxative. c. This drug is contraindicated with irritable bowel syndrome. d. This drug is no longer on the market.

a. This drug is only approved for use in women.

The nurse develops a teaching plan for a 77-year-old client who has been prescribed loperamide PRN. The nurse's priority teaching point is what? a. "This may cause hallucinations or respiratory depression." b. "Take the drug after each loose stool." c. "The drug remains in your bowel without being absorbed into your bloodstream." d. "Avoid taking vitamin supplements while taking the drug."

b. "Take the drug after each loose stool."

The nurse is caring for a 2-year-old child who has been having frequent diarrhea. What actions are appropriate? Select all that apply. a. Administer bismuth salts as prescribed b. Administer loperamide as prescribed c. Monitor the client's electrolyte levels closely d. Monitor the client's fluid balance e. Monitor the client's red cell indices carefully

b. Administer loperamide as prescribed c. Monitor the client's electrolyte levels closely d. Monitor the client's fluid balance

The nurse should question an order for bismuth salts in a client with what condition? a. Rheumatoid arthritis b. Allergy to aspirin c. Hypertension d. Viral gastroenteritis

b. Allergy to aspirin

A client taking a chemical stimulant laxative and medications for heart failure and osteoarthritis calls the clinic and reports, "I'm just not feeling right." What is the priority question the nurse should ask this client? a. Previous effectiveness of laxatives b. Timing of medication administration c. The amount of fiber intake d. Amount of fluid intake

b. Correct! Timing of medication administration

What is the priority nursing diagnosis for an 89-year-old client with frequent liquid stools? a. Imbalanced nutrition: less than body requirements b. Deficient fluid volume c. Deficient knowledge related to medications d. Pain related to abdominal cramping

b. Deficient fluid volume

A client who is taking metoclopramide presents to the clinic for a follow-up visit. The nurse will be most concerned about a drug-drug interaction when learning the client is taking what other medication? a. Albuterol b. Digoxin c. Furosemide d. Acetylsalicylic acid

b. Digoxin

The nurse provides drug teaching to the client who will begin taking polycarbophil. What is the nurse's priority teaching point? a. Do not eat or drink anything for 2 hours after taking the medication. b. Drink lots of water when taking the drug. c. Take at night before bedtime. d. The drug can be taken up to six times per day.

b. Drink lots of water when taking the drug.

A clinic client with a history of heart failure requires a laxative for treatment of chronic constipation. What medication would be most appropriate for this client? a. Senna b. Lactulose c. Magnesium sulfate d. Castor oil

b. Lactulose

What drug does the nurse administer that inhibits intestinal peristalsis through direct effects on the longitudinal and circular muscles of the intestinal wall? a. Bismuth subsalicylate b. Loperamide c. Paregoric d. Magnesium citrate

b. Loperamide

The nurse, providing client teaching, explains that difenoxin and diphenoxylate are chemically related to what medication? a. Morphine b. Meperidine c. Diphenhydramine d. Diflucan

b. Meperidine

The nurse is caring for a client who has had impacted stools twice in the past month. What is the most appropriate laxative for this client? a. Magnesium hydroxide b. Mineral oil c. Docusate d. Psyllium

b. Mineral oil

The nurse teaches the client to best promote optimal GI function by including what in the daily routine? a. Exercise, adequate sleep, and avoiding caffeine b. Nutritious diet, adequate fluid intake, and exercise c. Nutritious diet, avoiding alcohol, and cautious use of laxatives d. Avoiding prescription medications, increased fluid intake, and vigorous exercise

b. Nutritious diet, adequate fluid intake, and exercise

A client with diarrhea was instructed by the pharmacist to take bismuth subsalicylate. The client took the medication as instructed for 36 hours and has now called the clinic reporting dark stools that are "nearly black." What is the nurse's best action? a. Have the client come in for fecal occult blood testing b. Reassure the client that this is an expected effect of the drug that does not indicate pathology c. Have the client monitor his or her bowel movements for 24 hours and then call the clinic again d. Have the client come be assessed for a gastrointestinal bleed

b. Reassure the client that this is an expected effect of the drug that does not indicate pathology

What should the nurse tell the client who will begin taking rifaximin for traveler's diarrhea? a. "Do not start taking the drug until the diarrhea has persisted for at least 24 hours." b. "Taking the antibiotic will allow you to enjoy the local water and food without concern." c. "Do not take the drug if you have bloody diarrhea." d. "Start the drug 3 days before leaving for your trip and continue until you return."

c. "Do not take the drug if you have bloody diarrhea."

A client receiving loperamide (Imodium) should be alerted by the nurse to what possible adverse effect? a. Anxiety b. Bradycardia c. Constipation d. Urinary retention

c. Constipation

The home health nurse is caring for an 82-year-old man in his home. He reports almost daily diarrhea. The nurse should assess for what common cause of diarrhea in older adults? a. Inadequate fluid intake b. Antihypertensive medications c. Laxative overuse d. Inactivity

c. Laxative overuse

A client with a history of constipation has been taking OTC laxatives with good success. The client tells the nurse that he is relieved to have found a solution to his constipation. When providing health education, the nurse should prioritize what topic? a. Appropriate use of antidiarrheals in case of laxative overdose b. Preventative strategies against nausea and vomiting c. Strategies for preventing dependence on laxatives d. Optimal timing of food intake, fluid intake, and laxative use

c. Strategies for preventing dependence on laxatives

When would it be appropriate for the nurse to administer castor oil as a laxative? a. To ease the passage of stool in the client who recently had a baby b. To remove ingested poisons from the lower gastrointestinal (GI) tract c. To evacuate the bowel for diagnostic procedures d. To treat chronic constipation

c. To evacuate the bowel for diagnostic procedures

For which clients would it be appropriate for the nurse to administer a laxative? Select all that apply. a. A client diagnosed with a partial small bowel obstruction b. A client being assessed for appendicitis c. A pregnant client who is in early labor d. A client who is recovering from a myocardial infarction (MI) e. A client who has completed anthelmintic therapy

d. A client who is recovering from a myocardial infarction (MI) e. A client who has completed anthelmintic therapy

The nurse admits to the clinic a 7-month-old infant whose parents report that the baby has not had a bowel movement in 4 days. What is the nurse's best action? a. Encourage watchful waiting for 24 hours b. Administer magnesium hydroxide as prescribed c. Encourage feeding supplementation with free water d. Administer a glycerin suppository as prescribed

d. Administer a glycerin suppository as prescribed

A new mother required an episiotomy during the birth of her baby. Two days after the birth of her baby, the client is in need of a laxative. What will be the most effective drug for the nurse to administer? a. Bisacodyl b. Castor oil c. Magnesium sulfate d. Docusate

d. Docusate

For what action would the nurse administer magnesium citrate? a. Block absorption of fats b. Directly stimulate the nerve plexus in the intestinal wall c. Form a slippery coat on the contents of intestine d. Increase motility and the bulk of fecal matter

d. Increase motility and the bulk of fecal matter

A hospital client has been scheduled for a barium enema the following morning. The nurse should anticipate what prescription for the client's bowel preparation? a. Magnesium sulfate b. Polycarbophil c. Senna d. Polyethylene glycol-electrolyte solution

d. Polyethylene glycol-electrolyte solution

The nurse administers psyllium to a client with constipation. What outcome best demonstrates therapeutic effects? a. The client's bowel sounds are reduced. b. The client remains free of diarrhea. c. The client has two to three bowel movements daily. d. The bulk of the client's stools is increased.

d. The bulk of the client's stools is increased.

A client with an ileostomy has been experiencing excessive output for the past 48 hours. The nurse should collaborate with the provider to obtain a prescription for: a. cascara. b. octreotide. c. psyllium. d. loperamide.

d. loperamide.