NCLEX style questions ( G.I. Drugs)

A hospitalized client asks the nurse for sodium bicarbonate to relieve heartburn following a meal. The nurse reviews the client's medical record, knowing that the medication is contraindicated in which of the following conditions? 1. urinary calculi 2. chronic bronchitis 3. metabolic alkalosis 4. respiratory acidosis

3. Respiratory acidosis

An 80- year-old client has recently been started on cimetidine (Tagamet). The nurse monitors the client for which most frequent central nervous system (CNS) side effect of this medication? 1. Tremors 2. Dizziness 3. Confusion 4. Hallucination

3. confusion

A histamine (H2) - receptor antagonist will be prescribed for a client. The nurse understands that which medications are H2- receptor antagonists, one of which could be prescribed. Select all that apply. 1. Nizatidine (Axid) 2. Ranitidine (Zantac) 3. Famotidine (Pepcid) 4. Cimetidine (Tagamet) 5. Esomeprazole (Nexium) 6. Lansoprazole (Prevacid)

answer: 1,2,3,4 - 5 and 6 are PPI's (proton pump inhibitors)

After drinking the prescribed dose of GOLYTELY and have numerous stools, the client reports feeling chest palpitations to the nurse. The nurse suspects an electrolyte imbalance and requests a physician order for Lab work. Which ones concern you? 1. sodium 126 mEq/ L 2. potassium 2.8 mEq/L 3. chloride 90 mEq/L 4. calcium 9.4 mEq/dL 5. phosphrous 3.5 mEq/dL 6. Blood Urea nitrogen (BUN) 16 mg/dL

1,2,3 rationale: sodium is the most abundant cation in the blood and functions in the body to maintain osmotic pressure and acid-base balance to transmit nerve impulses, very low values can result in seizures and neurologic symptoms, normal adult range between 135 adn 146 mEq/L - Potassium is essential for maintaining fluid balance, nerve impulse function, muscle function, and cardiac (heart muscle) function. Very low values can cause cardiac arrhythmias, normal range in an adult is 3.5 and 5.5 mEq - Chloride is influenced by the extracellular fluid balance and acid-base balance. Choloride passively follows water and sodium. Normal adult range is 95 to 112 mEq/L

A client with a history of duodenal ulcer is taking calcium carbonate chewable tablets. The nurse determines that the client is experiencing optimal effects of the medication if: A. Heart burn is relieved B. Muscle twitching stops C. Serum calcium levels rise D. Serum phosphrous levels decrease

A. Heart burn is relieved

The physician prescribes docusate sodium (Colace) fo the client. The client asks the nurse to explain why the medication is needed. Which explanation given by the nurse correctly states the purpose of medication? A. To ease bowel evacuation and its related discomfort B. To irriatate the bowel and promote stool elimination C. To stimulate peristalsis to remove wastes after the digestion D. To reduce intestinal activity and decrease stool size

A. To ease bowel evacuation and its related discomfort Rationale: Docusate sodium (Colace) is a stool softner, retaining water in the stool, softens the mass and makes stool easier and less painful to pass.

A physician has written an order for ranitidine (Zantac) once daily. The nurse schedules the medications for which of the following times? A. At bed time B. After lunch C. With supper D. Before breakfast

A. at bed time, ranitidine (Zantac) is an H2 blocker

A nurse is reviewing medications for a client who has a diagnosis of small bowel obstruction. The nurse should withhold Senna (Senoket) prescribed orally based on an understanding of which of the following? A. laxatives are contraindicated in clients who have small bowel obstruction B. Only bulk-forming laxatives such as psyllium (Metamucil) should be prescribed C. Medication should be administered via NG tube than oral route D. Opioid analgesics, rather than laxative should be prescribed to alleviate discomfort

A. laxatives are contraindicated in clients who have small bowel obstruction Rationale: Laxatives are contraindicated in clients who have fecal impactation, bowel obstruction, and acute abdominal surgery to prevent perforation. Laxatives will cause increased abdominal cramping and discomfort

Your client is dx with end stage liver failure and receiving lactulose/granulote. which lab test tells you it is effective? A. serum ammonia B. BUN C. sodium D. serum Creatinine

A. serum ammonia

A nurse is talking with a client who has peptic ulcer disease and is starting therapy with sucralfate (Carafate). The nurse should instruct the client to take this medication: A. with antacid B. 1 hr before meals C. with food or milk D. immediatly after meals

B. 1 hr before meals rationale: Sucralfate is a mucosal protectant, the client should take it on an empty stomach, 1 hr before meals, for maximum effectiveness

A nurse is caring for a client with cirrhosis who has a new prescription for cephulac (Lactulose). Following administration, the nurse will monitor the client for which adverse effect of this medication? A. Dry mouth B. Diarrhea C. Headache D. Peripheral edema

B. Diarrhea Rationale: The nurse will monitor for diarrhea, Lactulose is a synthetic disaccharide that the small intestine cannot utilize. It causes diarrhea by lowering the ph so that the bacterial flora are changed in the bowel

A client is relying on OTC laxatives for regular elimination. Which of the following pieces of information is most important for the nurse to provide to the client? A. daily bowel movements are not necessary for good intestinal health B. Excessive laxative use may cause decreased sodium levels C. Chronic use of laxatives can lead to dependency of elimination D. The client should increase intake of high-fiber diet

B. Excessive laxative use may cause decreased sodium levels Rationale: Excessive laxative use causes G.I. system to become dependent on external methods to achieve elimination - Laxative dependence weakens peristalsis and musculature of colon

A client has been taking omeprazole (Prilosec) for 4 weeks. The nurse determines that the client is receiving the optimal intended effect of the medication if the client reports absence of which of the following symptoms? A. Diarrhea B. Heartburn C. Flatulence D. Constipation

B. Heartburn ,omeprazole (Prilosec) is used for GERD

How should the patient be taking (Prilosec) Omeprazole? A. take drugs 2 hours after a meal B. take 1 hour before meals and swallow tablets as whole C. take it with juice and crush tablets D. all of the above

B. Take 1 hour before meals and swallow tablet as whole rationale: Proton Pump inhibitors, decreases gastric juices and reduces pain, they are taken 1 hour before meals, not after and we don't take it crushed, take it whole

A physician prescribes bisacodyl (Dulcolax) for a client in preparation for a diagnostic test and wants the client to achieve a rapid effect from the medication. The nurse then tells the client to take the medication: A. With a large meal B. On an empty stomach C. At bedtime with a snack D. With two glasses of juice

B. on an empty stomach, bisacodyl (Dulcolax) is a stool softner

the pregnancy category for the antiflatulent drug simethicone is: a. category A b. category C c. category unknown d. category X

c. category unknown

A nurse is caring for a caring for a client who is receiving esomeprazole (Nexium) to manage GERD. Which of the following best indicates the desired therapeutic effect? A. " I don't pass gas a often" B. "my abdomen is no longer firm" C. "I don't have pain in my stomach" D. " I have regular BM's"

C. "I don't have pain in my stomach" rationale: esomeprazole (Nexium) is proton pump inhibitor (PPI) and works in the parietal cells of the stomach by inhibiting the proton pump enzyme that generates gastric acid secretion. - Treatment is for gastric ulcers, duodenal ulcers and GERD. - an expected finding if medication is effective will be a decrease in the client's symptoms of an ulcer or GERD. Heartburns are a common sign of GERD, so absence of pain means the medication is working

Your elderly pt is being administered Lomotil, what kind of drug? A. Antiflatulent B. Laxative C. Antidiarrheal D. Emetic

C. Antidiarrheal, its a narcotic

A nurse teaches a client taking metoclopramide (Reglan) to discontinue the medication immediately and call the physician if which side effect occurs with long- term use? A. Excessive excitability B. Anxiety or irritability C. Uncontrolled rhythmic movements of the face or limbs D. Dry mouth not helped by the use of sugar-free hard candy

C. Uncontrolled rhythmic movements of the face or limbs

A client has a PRN order for loperamide (Imodium). The nurse should plan to administer this medication if the client has: A. constipation B. abdominal pain C. episode of diarrhea D. Hematest-positive nasogastric tube drainage

C. episode of diarrhea, loperamide (Imodium) is an antidiarrheal

A physician orders a colonoscopy b/c of the client's persistent diarrhea. The nurse instructs the client to drink 250 mL of an electrolyte solution called GOLYTELY every 15 minutes over a 2 hour period. Which observation by the nurse provides the best evidence that the solution has achieved its primary purpose? A. the client's serum electrolyte levels are normal B. the client's intake approximates the output C. the client's stools become clear liquid D. the client's bladder fills with urine

C. the client's stools become clear liquid Rationale: GOLYTELY is given as a colonic lavage. Within 30 minutes of ingesting the 1st volume of the solution, the client should experience the 1st of many bowel movements. The bowel must be clear of feces for the colonoscopy to be effective! The solution is preferable to other forms of bowel clensing its less likely to deplete electrolytes or cause water intoxification

A client has a PRN order for ondansetron (Zofran). The nurse would administer this medication to the postoperative client for relief of: A. paralytic ileus B. incisional pain C. urinary retention D. Nausea and vomiting

D. Nausea and vomiting, ondansetron (Zofran) is an antiemetic

The Patient has GERD and they are prescribed( Prilosec) Omeprazole What kind of a drug is it? A. Antacid B. Histamine H2 Antagonist C. Anticholinergic D. Proton Pump Inhibitor

D. Proton Pump inhibitor

A client is taking docusate sodium (Colace). The nurse monitors which of the following to determine whether the client is having a therapeutic effect from this medication? A. Abdominal pain B. Reduction in steatorrhea C. Hematest-negative stools D. Regular bowel movements

D. Regular bowel movements

A client has been taking omeprazole (Prilosec) for the past 4 weeks. The nurse determines that the medication is effective when the client reports? A. nausea B. diarrhea C.headache D. acid indigestion

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

what do you tell patients to do with tablets (antacid)? A. take drugs 30 minutes before meals B. crush it and mix with orange juice C. take 1 hour after meal D. chew thoroughly and take with full glass of water

D. chew thoroughly and take with a full glass of water

A client with a gastric ulcer has an order for sucralfate (Carafate), 1 g orally four times a day. The nurse schedules the medications for which of the following times? A. With meals and at bedtime B. Every 6 hours around the clock C. One hour after meals and at bedtime D. One hour before meals and at bedtime

D. one hour before meals and at bedtime

A charge nurse and a newly licensed nurse are providing care for a client who reports nausea and has a presciption for metoclopramide (Reglan) as an antiemetic. Which of the following statements by the newly licensed nurse indicates a correct understanding of the actions of the medication. "Metoclopramide": A. depresses vagal nerve activity B. decreases gastric acid secretions C. slows peristalsis D. promotes gastric emptying

D. promotes gastric emptying Rationale: Metoclopramide is a gastrointestinal stimulant used to relieve nausea, vomiting, heartburn, stomach pain, bloating, and persistent feeling of fullness after meals. - Metoclopramide works by promoting gastric emptying

the nurse administers antidiarrheal drugs... a. after each loose bowel movement b. hourly until diarrhea ceases c. with food d. BID, in the AM and at bedtime

a. after each loose bowel movement

The patient asks how stool softeners relieve constipation. Which of the following would be the best response by the nurse? Stool softeners relieve constipation by: a. stimulating the walls of the intestine b. promoting the retention of sodium in the fecal mass c. promoting the retention of water in the fecal mass d. lubricating the intestinal walls

c. promoting the retention of water in the fecal mass

When recording the administration of diphenoxylate for multiple loose stools: a. document the daily number of drugs given b. record all stools once each shift c. indicate all stools on the MAR next to the drug d. document each dose on the MAR

d. document each dose on the MAR