Question 1

An elderly patient comes into the clinic.The nurse notes on her routine clinic-visit questionnaire that she has checked frequent use of a stimulant laxative.The nurse should pay close attention to which laboratory value for this patient?

Accepted Answer

Overdosage or overuse of stimulant laxatives may cause excessive fluid loss and electrolyte imbalance,particularly hypokalemia.

Question 2

An older patient has been diagnosed with having laxative dependency due to chronic laxative use.The nurse plans to educate the patient on nonpharmacologic measures to prevent constipation.What should the nurse's education plan include?

Accepted Answer

Nonpharmacologic interventions for treatment of constipation include increasing fluid intake to 6 to 8 glasses of water each day if permitted and tolerated and a regular exercise routine,such as a daily walk or active and passive exercise for bedridden patients.

Question 3

The nurse is giving discharge instructions to a patient who will be taking an antacid for gastric problems.Which responses are correct about antacids? (Select all that apply.)

Accepted Answer

Antacid neutralizes gastric acid; thus antacids are most beneficial if given between meals and at bedtime.

Question 4

A patient complains of constipation.Which high-fiber foods would the nurse instruct the patient to add to his diet? (Select all that apply.)

Accepted Answer

High-fiber foods increase the transit of food through the GI tract and have a mild laxative effect.Oranges,bran,and figs are high in fiber.

Question 5

A patient complains to her physician of abdominal bloating and discomfort.She is a known alcoholic and has been treated recently for pancreatitis.Which medications may be used to reduce abdominal discomfort resulting from intestinal spasm,increased motility,and acid production?

Accepted Answer

Anticholinergic-antispasmodic preparations are parasympatholytic drugs that act with antacids in prolonging the therapeutic benefits of both drug categories.

Question 6

A patient who has had gallbladder surgery finds that in the postoperative period she is bothered by an excess of intestinal gas,producing flatus and bloating.Which would be an appropriate medication for this symptom?

Accepted Answer

Simethicone is an antiflatulent that breaks up and prevents formation of mucus-surrounded pockets of gas in the intestine.

Question 7

A young female patient is diagnosed with irritable bowel syndrome and is in an acute phase.She is placed on Sal-Tropine (atropine sulfate)at the maximum dose.The patient will best benefit from this medication because of which reason?

Accepted Answer

Sal-Tropine (atropine sulfate)is among the most effective of the anticholinergic drugs,with minimal side effects when high doses are used.

Question 8

A patient is admitted to the hospital inpatient treatment unit for alcohol intoxication.After 2 days without alcohol,he is medically stable enough to begin therapy.He begins individual therapy and group sessions with Alcoholics Anonymous.Prior to discharge,the nurse anticipates the physician might also start him on which medication?

Accepted Answer

Disulfiram produces a severe sensitivity to alcohol that results in a very unpleasant reaction.

Question 9

A patient comes into the clinic complaining of severe abdominal pain that occurs approximately 45 to 60 minutes after eating.The pain also wakes him up at night.When he eats or drinks some milk,he feels better.When he eats Mexican food or drinks alcohol,it feels worse.The physician plans to order some x-ray films.Before the tests are completed,the nurse anticipates the physician will probably ask the patient to take which medication?

Accepted Answer

An antacid acts to neutralize or reduce acidity of gastric contents and the histamine H₂-receptor antagonists.

Question 10

A patient with gastritis asks why the physician put her on an antacid when she has already been eating well.Which would be the best response made by the nurse? (Select all that apply.)

Accepted Answer

Antacids neutralize gastric acid in patients who are eating or not eating.

Question 11

The physician orders an antacid for a patient diagnosed with functional dyspepsia.Which other types of medication may be ordered in conjunction with the antacid to treat this patient for stomach discomfort after eating?

Accepted Answer

Antiflatulents are often used together with antacid therapy.

Question 12

A patient on disulfiram should be cautioned to avoid ingesting alcohol used as an ingredient in certain preparations.Which product has hidden alcohol?

Accepted Answer

Cough syrup may contain alcohol.The patient should be cautioned against hidden forms of alcohol,because small amounts of any form of alcohol will provoke a reaction.

Question 13

A 47-year-old patient has been diagnosed with cholesterol gallstones.She has had increased abdominal pain following fatty meals for the past few weeks.The physician orders an x-ray examination,which reveals radiolucent cholesterol gallstones.What should the nurse anticipate the physician will do next?

Accepted Answer

Chenodiol acts on the liver to increase breakdown of radiolucent cholesterol gallstones.

Question 14

An alcoholic patient comes to the emergency department after drinking a beer.He has complaints of severe diarrhea,nausea,and vomiting.Which drug would produce this kind of reaction in the patient?

Accepted Answer

Disulfiram produces a severe sensitivity to alcohol that results in a very unpleasant reaction such as severe nausea,vomiting,and diarrhea.

Question 15

One of the nurse's older adult patients is abusing laxatives.Which would be an appropriate intervention for this patient to help reduce this chronic laxative use and dependency?

Accepted Answer

Older adult patients should be taught nondrug measures to prevent constipation,such as increasing fluid intake to 6 to 8 glasses of water a day if permitted and tolerated.

Question 16

The nurse is instructing an elderly patient about the use of bisacodyl enteric-coated tablets for the treatment of constipation.Which response is true about this medication?

Accepted Answer

Bisacodyl enteric-coated tablets must be swallowed whole,never chewed or crushed,and never taken with milk or antacids.

Question 17

A patient recovering from alcoholism has been taking disulfiram for a week.On a return visit to the clinic,the patient tells the nurse that he is experiencing flushing and warming of the face.What may be causing this reaction?

Accepted Answer

There might be a disulfiram reaction present until alcohol is completely metabolized.

Question 18

The nurse is preparing to administer a saline laxative with a patient who has been constipated for 4 days.Which is the priority task to be completed by the nurse first?

Accepted Answer

Laxatives should never be given without assessing for bowel sounds because constipation could be caused by a small bowel obstruction.

Question 19

A patient is diagnosed as having a duodenal ulcer.Which medication does the nurse anticipate the physician will order?

Accepted Answer

Proton pump inhibitors are used in the short-term treatment of active duodenal ulcers,usually after adequate courses of H₂-receptor antagonists have not been successful.

Question 20

A frail 67-year-old nursing-home patient is brought to the clinic for a barium enema.For the next few days following the procedure,he fails to have any bowel movements.The nurse anticipates the physician will probably order which treatment?

Accepted Answer

Saline laxatives are used to cleanse the bowel in preparation for,or following,endoscopic or colonoscopic examination,x-ray studies,or surgery.

Quiz 16: Gastrointestinal Medications