GI Pharmacology practice questions:

A patient who is prescribed a bisacodyl (Dulcolax) suppository. Which explanation will the nurse use to explain the action of bisacodyl? A.) Acts on smooth intestinal muscle to gently increase peristalsis B.) Absorbs water into the intestines to increase bulk and peristalsis C.) Lowers surface tension and increases water in the feces to increase bulk D.) Pulls salt into the colon and increases water in the feces to increase bulk

A.) Acts on smooth intestinal muscle to gently increase peristalsis ***STIMULANT

The nurse is administering diphenoxylate with atropine (Lotomil) to a patient. Which should be included in the patient teaching teaching regarding this medication? Select all that apply A.) Caution the patient to avoid laxative abuse B.) Record the frequency of bowel movements C.) Caution the patient against taking sedatives concurrently D.) Encourage the patient to increase fluids E.) Instruct patient to avoid this drug if he/she has narrow-angle glaucoma F.) Teach the patient that the drug acts by drawing water into the intestine

A.) Caution the patient to avoid laxative abuse B.) Record the frequency of bowel movements C.) Caution the patient against taking sedatives concurrently D.) Encourage the patient to increase fluids E.) Instruct patient to avoid this drug if he/she has narrow-angle glaucoma

A patient is diagnoses with peptic ulcer disease. The nurse realizes that which is a predisposing factor for this condition? A.) Heliobacter pylori B.) Hyposecretion of pepsin C.) Decreased hydrochroric acid D.) Escherichia Coli

A.) Heliobacter pylori

The patient has been prescribed a treatment regimen that includes nizatidine (Axid). Which statement by the patient indicates a therapeutic outcome? A.) "I don't have any more stomach pain." B.) "My constipation has been relieved." C.) "I don't have such frequent headaches." D.) "My anxiety has been under control."

A.) Nizatidine (Axid) is used to treat stomach ulcers and to prevent their recurrence.

What is a priority nursing intervention when administering ranitidine (Zantac)? A.) Administer just before meals. B.) Administer right after eating. C.) Administer 1 to 2 hours after meals. D.) Administer during meals.

A.) Ranitidine (Zantac) should be given just before meals to decrease food-induced acid secretion or at bedtime.

An older adult patient reports taking aluminum hydroxide (Amphojel) on a daily basis to relieve symptoms of GERD. The nurse needs to evaluate for which condition? A.) Constipation B.)Diarrhea C.)Flatulence D.)Abdominal pain

Answer: A Rationale: Use of aluminum hydroxide most often causes constipation. Magnesium products can cause diarrhea.

When administering the histamine2 blocker ranitidine (Zantac), the nurse will: A.) monitor laboratory results because ranitidine decreases the effect of oral anticoagulants. B.) separate ranitidine (Zantac) and antacid dosage by at least 1 hour if possible. C.) teach the patient to avoid foods rich in vitamin B12. D.) expect a reduction in the patient's pain to occur after 5 days of therapy.

Answer: B Rationale: Antacids can be given 1 hour before or after ranitidine (Zantac) as part of the antiulcer drug regimen. Ranitidine (Zantac) can increase the effect of oral anticoagulants. Patients on ranitidine (Zantac) should eat a diet rich in vitamin B12 to avoid deficiency as a result of drug therapy. The patient's abdominal pain is expected to decrease after 1 to 2 weeks of drug therapy.

The nurse is administering loperamide (Imodium) to a patient with diarrhea. What assessment is essential for the nurse to perform? A.) Vascular assessment B.) Gastric assessment C.) Hourly blood pressure measurements D.) Intake and output every shift

B.) Adverse effects associated with loperamide (Imodium) include central nervous system symptoms such as fatigue and dizziness, epigastric pain, abdominal cramps, nausea, dry mouth, vomiting, and anorexia. The nurse should be auscultating bowel sounds on the patient to verify that they are present in each quadrant. There is no evidence to support vascular assessment or hourly blood pressure measurements. Although intake and output is important because the patient is experiencing diarrhea, it does not have the priority that gastric assessment does.

In developing a plan of care for a patient receiving an antihistamine antiemetic agent, which nursing diagnosis is of highest priority? A.) Knowledge deficit regarding medication administration B.) Fluid volume deficit related to nausea and vomiting C.) Risk for injury related to side effects of medication D.) Alteration in comfort related to nausea and vomiting

B.) Although all of the options are appropriate nursing diagnoses, fluid volume deficit is the highest priority because it has the highest associated mortality rate.

The nurse is caring for a patient who is taking sucralfate (Carafate) for treatment of a duodenal ulcer. Which assessment requires action by the nurse? A.) A sodium level 140 mEq/L B.) Absent bowel sounds, hard abdomen C.) Urinary output of 30 mL/hr D.) A calcium level 8.5 mg/dL

B.) As sucralfate (Carafate) is not systemically absorbed, there are few adverse effects. Constipation is an adverse effect of sucralfate, so the absence of bowel sounds and a hard abdomen would require immediate action from the nurse. The sodium level listed is considered to be within the normal range; 30 mL/hr is a normal urinary output.

A patient w/ nausea is taking ondansetron (Zofran). She asks the nurse how this drug works. The nurse is aware that this medication has which action? A.) Enhances H1 receptor sites B.) Blocks seratonin receptors in the CTZ C.) Blocks dopamine receptors in the CTZ D.) Stimulates anticholinergic receptor sites

B.) Blocks seratonin receptors in the CTZ

A patient is taking famotidine (Pepsid) to inhibit gastric secretions. Which side effects of famotidine will the nurse teach the patient? (Select all that apply) A.) Diarrhea B.) Dizziness C.) Dry mouth D.) HA E.) blurred vision F.) decreased libido

B.) Dizziness D.) HA F.) decreased libido

The nurse is caring for a patient who is experiencing gastric distress from the long-term use of aspirin for treatment of arthritis. Which intervention does the nurse anticipate that the provider may order? A.) Stop all aspirin therapy. B.) Administer misoprostol (Cytotec). C.) Instruct the patient to take the aspirin with milk. D.) Instruct the patient to take the aspirin on an empty stomach.

B.) Misoprostol (Cytotec) is indicated for the prevention of NSAID-induced ulcer. It may be taken during NSAID therapy, including with aspirin. The patient may not be able to be completely taken off of all aspirin products; there is no evidence to support the need to take the aspirin with milk. Certain drugs like NSAIDs, which include aspirin, should be taken with food.

Which statement demonstrates to the nurse that the patient understands instructions regarding the use of histamine2-receptor antagonists? A.) "Since I am taking this medication, it is all right for me to eat spicy foods." B.) "Smoking decreases the effects of the medication, so I should try a cessation program." C.) "I should take this medication 1 hour after each meal to decrease gastric acidity." D.) "I should decrease bulk and fluids in my diet to prevent diarrhea."

B.) Patients taking histamine2-receptor blocking agents should avoid spicy foods, extremes in temperatures, alcohol, and smoking. They should also increase bulk and fluids in their diets to prevent constipation. The medications should be taken with meals, not after meals.

A patient complains of constipation and requires a laxative. In providing teaching for this patient, the nurse review the common causes of constipation, including which cause? A.) Motion sickness B.) Poor dietary habits C.) Food intolerance D.) Bacteria (Escherichia coli)

B.) Poor dietary habits

The patient's health care provider prescribes rabeprazole (Aciphex) to a patient. The nurse recognizes that this drug is effective for the patient because it belongs to which drug class? A.) Antiinfective agent B.) Proton pump inhibitor C.) Antacid D.) Histamine2 blocker

B.) The drug rabeprazole (Aciphex) is classified as a proton pump inhibitor.

A patient has been prescribed aluminum hydroxide (Amphojel) and has received patient teaching. Which statement by the patient indicates an understanding of the instructions? A.) "I will take aluminum hydroxide at mealtime." B.) "I will drink 2 ounces of water after taking aluminum hydroxide." C.) "I will take aluminum hydroxide within 30 minutes of my other medications." D.) "I will take a laxative if I develop constipation."

B.) The patient should drink 2 ounces of water after taking aluminum hydroxide to ensure the drug reaches the stomach. Aluminum hydroxide should not be taken at mealtime as it slows gastric emptying time. Aluminum hydroxide should not be taken within 1 to 2 hours of other oral medications. The patient should contact the health care provider if constipation develops as the antacid may need to be changed; self-treatment should be avoided.

Which nursing intervention is a priority before administering magnesium hydroxide to a patient? A.) Obtain a history of constipation and causes. B.) Record baseline vital signs. C.) Assess renal function. D.) Advise the patient to take the medication with a glass of water.

C.) Adequate renal function is needed to excrete excess magnesium. This intervention is essential to predict how the patient will handle the therapy. The other interventions are important, but assessing renal function is the priority.

When metoclopramide (Reglan) is given for nausea, the nurse plans to caution the patient to avoid which substance? A.) Milk B.) Coffee C.) Alcohol D.) Carbonated beverages

C.) Alcohol

What instruction is most important for the nurse to teach a patient who is taking an anticholinergic agent to treat nausea and vomiting? A.) "Assess your stools for dark streaks." B.) "Do not take more than two doses of this medication." C.) "Brush your teeth and gargle to help with dryness in your mouth." D.) "Check your heart rate and call the health care provider if it gets below 50 beats/min."

C.) Anticholinergic agents block the parasympathetic nervous system, which causes the body to "rest and digest." Blocking of these effects leads to constipation, urinary retention, and decreased secretions (dry mouth).

Which outcome assessment is essential to monitor for in the patient taking diphenoxylate with atropine (Lomotil)? A.) Increase in bowel sounds B.) Increase in number of bowel movements C.) Decrease in gastric motility D.) Decrease in urination

C.) Diphenoxylate with atropine (Lomotil) acts on the smooth muscle of the intestinal tract to inhibit gastrointestinal motility and excessive propulsion of the gastrointestinal tract (peristalsis). A decrease in the gastric motility results in a decrease in the number of bowel movements. Bowel movements should not increase; bowel sounds should not increase, and there should be no change in urination.

Which assessment is most important for the patient who is taking stimulant laxatives? A.) Monitor bowel elimination daily. B.) Monitor intake and output. C.) Monitor signs and symptoms of fluid and electrolyte imbalance. D.) Monitor heart rate and blood pressure every 4 hours.

C.) Fluid and electrolyte imbalance is a serious complication of the therapy. The patient needs to be monitored for potential problems.

The health care provider prescribes lansoprazole (Prevacid) for a patient. Which assessment indicates to the nurse that the medication has had a therapeutic effect? A.) The patient has no diarrhea. B.) The patient has no gastric pain. C.) The patient has no esophageal pain. D.) The patient is able to eat.

C.) Lansoprazole (Prevacid) is a proton pump inhibitor that is effective in suppressing gastric acid secretions. An absence of esophageal pain would be an indication that the patient does not have reflux esophagitis.

What information will the nurse include in a teaching plan for the patient who is prescribed sucralfate (Carafate)? A.) "This medication will neutralize gastric acid." B.) "This medication will enhance gastric absorption of meals." C.) "This medication will form a protective barrier over the gastric mucosa." D.) "This medication will inhibit gastric acid."

C.) Sucralfate (Carafate) affects the gastric mucosa. It forms a paste-like substance in the stomach, which adheres to the gastric lining, protecting against adverse effects related to gastric acid. It also stimulates healing of any ulcerated areas of the gastric mucosa.

The health care provider has prescribed lansoprazole (Prevacid) for the patient. Within 30 minutes of receiving the first dose of the medication, the patient experiences shortness of breath and develops a rash on his skin. What does the nurse expect that the patient is experiencing? A.) Unexpected side effect of the medication B.) Toxic level of the medication C.) Allergic reaction to the medication D.) Typical side effect of the medication

C.) The patient's symptoms are indicative of an allergic reaction to the medication.

Which statement by the patient indicates that further teaching is needed about antiemetic medication? A.) "I will not drive while I am taking these medications because they may cause drowsiness." B.) "I may take Tylenol to treat the headache caused by ondansetron (Zofran)." C.) "I will apply the scopolamine patches to rotating sites on my upper arms." D.) "I should take my prescribed antiemetic before receiving my chemotherapy dose and continue afterwards."

C.) Transdermal scopolamine patches should be applied to non-irritated areas behind the ear, not on the arms. It is appropriate for the patient to refrain from driving while utilizing antiemetics, to use Tylenol to treat headaches caused by ondansetron (Zofran), and to take antiemetics preventatively prior to and after chemotherapy.

A patient is taking ranitidine (Zantac). What information should the nurse teach the patient about this drug. (select all that apply) A.) drug induced impotence is irreversible B.) the drug must be administered 30 minutes before meals C.) the drug must be administered separately from an antacid by at least one hour D.) the drug must always be administered with magnesium hydroxide E.) smoking should be avoided on this drug F.) food high in vitamin B12 should be increased in diet

C.) the drug must be administered separately from an antacid by at least one hour E.) smoking should be avoided on this drug F.) food high in vitamin B12 should be increased in diet

The patient is taking esomeprazole magnesium (Nexium) for an erosive GERD. Which should the nurse include in patient teaching? A.) take with breakfast daily B.) healing should occur within a week C.) this medication decreases stomach acid secretion D.) blood test to check kidney function should be done

C.) this medication decreases stomach acid secretion

What will the nurse teach the patient about the reason for administering multiple medications for relief of nausea and vomiting? A.) Combination therapy decreases the risk of constipation. B.) Combination therapy is more cost-effective. C.) Combination therapy blocks different vomiting pathways. D.) Combination therapy decreases side effects due to lower doses of each drug.

Combining antiemetic agents from various categories allows the blocking of the vomiting center and chemoreceptor trigger zone through different pathways, thus enhancing the antiemetic effect.

A patient is prescribed scopolamine. What information should the nurse include on the teaching plan for this patient? (Select all that apply.) A.) "Do not take this medication if you are dizzy." B.) "Do not use laxatives while on this medication." C.) "Do not use this medication for longer than a day." D.) "After 3 days, switch patch to alternate ear." E.) "Apply patch 4 hours before effect is desired." F.) "Drowsiness is a concern while on this medication."

D,E,F.) This medication is used for motion sickness and has anticholinergic side effects, including dizziness, drowsiness, dry mouth, and constipation. The patient can use it for longer than 3 days, but must switch ears. It should be applied 4 hours before the effect is needed.

A patient is prescribed lorazepam (Ativan) and a glucocorticoid during chemotherapy treatments. What is the nurse's best action? A.) Call the health care provider and question the order. B.) Only administer the Ativan if the patient seems anxious. C.) Administer the two medications at least 12 hours apart. D.) Administer the medications and assess the patient for relief.

D.) Drug combination therapy is commonly used to manage chemotherapy-induced nausea and vomiting. Both lorazepam (Ativan) and the glucocorticoids have been found to be effective medications to assist in preventing and managing chemotherapy-induced nausea and vomiting.

A patient is using scopolamine (Transderm-Scop) to prevent motion sickness. About which common side effect should the nurse teach the patient? A.) Diarrhea B.) Vomiting C.) Insomnia D.) Dry mouth

D.) Dry mouth

A student nurse is preparing to administer sucralfate (Carafate) to a patient. Which statement by the student nurse demonstrates understanding of sucralfate's mode of action? A.) sucralfate neutralizes gastric acidity B.) gastric acid secretion is decreased by inhibiting histamine at h2 receptors in parietal cells C.) Gastric acid secretion is suppressed by inhibiting the hydroen/potassium ATPase enzyme D.) Sucralfate combines with protein to form a viscous substance that forms a protective covering of ulcer

D.) Sucralfate combines with protein to form a viscous substance that forms a protective covering of ulcer

When a patient complains of pain accompanying a peptic ulcer, why should the nurse give an antacid? A.) Antacids decrease GI motility B.) antacids decrease acid secretion C.) antacids strengthen the lower esophageal sphincter's actions D.) antacids neutralize HCL and reduce pepsin activity

D.) antacids neutralize HCL and reduce pepsin activity