Pharmacology exam 5 - GI tract disorders

Which patient teaching points would a nurse share with a patient who has been prescribed loperamide hydrochloride? Select all that apply. "Loperamide hydrochloride may increase your risk for bleeding." "Avoid alcohol while receiving loperamide hydrochloride because there is a risk for central nervous system (CNS) depression." "You can expect the tongue to turn black and the stools to darken while receiving loperamide hydrochloride." "Use caution when driving or performing tasks that require mental alertness while receiving loperamide hydrochloride." "If diarrhea continues for more than 48 hours after initiation of loperamide hydrochloride, contact your health care provider."

"Avoid alcohol while receiving loperamide hydrochloride because there is a risk for central nervous system (CNS) depression." "Use caution when driving or performing tasks that require mental alertness while receiving loperamide hydrochloride." "If diarrhea continues for more than 48 hours after initiation of loperamide hydrochloride, contact your health care provider."

Which patient statement about glycerin administration and effects requires further intervention? "I can expect the laxative effect to occur in about 1 hour." "I should try to keep the suppository in for about 15 to 30 minutes." "The suppository does not need to melt for a bowel movement to occur." "I should insert one suppository into my rectum once or twice daily as needed for constipation."

"I can expect the laxative effect to occur in about 1 hour."

Which statement by the patient in regard to bisacodyl plus senna administration requires further education? "I can take this medication as long and as often as I need it." "I may experience diarrhea and cramping from taking this medication." "I should take the medication with plenty of water to help with absorption." "I should wait at least 1 hour after taking bisacodyl and senna to take my other medications."

"I can take this medication as long and as often as I need it."

A nurse is caring for a patient who will be using a scopolamine patch for motion sickness. In addition to scopolamine, the patient is also taking diphenhydramine, an antihistamine, as needed for allergies. Which patient statement about scopolamine requires further intervention? "I will apply the patch to my upper arm." "The patch should be applied 4 hours before travel." "I will apply the patch every 3 days as I am travelling." "If I use scopolamine with diphenhydramine, I may have significant dry mouth and dry eyes."

"I will apply the patch to my upper arm."

Which statement by the nursing student regarding the pharmacokinetic parameters of lubiprostone requires further intervention? "Lubiprostone has low systemic availability with oral administration." "The drug is 94% protein bound with minimal distribution outside of the gastrointestinal (GI) tract." "Lubiprostone is quickly metabolized in the stomach and jejunum by the cytochrome P450 (CYP450) system." "The drug is excreted mostly in urine and some in feces."

"Lubiprostone is quickly metabolized in the stomach and jejunum by the cytochrome P450 (CYP450) system." Although lubiprostone is rapidly metabolized in the stomach and jejunum, this metabolism occurs through carbonyl reductase. The CYP450 system is not involved in its metabolism.

Which statement by the nursing student in regard to the pharmacokinetic parameters of calcium carbonate requires further intervention? "The solubility of calcium is decreased in an acidic environment." "Calcium carbonate distributes primarily into bone and teeth." "Calcium carbonate is 40% protein bound." "Excretion of calcium is mostly in the feces with some excretion in the urine."

"The solubility of calcium is decreased in an acidic environment."

Which time frame describes when a patient will begin to experience relief from treatment with magnesium hydroxide (non systemic)?

.5-6hrs

Which time frame describes how long a patient can expect the effects of aluminum hydroxide to last?

1-3 hours

Which time frame can a nurse expect aluminum hydroxide to reach its peak concentration?

30 minutes

In which time frame would a patient expect dronabinol (cannabinoid) to begin working? 5 to 15 minutes 30 to 60 minutes 2 to 3 hours 4 to 6 hours

30-60 minutes

Which time frame can a nurse expect dexamethasone to reach its peak concentration? 5 to 10 minutes 15 to 30 minutes 45 to 60 minutes 1.5 to 2 hours

5-10 minutes

Which length of time is the anticipated duration of action for meclizine's effects? 1 hours 2 hours 6 hours 8 hours

6 hours

In which time frame would a nurse expect to note the effects of oral bisacodyl in a patient? 15 to 60 minutes 2 to 4 hours 6 to 12 hours 10 to 12 hours

6-12 hrs

Which patients would a nurse determine cannot safely receive therapy with promethazine? Select all that apply. A 50-year-old patient with osteoarthritis A 27-year-old patient with hypothyroidism A 1-year-old child with profuse vomiting A 31-year-old patient who is breastfeeding A 33-year-old patient with generalized anxiety disorder

A 1-year-old child with profuse vomiting A 31-year-old patient who is breastfeeding

Which patients would a nurse determine require cautious use or avoidance of aluminum hydroxide? A 51-year-old patient with gout A 29-year-old patient who is pregnant A 71-year-old patient with dyslipidemia A 55-year-old patient with chronic kidney disease A 29-year-old patient with hypophosphatemia

A 29-year-old patient who is pregnant A 71-year-old patient with dyslipidemia A 55-year-old patient with chronic kidney disease A 29-year-old patient with hypophosphatemia

Which patients would a nurse determine can safely receive treatment with scopolamine (anticholinergic)? Select all that apply. A patient with asthma A patient with glaucoma A patient with depression A patient with breast cancer A patient with myasthenia gravis

A patient with asthma A patient with depression A patient with breast cancer

Which patients would a nurse determine cannot safely receive treatment with loperamide without consultation with a health care provider? A patient with gout A patient with liver disease A patient with ulcerative colitis A patient who has misused opioids A patient with type 2 diabetes mellitus

A patient with liver disease A patient with ulcerative colitis A patient who has misused opioids

Which statements regarding the absorption of calcium carbonate are accurate? Absorption of calcium varies with age. During pregnancy, calcium absorption doubles. Calcium absorption occurs mostly in the jejunum. Calcium absorption is reduced in achlorhydria and uremia. The absorption of calcium depends on calcitriol and vitamin D. Food reduces the absorption of calcium carbonate by 10% to 30%.

Absorption of calcium varies with age. During pregnancy, calcium absorption doubles. Calcium absorption is reduced in achlorhydria and uremia. The absorption of calcium depends on calcitriol and vitamin D.

Which effect would a nurse anticipate will occur if a patient takes hydrocodone, an opioid, while receiving loperamide? Additive central nervous system (CNS) stimulant effects Additive CNS depressant effects Reduced efficacy of loperamide Reduced efficacy of hydrocodone

Additive CNS depressant effects

To which classification of antidiarrheal drugs does bismuth subsalicylate belong? Opiates Probiotics Adsorbents Anticholinergics

Adsorbents

A patient who takes an antacid frequently for persistent heartburn presents with confusion and extreme muscle weakness. The patient is also having difficulty speaking. Which antacid would a nurse suspect this patient may have been receiving in excess? Calcium carbonate Sodium bicarbonate Aluminum hydroxide Magnesium hydroxide

Aluminum hydroxide

Which statement about the classification of antacids is accurate? Magnesium hydroxide is a systemic antacid that can cause diarrhea. Aluminum hydroxide is a non-systemic antacid that can cause constipation. Calcium carbonate is a non-systemic antacid and can lead to hypercalcemia. Sodium bicarbonate is systemically absorbed and may cause metabolic acidosis.

Aluminum hydroxide is a non-systemic antacid that can cause constipation.

Which statement regarding the pharmacokinetic parameters of bismuth subsalicylate is accurate? Bismuth is extensively absorbed with oral administration. Subsalicylate is minimally absorbed after oral administration. Bismuth subsalicylate is metabolized in the liver to bismuth and salicylic acid. The drug is excreted in the feces.

Bismuth subsalicylate is metabolized in the liver to bismuth and salicylic acid.

Which phrase describes how ondansetron works to treat nausea and vomiting? Blocks dopamine2 receptors in the chemoreceptor trigger zone Inhibits cholinergic stimulation of the vestibular and reticular systems Blocks the serotonin receptors in the chemoreceptor trigger zone and vagal nerve terminals in the gastrointestinal (GI) tract Binds to acetylcholine receptors deep within the brain to block the nausea-inducing signal from communicating to the vomiting pathway

Blocks the serotonin receptors in the chemoreceptor trigger zone and vagal nerve terminals in the gastrointestinal (GI) tract

Which patient parameters would a nurse ensure are assessed before administering loperamide to a 71-year-old patient? Select all that apply. Glucose level Blood pressure (BP) Hydration status Recent foods consumed History of viral or bacterial infections, including Clostridium difficile

Blood pressure (BP) Hydration status Recent foods consumed History of viral or bacterial infections, including Clostridium difficile

Which patient parameters would a nurse ensure are assessed before administering bisacodyl to a 17-year-old female patient? Blood urea nitrogen (BUN)/Serum creatinine (SCr) Bowel patterns Blood pressure (BP) Liver function tests History of eating disorders

Blood urea nitrogen (BUN)/Serum creatinine (SCr) Bowel patterns Blood pressure (BP) History of eating disorders

A nurse is caring for a patient who appears to be dehydrated. It has been determined that the patient has been unintentionally overusing laxative therapy. Which patient parameters would be assessed in this patient? Select all that apply. Bowel sounds Blood pressure Thyroid function Electrolytes Fluid intake and output

Bowel sounds Blood pressure Thyroid function Electrolytes Fluid intake and output

Which patient parameters would a nurse ensure are assessed before a patient receives calcium carbonate? Weight Calcium levels Renal function Blood pressure (BP) Phosphate levels

Calcium levels Renal function Phosphate levels

Which outcome would a nurse anticipate might occur when magnesium hydroxide is administered with phenytoin? Enhanced absorption and efficacy of phenytoin Decreased absorption and efficacy of phenytoin Enhanced absorption and efficacy of magnesium hydroxide Decreased absorption and efficacy of magnesium hydroxide

Decreased absorption and efficacy of phenytoin

Which outcome would a nurse anticipate will occur as a result of a drug interaction in a patient who is taking psyllium and has been prescribed tetracycline for an infection? Increased effects of psyllium Decreased effects of psyllium Increased absorption of tetracycline Decreased absorption of tetracycline

Decreased absorption of tetracycline

Which outcome does a nurse anticipate will occur as a result of a drug interaction in a patient who is taking the anticoagulant warfarin and bismuth subsalicylate? Increased absorption of warfarin Decreased absorption of warfarin Increased absorption of bismuth subsalicylate Decreased absorption of bismuth subsalicylate

Decreased absorption of warfarin

Which side effects would the nurse advise Ms. Smith to monitor for while receiving promethazine? Select all that apply. Shivering Dizziness Dry mouth Blurry vision Tachycardia

Dizziness Dry mouth Blurry vision Tachycardia

Which patient teaching points would the nurse share with a patient who is receiving psyllium powder? Select all that apply. Do not administer the powder without mixing it with water. Drink the psyllium solution within 1 hour of mixing. Drink one glass of water after administration of psyllium. Mix the psyllium powder well with 8 to 10 oz of water. Inhalation of the powder may cause runny nose, wheezing, and watery eyes.

Do not administer the powder without mixing it with water. Drink one glass of water after administration of psyllium. Mix the psyllium powder well with 8 to 10 oz of water. Inhalation of the powder may cause runny nose, wheezing, and watery eyes.

Draws water into the intestine to relieve constipation Softens and increases bulk of digested food Increases water in stools to soften it so it is more comfortable to pass Activates chloride channels to enhance intestinal fluid secretion Mineral Oil Polyethylene glycol lubiprostone Psyllium

Draws water into the intestine to relieve constipation Polyethylene glycol Softens and increases bulk of digested food Psyllium Increases water in stools to soften it so it is more comfortable to pass Mineral oil Activates chloride channels to enhance intestinal fluid secretion Lubiprostone

Which antiemetic is excreted in urine, feces, and bile? Meclizine Dronabinol Ondansetron Promethazine

Dronabinol

Which side effects would the nurse alert Mr. Frank to be monitored for while receiving loperamide (opiate)? Tinnitus Drowsiness Dark stools Urinary retention Metallic taste and black tongue

Drowsiness Urinary Retention

A nurse determines that patients with which conditions can safely receive laxative therapy? Dyslipidemia Osteoarthritis Hypothyroidism Fecal impaction Intestinal obstruction

Dyslipidemia Osteoarthritis Hypothyroidism

Which patient parameters would a nurse evaluate in a patient receiving meclizine? Select all that apply. Heart rate Gastric pH Intake/Output Bowel sounds Blood pressure

Heart rate Intake/Output Bowel sounds Blood pressure

Which electrolyte abnormality would a nurse monitor for in a patient receiving dexamethasone as an antiemetic who is also receiving furosemide, a loop diuretic? Hypokalemia Hyperkalemia Hyponatremia Hypernatremia

Hypokalemia

Which effect would a nurse anticipate might occur from the drug interaction between dronabinol and warfarin? Increase in warfarin concentration Decrease in warfarin concentration Increase in dronabinol concentration Decrease in dronabinol concentration

Increase in warfarin concentration

Which outcome would a nurse anticipate would occur in a patient taking bismuth subsalicylate and aspirin as a result of a drug interaction? Increased effect of bismuth subsalicylate Decreased effect of bismuth subsalicylate Increased risk for bleeding, bruising, and confusion Decreased risk for bleeding, bruising, and confusion

Increased risk for bleeding, bruising, and confusion

Which statement regarding the pharmacodynamic parameters of intravenous (IV) ondansetron is accurate? Its onset of action is 15 minutes. It reaches its peak concentration in 30 minutes. Its duration of action is 2 to 4 hours. Its elimination half-life is 3 to 5 hours.

Its elimination half-life is 3-5 hrs

Which laxative absorbs fat-soluble vitamins, thereby reducing the body's absorption of these vitamins from foods? Psyllium Bisacodyl Mineral oil Lubiprostone

Mineral Oil

Which phrase describes how loperamide acts to exert antidiarrheal effects? Destroys bacteria and toxins by lining the gastrointestinal (GI) tract Replaces bacteria to promote normal bacterial flora in the GI tract Slows GI motility, reduces electrolyte loss, and decreases fecal volume Decreases GI contractions as well as reduces gastric secretions through drying effects

Opiate Slows GI motility, reduces electrolyte loss, and decreases fecal volume

Which statement regarding the pharmacokinetic and pharmacodynamic parameters of psyllium is accurate? Psyllium is excreted mostly in the urine. Psyllium has an onset of action of 1 to 3 hours. Psyllium reaches its peak concentration in 12 hours. Psyllium is not absorbed after oral administration.

Psyllium is not absorbed after oral admin

Which phrases accurately describe the mechanisms of action exerted by antacids? Raise gastric pH Lower pepsin activity Reduce acid secretion Neutralize stomach acidity Provide a protective barrier over an ulcer

Rasie gastric pH Neutralize stomach acidity Lower pepsin activity

Which antiemetic can a nurse anticipate having the longest duration of action? Meclizine Aprepitant Dronabinol Scopolamine

Scopolamine

Which antiemetic exerts its effects by binding to acetylcholine receptors to block the nausea-inducing signal from communicating to the vomiting pathway? Aprepitant Scopolamine Ondansetron Promethazine

Scopolamine

Which adverse effects would a nurse monitor for in a patient receiving lubiprostone for irritable bowel syndrome? Hypertension Severe diarrhea Urinary tract infection (UTI) Intestinal nerve damage Upper respiratory tract infection

Sever diarrhea UTI upper respiratory tract infection

Which side effects would a nurse monitor for in a patient who is receiving lubiprostone? Select all that apply. Paralysis Complete heart block Severe diarrhea Urinary tract infection (UTI) Upper respiratory tract infection

Severe diarrhea Urinary tract infection (UTI) Upper respiratory tract infection

Which administration point would the nurse share with Mrs. Woods in regard to magnesium hydroxide therapy? She should shake the suspension well before administration. She should take the magnesium hydroxide as often as needed throughout the day. She should take the magnesium hydroxide 15 to 30 minutes before she takes aspirin and lisinopril. She should follow administration of magnesium hydroxide with an 8-oz glass of orange juice.

She should shake the suspension well before administration.

Match the antiemetic with its drug class Substance P/Neurokinin 1 Antagonists Dopamine antagonists Cannabinoids Antihistamine Meclizine Ondansetron Dronabinol Aprepitant Dexamethasone

Substance P/Neurokinin 1 Antagonists - Aprepitant Dopamine antagonists - Ondansetron Cannabinoids - Dronabinol Antihistamine - Meclizine

A nurse is caring for a patient who takes calcium carbonate and was recently prescribed ciprofloxacin, a quinolone, for a urinary tract infection. Which teaching point would the nurse share with this patient about administration of these drugs? These two drugs may be safely taken together on an empty stomach. Take calcium carbonate 1 to 2 hours after ciprofloxacin. Take ciprofloxacin 1 to 2 hours after calcium carbonate. Take calcium carbonate with meals and ciprofloxacin together with food.

Take calcium carbonate 1 to 2 hours after ciprofloxacin.

Which explanation would a nurse provide a patient about the avoidance of alcohol while taking promethazine? The combination may cause excessive central nervous system (CNS) effects such as sedation. Tardive dyskinesia may occur when the combination of alcohol and promethazine is taken. QT prolongation may occur if the patient consumes alcohol while taking promethazine. If the patient consumes alcohol with promethazine, there is a risk for psychotic symptoms.

The combination may cause excessive central nervous system (CNS) effects such as sedation.

Which statement regarding the pharmacokinetics of promethazine is accurate? The drug is easily absorbed through the gastrointestinal (GI) tract. Promethazine is minimally protein bound. The drug does not undergo metabolism. Promethazine undergoes biliary excretion.

The drug is easily absorbed through the gastrointestinal (GI) tract.

Which statement regarding the pharmacokinetic parameters of aprepitant is accurate? The drug has an oral bioavailability of 25%. Aprepitant is minimally protein bound (<5%). The drug undergoes metabolism mostly by CYP3A4. Excretion of aprepitant is predominantly in the feces.

The drug undergoes metabolism mostly by CYP3A4

Which statements regarding the pharmacodynamics of bismuth subsalicylate are accurate? The onset of action for bismuth subsalicylate is 1 hour. The duration of action of bismuth subsalicylate is 12 hours. The time to peak concentration of bismuth subsalicylate is 2 hours. The elimination half-life of bismuth is 24 hours. The elimination half-life of salicylate is 2 to 5 hours.

The onset of action for bismuth subsalicylate is 1 hour. The time to peak concentration of bismuth subsalicylate is 2 hours. The elimination half-life of salicylate is 2 to 5 hours.

Which statements regarding the pharmacodynamic parameters of loperamide are accurate? The onset of action for loperamide is 1 hour. The capsule formulation of loperamide has a time to peak concentration of 30 minutes. The liquid formulation of loperamide has a time to peak concentration of 2.5 hours. The duration of action of loperamide is 24 hours. Loperamide's elimination half-life ranges from 5 to 6 hours.

The onset of action for loperamide is 1 hour. The liquid formulation of loperamide has a time to peak concentration of 2.5 hours. The duration of action of loperamide is 24 hours.

A nurse is caring for a patient with breast cancer who is experiencing chemotherapy-induced nausea and vomiting. Which side effects and adverse effects would a nurse monitor for if the patient is receiving aprepitant? Select all that apply. Urticaria Thrombocytopenia Deep vein thrombosis Extrapyramidal symptoms Neuroleptic malignant syndrome

Urticaria - side effect Thrombocytopenia - adverse effect Deep vein thrombosis - adverse effect

Which patients would a nurse determine have precautions to treatment with calcium carbonate? A patient with osteoporosis A patient with prostate cancer A patient with type 2 diabetes mellitus A patient with hypoparathyroid disease A patient with renal dysfunction on dialysis

a patient with hypoparathyroid disease a patient with real dysfunction on dialysis

Which frequency would a nurse anticipate seeing promethazine prescribed for a patient with nausea and vomiting? Once daily Every 4 to 6 hours Every 8 to 12 hours Every 3 days

every 4-6 hours

Which effect would a nurse monitor for in a patient who is receiving glipizide, a sulfonylurea, and aluminum hydroxide? Diarrhea Hypoglycemia Hyperglycemia Aluminum toxicity

hypoglycemia