GI, Hepatic, and Exocrine Pancreas Disorders Exam 2 Corrections

After teaching a client who is receiving sucralfate about the drug, which statement indicates that the teaching has been successful? "I need to limit my fluid intake." "I should eat a high-fiber diet." "I may need something to control diarrhea." "I need to avoid sugarless lozenges."

"I should eat a high-fiber diet." Rationale: Constipation is the most frequently seen adverse effect; thus, the client should increase his fiber intake to prevent constipation. Diarrhea is possible, but constipation is more likely. The client should drink fluids and use sugarless lozenges to help with a dry mouth. Fluid intake also will help to prevent constipation.

A woman with numerous chronic health problems has been diagnosed with a benign gastric ulcer has begun treatment with ranitidine (Zantac). Which of the following teaching points should the nurse provide to this patient? "Quitting smoking will significantly increase the chance that this drug will heal your ulcer." "This drug will help to eliminate the bacteria in your stomach that caused your ulcer." "You should eat several small meals each day rather than three larger meals." "Take each dose of ranitidine with an antacid of your choice."

"Quitting smoking will significantly increase the chance that this drug will heal your ulcer." Rationale: Smoking reverses the drug-induced inhibition of nocturnal gastric acid production and hinders ulcer healing. Cigarette smoking also is related closely to ulcer recurrence. Ranitidine should not be taken simultaneously with antacids and it does not eradicate H. pylori. It is not necessary to eat multiple small meals during the day.

A nurse is caring for a patient with intestinal stenosis who has been prescribed psyllium. During the course of the treatment, the patient shows the signs of colon obstruction. What intervention should the nurse perform to avoid the occurrence of colon obstruction? Administer the drug with adequate fluid intake. Give mineral oil to the patient after meals. Administer the drug after chilling it. Provide foods high in bulk or roughage.

Administer the drug with adequate fluid intake. Rationale: The nurse should administer the drug with adequate fluid intake to avoid obstruction of the esophagus, stomach, small intestine, and colon in a patient with intestinal stenosis. Mineral oil is given to the patient 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 patient receiving laxatives. The nurse administers a laxative with an unpleasant or salty taste after chilling it to disguise its taste.

A new mother had to have an episiotomy during the birth of her baby. Two days after delivery, the client is in need of a laxative. What will the nurse administer? Bisacodyl (Dulcolax) Castor oil (Neolid) Magnesium sulfate (Epsom salts) Docusate (Colace)

Docusate (Colace) Rationale: A mild laxative may be used after delivery with care that it not enter breast milk and affect the newborn if the mother is nursing. Docusate would be the drug of choice from this list because it is mild and will produce a soft stool and decrease the need to strain. The other options would not be appropriate.

Which substance is secreted by the parietal cells of the stomach? Hydrochloric acid Pepsin Gastrin Bile

Hydrochloric acid Rationale: The parietal cells of the stomach secrete hydrochloric acid. Pepsin is secreted by the chief cells. Gastrin is stimulated by the arrival of the food bolus in the stomach. Bile is secreted by the gall bladder.

Upon stimulation of the chemoreceptor trigger zone, what occurs next? Increased production of mucus Increased salivation Decreased acid production Increased sweating

Increased salivation Rationale: Once the chemoreceptor trigger zone is stimulated, a series of reflexes occurs. Salivation increases, and there is a large increase in the production of mucus in the upper GI tract, which is accompanied by a decrease in gastric acid production. This action protects the lining of the GI tract from potential damage by the acidic stomach contents. The sympathetic system is stimulated, with a resultant increase in sweating, increased heart rate, deeper respirations, and nausea.

A client is scheduled for a colonoscopy. The nurse knows that the preferred drug for bowel cleansing before this procedure is: Polyethylene glycol-electrolyte solution (NuLYTELY) Polyethylene glycol solution (MiraLAX) Bisacodyl (Dulcolax) Psyllium (Metamucil)

Polyethylene glycol-electrolyte solution (NuLYTELY) Rationale: Polyethylene glycol-electrolyte solution taken orally will rapidly provoke extensive diarrhea with complete emptying of the lower intestine. Polyethylene glycol solution, bisacodyl, and psyllium work much more slowly and are useful in managing constipation.

What is the stimulus for the duodenal-colic reflex? Cephalic stimulation Presence of food Overextension of stomach Swallowing

Presence of food Rationale: Duodenal-colic reflex is the presence of food or stretching in the duodenum that stimulates colon activity and mass movement, again to empty the colon for the new chyme.

The home care nurse is visiting a client who is receiving antiemetics. Which actions will the nurse perform to ensure safe and effective treatment for the client? (Select all that apply.) Reinforce teaching about dosage. Encourage the client to get up and walk after taking the medication. Take the medication approximately 5 minutes before taking the medication that makes you nauseated. Encourage client to sip on clear fluids to prevent dehydration. Do not drive while taking antinausea medicine.

Reinforce teaching about dosage. Encourage client to sip on clear fluids to prevent dehydration. Do not drive while taking antinausea medicine. Rationale: The home care nurse would reinforce medication teaching which would include how much medication and when to take the medication. It is usually taken 30 to 60 minutes before the event that causes nausea. The client should sit or lie quietly after taking the medication because it may cause sedation. This is also a reason that the client should not drive. The client should be encouraged to drink clear liquids to prevent dehydration.

The nurse is caring for a 27-year-old female client who has just been prescribed misoprostol. What is a priority teaching point for this client? The need to use a barrier-type contraceptive A warning against using NSAIDs Adverse effects include nausea and diarrhea It protects the lining of the stomach

The need to use a barrier-type contraceptive Rationale: Women of childbearing age who use misoprostol should be advised to use barrier-type contraceptives. All other options are correct but are not the priority for this client.

When mucus secretion is absent in the digestive tract, which will occur? Diarrhea Ulceration Constipation Distention

Ulceration Rationale: Mucus functions to protect the lining of the digestive tract from digestive juices and protects the gastrointestinal mucosa from injury. Peptic ulcers can develop when there is a decrease in the protective mucosal layer or an increase in acid production. Mucous does not cause diarrhea, constipation, or distention.

A client, prescribed an antihistamine for nausea, should be monitored for which adverse effect of this classification of medication? diarrhea prolonged QRS complex urinary retention inverted T wave

Urinary retention Rationale: Adverse anticholinergic effects of antihistamines are dizziness, confusion, dry mouth, and urinary retention. Urinary incontinence, prolonged QRS complex, and inverted T wave are not adverse effects of antihistamines.