ATI Gastrointestinal System
A nurse is planning teaching for a client who has been prescribed loperamide to treat diarrhea. Which of the following statements should the nurse plan to include? "Avoid driving or activities requiring alertness" "Avoid driving or activities requiring alertness." "If you miss a dose, double the next dose." "Rinsing the mouth with alcohol-based mouthwash can reduce dryness." "Having one glass of wine each night can improve medication effectiveness."
"Avoid driving or activities requiring alertness." Loperamide can cause drowsiness and dizziness. The client should avoid driving or activities requiring alertness while taking the drug.
A health care professional should question the use of misoprostol (Cytotec) for a patient who has which of the following?
A positive pregnancy test
The nurse should recognize that misoprostol is contraindicated for a client who has which of the following conditions? A seizure disorder Rheumatoid arthritis A positive pregnancy test Heart failure
A positive pregnancy test Misoprostol, a prostaglandin E1 analog, is a teratogenic drug. It can cause uterine contractions and induce spontaneous abortion; therefore, providers must confirm that clients are not pregnant before prescribing the drug; and clients who take misoprostol must use contraception.
A health care professional should question the use of dimenhydrinate for a patient who has which of the following disorders? A.) Hyperthyroidism B.) Angle-close glaucoma C.) Hypertension D.) Diabetes mellitus
Angle-closure glaucoma
A health care professional is caring for a patient who is about to begin taking alosetron (Lotronex) to treat irritable bowel syndrome. The health care professional should tell the patient to report which of the following adverse effects? Headache Drowsiness Abdominal pain Sore throat
Abdominal pain - Alosetron, a serotonin 5-HT3 receptor antagonist, can cause ischemic colitis. The nurse should tell the client to report abdominal pain, bloody diarrhea, or rectal bleeding, and to stop taking the drug if these manifestations occur
A nurse is caring for a client who is taking allopurinol to treat gout and has a new prescription for Azathioprine to treat ulcerative colitis. For which of the following reasons should the nurse clarify these prescriptions with the provider? Allopurinol delays the conversion of azathioprine and can lead to toxicity. Azathioprine increases the effectiveness of allopurinol. Allopurinol increases the metabolism of azathioprine and can require an increased dosage. Azathioprine decreases the effectiveness of allopurinol.
Allopurinol delays the conversion of azathioprine and can lead to toxicity. Allopurinol delays the conversion of azathioprine to an inactive form and can lead to toxicity. If used concurrently, the dose of azathioprine must be reduced.
A health care professional is caring for a patient who is about to begin taking ranitidine (Zantac) to treat GERD. The health care professional should tell the patient to take certain precautions when taking which of the following over-the-counter drugs? Ginkgo biloba Antidiarrheals St. John's wort Antacids
Antacids Antacids can decrease the absorption of famotidine, a histamine2-receptor antagonist. The nurse should instruct the client to wait at least 1 hr between taking famotidine and taking an antacid.
When talking with a patient about taking loperamide (Imodium), the health care professional should include which of the following instructions? - Dissolve the powder thoroughly in 8 oz (237 mL) of water. - Take with diphenhydramine to prevent extrapyramidal effects. - Avoid activities that require alertness. - Take 30 min before activities that trigger nausea.
Avoid activities that require alertness. - Loperamide, an opioid agonist, can cause sedation and dizziness. The nurse should instruct the client to avoid taking it before activities that require alertness.
A health care professional is caring for a patient who is about to begin taking azathioprine (Imuran) to treat inflammatory bowel disease. The health care professional should tell the patient to report which of the following adverse effects? (Select all that apply.)
Bruising is correct. Azathioprine can cause thrombocytopenia. The health care professional should monitor platelet count, and tell the patient to report easy or unexplained bruising or bleeding. Jaundice is correct. Azathioprine can cause hepatitis. The health care professional should monitor liver function tests, and tell the patient to report abdominal pain or jaundice. Sore throat is correct. Azathioprine can cause agranulocytosis. The health care professional should tell the patient to report sore throat or fatigue. Nausea is correct. Azathioprine can cause nausea, vomiting, and anorexia. The health care professional should tell the patient to take azathioprine with food to minimize GI effects.
A health care professional should question the use of metoclopramide (Reglan) for a patient who is taking which of the following drugs? A.) Digoxin (Lanoxin) B.) Warfarin (Coumadin) C.) Fluvoxamine (Luvox) D.) Allopurinol (Zyloprim)
Digoxin (Lanoxin)
When talking with a patient about taking metoclopramide (Reglan) to treat GERD, the health care professional should include which of the following instructions? A.) Take the drug once a day in the morning B.) Stop taking the drug if drowsiness develops C.) Chew gum or suck on hard candy D.) Take acetaminophen (Tylenol) for headaches
Chew gum or suck on hard candy.
When talking with a patient about taking lubiprostone (Amitiza), the health care professional should tell the patient not to take the drug if he has which of the following?
Diarrhea
A health care professional is assessing a client who was administered ondansetron (Zofran) IV 1 hr ago. Which of the following findings is an adverse effect of this drug? Dizziness Bradycardia Tardive dyskinesia Dyspepsia
Dizziness - Dizziness and lightheadedness are the most common adverse effects of ondansetron.
A nurse is teaching a client who has a new prescription for methotrexate. The nurse should instruct the client to monitor for manifestations of which of the following conditions? Gout Constipation Insomnia HIrsustism
Gout An adverse effect of methotrexate is hyperuricemia, which causes gout. The nurse should instruct the client to drink plenty of fluids to minimize this effect, and to report edema or pain in the joints.
A nurse is caring for a client who is taking lubiprostone. The nurse should tell the client that lubiprostone can cause which of the following adverse drug reactions? Nausea Constipation Urinary retention Sore throat
Nausea Lubiprostone, a chloride channel activator, can cause nausea. Clients who develop this effect do not need to discontinue the drug but should take it with food and water to minimize GI upset.
A health care professional is reviewing the medical record of a patient who is to begin taking ranitidine (Zantac). Which of the following medications interacts with ranitidine? Phenobarbital sodium Ketoconazole Lisinopril Hydrochlorothiazide
Ketoconazole Famotidine reduces the absorption of ketoconazole.
A health care professional should conclude that alosetron (Lotronex) therapy is effective when a patient who is taking it reports which of the following? One formed stool per day Urination without burning Cessation of nausea or vomiting Reduced GI reflux effects
One formed stool per day Alosetron, a serotonin 5-HT3 receptor antagonist, treats the diarrhea and pain of severe irritable bowel syndrome. One formed stool per day indicates effective therapy.
A health care professional is caring for a patient who has recently had a myocardial infarction and is about to begin taking docusate sodium (Colace). The health care professional should explain that docusate sodium will have which of the following therapeutic effects? Reduces inflammation Reduces gastric acid Prevents diarrhea Prevents straining
Prevents straining Docusate sodium, a stool softener, prevents straining during defecation and prevents the elevation in blood pressure that can result from straining. It also helps relieve constipation and reduces the painful elimination of hard stools.
When talking with a patient about taking omeprazole (Prilosec) to treat a duodenal ulcer, the health care professional should include which of the following instructions? Take the medication with food. Swallow the capsules whole. Dissolve the tablets in water. Take the medication at bedtime.
Swallow the capsules whole. - Omeprazole, a proton pump inhibitor, is unstable in stomach acid. The nurse should instruct the client to swallow the capsules or tablets whole and not to crush or chew the capsules or tablets.
When talking with a patient about taking psyllium (Metamucil) to treat constipation, the health care professional should include which of the following instructions? (Select all that apply.) Expect results in 6 to 12 hr. Urinate every 4 hr. Take the drug with at least 8 oz (237 mL) of fluid. Avoid activities that require alertness. Increase fluid and fiber intake.
Take the drug with at least 8 oz Increase fluid and fiber intake Take the drug with at least 8 oz of fluid is correct. To prevent esophageal obstruction, patients should take psyllium with at least 8 oz of fluid, and, after mixing the powdered form, drink it immediately. Increase fluid and fiber intake is correct. The health care professional should tell the patient to increase activity and fluid and fiber intake, and to keep track of bowel function.
A nurse is caring for a male client asked the nurse about taking alosetron for irritable bowel syndrome with diarrhea (IBS-D) lasting three months. Which of the following information should the nurse provide the clients about alosetron? The drug is prescribed to female clients who have IBS-D lasting more than 6 months. The drug is prescribed to clients who have chronic diarrhea lasting more than 12 months. The drug is most beneficial for male clients who have inflammatory bowel disease. The drug is most beneficial in treating clients who have constipation-predominant IBS (IBS-C).
The drug is prescribed to female clients who have IBS-D lasting more than six months Alosetron is approved only to be prescribed to females who have IBS-D lasting 6 months or longer that has not been controlled by conventional treatment.
A nurse is teaching a client who has a new prescription for sulfasalazine which of the following statements should the nurse make "Use sunscreen and protective clothing while taking sulfasalazine to prevent sunburn." "The medication can stain your contact lenses green." "The medication can color your urine dark brown." "Take an iron supplement when you take sulfasalazine to prevent anemia."
Use sunscreen and protective clothing while taking sulfasalazine to prevent sunburn Photosensitivity is a possible adverse effect of sulfasalazine that makes the skin sensitive to light. The nurse should instruct the client to wear sunscreen and protective clothing when outdoors to prevent burning.
A primary care provider should use caution when prescribing bisacodyl (Dulcolax) for a patient who has
anorexia nervosa.
A primary care provider should use caution when prescribing sulfasalazine (Azulfidine) for a patient who has Pancreatitis Aspirin sensitivity Bronchitis GERD
aspirin sensitivity. Any sensitivity to salicylates, sulfonamides, or trimethoprim is a contraindication for the use of sulfasalazine, a 5-aminosalicylate. This is because intestinal bacteria metabolize the drug into 5-aminosalicylic acid, a salicylate. Aspirin is also a salicylate.
A health care professional is caring for a patient who takes phenytoin (Dilantin) for a seizure disorder and is about to begin sucralfate (Carafate) therapy to treat a duodenal ulcer. The health care professional should tell the patient to take the drugs at least 2 hr apart because Phenytoin increases the metabolism of sucralfate. Phenytoin reduces the effectiveness of sucralfate. Sucralfate increases the risk for phenytoin toxicity. Sucralfate interferes with the absorption of phenytoin.
sucralfate interferes with the absorption of phenytoin. Sucralfate decreases the absorption of phenytoin. The nurse should instruct the client to allow at least 2 hr between taking the two drugs and should monitor the client's phenytoin levels.
Which of the following drugs has protocols that require patients to meet specific risk-management criteria and sign a treatment agreement before the health care professional can administer the drug? Lubiprostone Azathioprine Sulfasalazine Alosetron
Alosetron (Lotronex) Clients who take alosetron, a serotonin 5-HT3 receptor antagonist, can develop severe constipation that can lead to impaction, bowel obstruction, perforation, and potentially fatal ischemic colitis. Because of these risks, nurses must inform clients of the benefits and risks of the drug therapy, and clients must sign a treatment agreement.
A primary care provider who is considering the various pharmacologic options for a patient who has peptic ulcer disease should understand that which of the following drugs require monitoring of the patient's phosphorus levels? Omeprazole Aluminum hydroxide Sucralfate Famotidine
Aluminum hydroxide (Amphojel) Antacids that contain aluminum, such as aluminum hydroxide, can cause hypophosphatemia because of aluminum's ability to bind with phosphate and decrease its absorption. The nurse should monitor the client's phosphorus levels while administering this drug.
A health care professional should question the use of diphenoxylate/atropine (Lomotil) for a patient who has which of the following disorders? Inflammatory bowel disease Thrombophlebitis Agranulocytosis Immunization with a live virus vaccine within the last 6 weeks
Inflammatory bowel disease Diphenoxylate is an opioid, which can cause the severe complication of toxic megacolon in clients who have inflammatory bowel disease. The nurse should have the client monitor the consistency and frequency of stools throughout therapy.
A health care professional is about to administer ondansetron (Zofran) to a patient who is receiving chemotherapy. Which of the following actions should the health care professional take? (Select all that apply.) Infuse the drug 30 min prior to chemotherapy. Administer the drug when the client reports nausea. Infuse the drug slowly over 15 min. Administer the drug immediately following chemotherapy. Repeat the dose 4 hr after chemotherapy.
Infuse the drug 30 min prior to chemotherapy is correct. The health care professional should administer IV ondansetron, a serotonin antagonist, 30 min prior to chemotherapy to prevent chemotherapy-induced nausea and vomiting. When treating radiation-induced nausea and vomiting, it is appropriate to give the drug orally 1 to 2 hr prior to radiation therapy and then every 8 hr. Infuse the drug slowly over 15 min is correct. The health care professional should infuse ondansetron slowly over 15 min to prevent chemotherapy-induced nausea. Repeat the dose 4 hr after chemotherapy is correct. For maximum effectiveness, the health care professional should administer ondansetron 4 hr and then 8 hr after chemotherapy. When treating anesthesia-induced nausea and vomiting, it is appropriate to give the drug 1 hr before anesthesia induction.
A health care professional is caring for an older adult patient who is about to begin taking cimetidine (Tagamet) to treat a duodenal ulcer. The health care professional should tell the patient to report which of the following adverse reactions? Lethargy Cellulitis Dry mouth Myalgia
Lethargy Cimetidine is a histamine2 receptor antagonist, which can potentially cross the blood-brain barrier. Older adult clients who have kidney impairments are at risk for central nervous system (CNS) effects such as lethargy, depression, confusion, and seizures. The nurse should instruct the client to report these manifestations to their provider.
When administering sulfasalazine (Azulfidine) to a patient, the health care professional should check which of the following to help identify an adverse effect of the drug? Select all that apply. Level of consciousness Skin integrity Temperature Urine output CBC
Skin integrity Temperature CBC Temperature is correct. Sulfasalazine can cause a fever, so the health care professional should check the patient's temperature and treat fever with an antipyretic. Skin integrity is correct. Sulfasalazine can cause a skin rash, so the health care professional should check the patient's skin for rashes. The drug can also cause nausea. If the patient reports nausea, the health care professional should suggest taking the drug with food or water. CBC is correct. Sulfasalazine can cause hematologic disorders, such as agranulocytosis and hemolytic and macrocytic anemia. The health care professional should check the patient's CBC periodically during therapy, and tell her to report sore throat or fatigue.
A health care professional is caring for a patient who is about to begin using dimenhydrinate to prevent motion sickness. Which of the following instructions should the health care professional include when talking with the patient about taking the drug? (Select all that apply.) Sit upright for 30 min after taking the drug. Avoid antacids. Take the drug 30 to 60 min before activities that trigger nausea. Avoid activities that require alertness. Increase fluid and fiber intake
Take the drug 30 to 60 min before activities that trigger nausea is correct. The health care professional should tell the patient to take dimenhydrinate 30 to 60 min before activities that cause nausea and again before meals and at bedtime. Avoid activities that require alertness is correct. Dimenhydrinate can cause sedation. The health care professional should suggest avoiding activities that require alertness. Increase fluid and fiber intake is correct. Dimenhydrinate can cause anticholinergic effects, such as dry mouth and constipation. The health care professional should tell the patient to increase activity level and fluid and fiber intake.
