Deck 51: Bowel Disorder Drugs

Question 1

While recovering from surgery, a 74-year-old woman started taking a stimulant laxative, senna (Senokot), to relieve constipation caused by the pain medications. Two weeks later, at her follow-up appointment, she tells the nurse that she likes how "regular" her bowel movements are now that she is taking the laxative. Which teaching principle is appropriate for this patient?

A) She needs to be sure to take this medication with plenty of fluids.
B) It is important to have a daily bowel movement to promote bowel health.
C) Long-term use of laxatives often results in decreased bowel tone and may lead to dependency.
D) She needs to switch to glycerin suppositories to continue having daily bowel movements.

Answer 1

Long-term use of laxatives often results in decreased bowel tone and may lead to dependency.

Question 2

When administering mineral oil, the nurse recognizes that it can interfere with the absorption of which substance?

A) Fat-soluble vitamins
B) Water-soluble vitamins
C) Minerals
D) Electrolytes

Answer 2

Fat-soluble vitamins

Question 3

A patient is receiving lactulose ( Chronulac ) three times a day. The nurse knows that the patient is not constipated and is receiving this drug for which reason?

A) High ammonia levels due to liver failure
B) Prevention of constipation
C) Chronic renal failure
D) Chronic diarrhea

Answer 3

High ammonia levels due to liver failure

Question 4

A patient is severely constipated and needs immediate relief. The nurse knows that which class of laxative will provide the most rapid results?

A) Bulk-forming laxative, such as psyllium (Metamucil)
B) Stool softener, such as docusate salts (Colace)
C) Magnesium hydroxide (MOM)
D) Magnesium oxide tablets

Question 5

The nurse is giving oral mineral oil as an ordered laxative dose. The nurse will take measures to prevent which potential problem that may occur with mineral oil?

A) Fecal impaction
B) Electrolyte imbalances
C) Lipid pneumonia
D) Esophageal blockage

Question 6

A patient is taking tegaserod (Zelnorm) to treat irritable bowel syndrome (IBS). The nurse will monitor this patient for which adverse effect?

A) Chest pain
B) Chronic constipation
C) Abdominal cramps
D) Elevated blood glucose levels

Question 7

A laxative has been ordered for a patient. The nurse checks the patient's medical history and would be concerned if which condition is present?

A) High ammonia levels due to liver failure
B) Diverticulosis
C) Abdominal pain of unknown origin
D) Chronic constipation

Question 8

A patient who has been on antibiotic therapy for 2 weeks has developed persistent diarrhea. The nurse expects which medication class to be ordered to treat this diarrhea?

A) Lubricants
B) Adsorbents
C) Anticholinergics
D) Probiotics

Question 9

The nurse is reviewing the mechanism of action of antidiarrheal drugs. Which type of antidiarrheal medication works by decreasing the intestinal muscle tone and peristalsis of the intestines?

A) Adsorbents such as Pepto-Bismol
B) Anticholinergics such as belladonna alkaloids
C) Probiotics such as Lactinex
D) Lubricants such as mineral oil

Question 10

When administering a bulk-forming laxative, the nurse instructs the patient to drink the medication mixed in a full 8-ounce glass of water. Which statement best explains the rationale for this instruction?

A) The water acts to stimulate bowel movements.
B) The water will help to reduce the bulk of the intestinal contents.
C) These laxatives may cause esophageal obstruction if taken with insufficient water.
D) The water acts as a lubricant to produce bowel movements.

Question 11

A patient will be taking bismuth subsalicylate (Pepto-Bismol) to control diarrhea. When reviewing the patient's other ordered medications, the nurse recognizes that which medication or medication class will interact significantly with the Pepto-Bismol?

A) Oral hypoglycemic drugs
B) Antibiotics
C) acetaminophen (Tylenol)
D) Antidepressants

Question 12

The nurse is discussing the use of adsorbents such as bismuth subsalicylate (Pepto-Bismol) with a patient who has diarrhea. The nurse will warn the patient about which possible adverse effects?

A) Dark stools and blue gums
B) Urinary hesitancy
C) Drowsiness and dizziness
D) Blurred vision and headache

Question 13

A patient is about to undergo a diagnostic bowel procedure. The nurse expects which drug to be used to induce total cleansing of the bowel?

A) docusate sodium ( Colace )
B) magnesium hydroxide ( milk of magnesia )
C) mineral oil
D) polyethylene glycol ( GoLYTELY )

Question 14

A patient asks the nurse about the difference between diphenoxylate with atropine (Lomotil) and the over-the-counter drug loperamide (Imodium). Which response by the nurse is correct?

A) "Lomotil acts faster than Imodium."
B) "Imodium does not cause physical dependence."
C) "Lomotil is available in suppository form."
D) "Imodium is a natural antidiarrheal drug."

Question 15

The nurse is preparing to administer methylnaltrexone (Relistor), a peripherally acting opioid antagonist. This drug is appropriate for which patient?

A) A patient with diarrhea
B) A terminally ill patient who has opioid-induced constipation
C) A patient who is scheduled for a colonoscopy
D) A patient who will be having colon surgery in the morning

Question 16

A patient will be taking bismuth subsalicylate ( Pepto-Bismol ) to control diarrhea. When reviewing the patient's other ordered medications, the nurse recognizes that which medication will interact significantly with the Pepto-Bismol?

A) acetaminophen (Tylenol), an analgesic
B) levothyroxine ( Synthroid ), a thyroid replacement drug
C) warfarin ( Coumadin ), an anticoagulant
D) fluoxetine ( Prozac ), an antidepressant

Question 17

The nurse is reviewing the uses of oral laxatives. Which conditions are general contraindications to or cautions about the use of oral laxatives? (Select all that apply.)

A) Irritable bowel syndrome
B) Abdominal pain of unknown origin
C) Nausea and vomiting
D) Fecal impaction
E) Ingestion of toxic substances
F) Acute abdominal pain

Question 18

The nurse is providing teaching to a patient who will be taking the laxative bisacodyl (Dulcolax). Which statement by the nurse is appropriate during this teaching session?

A) "You can crush the laxative tablets for improved action."
B) "Take the tablets with water, not milk or juice."
C) "This laxative is not known to cause dependence."
D) "In a normal bowel pattern, a bowel movement occurs daily."

Question 19

A patient has been treated with alosetron (Lotronex) for severe irritable bowel syndrome (IBS) for 2 weeks. She calls the clinic and tells the nurse that she has been experiencing constipation for 3 days. The nurse will take which action?

A) Advise the patient to increase intake of fluids and fiber
B) Advise the patient to hold the drug for 2 days
C) Instruct the patient to stop taking the drug and to come to the clinic right away to be evaluated
D) Instruct the patient to continue the alosetron and to take milk of magnesia for the constipation

Question 20

A patient wants to prevent problems with constipation and asks the nurse for advice about which type of laxative is safe to use for this purpose. Which class of laxative is considered safe to use on a long-term basis?

A) Emollient laxatives
B) Bulk-forming laxatives
C) Hyperosmotic laxatives
D) Stimulant laxatives

Question 21

A 10-year-old child will be receiving docusate sodium (Colace), 120 mg/day PO, divided into 3 doses. How many milligrams will the child receive per dose?