Question 1

The nurse is instructing a patient who will take psyllium (Metamucil) to treat constipation. What information will the nurse include when teaching this patient?&#10;A) The importance of consuming adequate amounts of water&#10;B) The need to monitor for systemic side effects&#10;C) The onset of action of 30 to 60 minutes after administration&#10;D) The need to use the dry form of Metamucil to prevent cramping

Accepted Answer

Psyllium (Metamucil) works by absorbing water in the intestines, which softens stools and makes them easier to pass. However, if the patient does not consume enough water, the psyllium can become compacted in the intestines and potentially worsen constipation. Therefore, it is important to instruct the patient to drink adequate amounts of water when taking Metamucil. Option B is incorrect because psyllium is not absorbed systemically and does not typically cause systemic side effects. Option C is incorrect because the onset of action is typically 12 to 72 hours after administration. Option D is incorrect because the powder form of Metamucil can cause cramping if not mixed in enough water before administration.

Question 2

The nurse is caring for an older adult who is receiving diphenoxylate with atropine (Lomotil) to treat severe diarrhea. The nurse will monitor this patient closely for which effect?&#10;A) Bradycardia&#10;B) Fluid retention&#10;C) Urinary incontinence&#10;D) Respiratory depression

Accepted Answer

Diphenoxylate with atropine can cause respiratory depression in older adults, especially those with pre-existing respiratory conditions. The nurse should monitor the patient's respiratory status closely and be prepared to provide respiratory support if needed.

Question 3

The parent of an 18-month-old toddler calls the clinic to report that the child has vomited 5 times that day. The nurse determines that the child has had three wet diapers in the past 6 hours. What will the nurse recommend for this child?

A) Administering an OTC antiemetic medication such as diphenhydramine
B) Giving frequent, small amounts of Pedialyte
C) Keeping the child NPO until vomiting subsides
D) Taking the child to the emergency department for IV fluids

Accepted Answer

The child is likely experiencing mild dehydration from vomiting and not taking in enough fluids due to nausea. Giving frequent, small amounts of Pedialyte can help replace lost fluids and electrolytes while also being gentle on the stomach. Administering an antiemetic medication or keeping the child NPO may be necessary in some cases, but first-line treatment for mild dehydration is oral rehydration with clear fluids such as Pedialyte. Going to the emergency department for IV fluids is typically reserved for cases of severe dehydration.

Question 4

The nurse is caring for a patient who has unexplained, recurrent vomiting and who is unable to keep anything down. Until the cause of the vomiting is determined, the nurse will anticipate administering which medications?

A) Antibiotics and antiemetics
B) Intravenous fluids and electrolytes
C) Nonprescription antiemetics
D) Prescription antiemetics

Accepted Answer

The patient is vomiting and unable to keep anything down, indicating a high risk for dehydration and electrolyte imbalances. Therefore, the nurse should anticipate administering intravenous fluids and electrolytes until the cause of the vomiting is determined. Antibiotics and antiemetics may or may not be necessary depending on the cause of vomiting, and nonprescription antiemetics may not be sufficient to adequately manage the patient's symptoms. Prescription antiemetics may also depend on the underlying cause of the vomiting and should be determined by the healthcare provider.

Question 5

The nurse is teaching a group of nursing students about the use of antipsychotic drugs for antiemetic purposes. The nurse will explain that, when given as antiemetics, these drugs are given:&#10;A) in smaller doses.&#10;B) less frequently.&#10;C) with anticholinergics.&#10;D) with antihistamines.

Accepted Answer

When antipsychotic drugs are used as antiemetics, they are typically given in smaller doses than when they are used to treat psychiatric disorders.

Question 6

A patient who experiences motion sickness when flying asks the nurse the best time to take the medication prescribed to prevent motion sickness for a 0900 flight. The nurse will instruct the patient to take the medication at which time?

A) As needed, at the first sign of nausea
B) At 0700, before leaving for the airport
C) At 0830, just prior to boarding the plane
D) When seated, just prior to takeoff

Accepted Answer

The patient should take the medication just prior to boarding the plane, around 0830, so that it has time to take effect before the flight takes off. Taking the medication too early could result in it wearing off before the end of the flight, whereas taking it too late may not give it enough time to work. It is not recommended to take the medication as needed at the first sign of nausea, as it is intended as a preventive measure, and taking it when seated just prior to takeoff may not be enough time for it to take effect.

Question 7

A child is brought to the emergency department after ingestion of a toxic substance. The child is alert and conscious and is reported to have ingested kerosene 20 minutes prior. The nurse will anticipate administering

A) activated charcoal.
B) an anticholinergic antiemetic.
C) gastric lavage.
D) syrup of ipecac.

Accepted Answer

Activated charcoal is the preferred treatment for ingested toxins as it adsorbs the toxin and prevents absorption in the gastrointestinal tract. Anticholinergic antiemetics and syrup of ipecac are not recommended due to their potential for causing adverse effects and lack of efficacy. Gastric lavage may be done in certain cases, but is not routinely recommended in the treatment of ingested toxins.

Question 8

The parent of a child who is receiving chemotherapy asks the nurse why metoclopramide (Reglan) is not being used to suppress vomiting. The nurse will explain that, in children, this drug is more likely to cause which adverse effect?

A) Excess sedation
B) Extrapyramidal symptoms
C) Paralytic ileus
D) Vertigo

Accepted Answer

Metoclopramide is a prokinetic agent that can cause extrapyramidal symptoms such as dystonia, akathisia, and parkinsonism, particularly in children. Therefore, it is not the preferred antiemetic for children receiving chemotherapy.

Question 9

A patient who is receiving chemotherapy will be given dronabinol (Marinol) to prevent nausea and vomiting. The nurse will tell the patient that this drug will be given at which time?&#10;A) Before and after the chemotherapy&#10;B) During chemotherapy&#10;C) Immediately prior to chemotherapy&#10;D) 24 hours prior to chemotherapy

Accepted Answer

Dronabinol is typically administered before and after chemotherapy to help prevent and control nausea and vomiting associated with cancer treatment.

Question 10

A patient who is taking diphenoxylate with atropine (Lomotil) to treat diarrhea asks the nurse why it contains atropine. The nurse will explain that atropine is added, in part, to:&#10;A) decrease abdominal cramping.&#10;B) increase intestinal motility.&#10;C) minimize nausea and vomiting.&#10;D) provide analgesia.

Accepted Answer

Atropine is added to diphenoxylate to decrease abdominal cramping, which can occur as a side effect of the medication. Atropine also helps to reduce gastrointestinal secretions and slow down motility, which can help to alleviate diarrhea.

Question 11

A patient reports having three to four stools, which are sometimes hard, per week. The patient states that this represents less bowel movements than normal for her. The nurse will perform which action?

A) Recommend increased intake of fluids and dietary fiber.
B) Request an order for a stimulant laxative as needed.
C) Request an order for a stool softener.
D) Request an order for magnesium citrate.

Accepted Answer

The answer of A patient reports having three to four...

Question 12

A patient asks the nurse about using loperamide (Imodium) to treat infectious diarrhea. Which response will the nurse give?&#10;A) &#34;Loperamide results in many central nervous system (CNS) side effects.&#34;&#10;B) &#34;Loperamide has no effect on infectious diarrhea.&#34;&#10;C) &#34;Loperamide is taken once daily.&#34;&#10;D) &#34;Loperamide can be used to treat diarrheal symptoms but may also slow the exit of the infectious organisms from the GI tract.&#34;

Accepted Answer

The answer of A patient asks the nurse about using...

Question 13

The nurse is teaching a patient who is about to take a long car trip about using dimenhydrinate (Dramamine) to prevent motion sickness. What information is important to include when teaching this patient?

A) "Do not drive while taking this medication."
B) "Dry mouth is a sign of toxicity with this medication."
C) "Take the medication 1 to 2 hours prior to beginning the trip."
D) "Take 100 mg up to 6 times daily for best effect."

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Accepted Answer

The answer of The nurse is teaching a patient who...

Question 14

A woman who is 2 months pregnant reports having morning sickness every day and asks if she can take any medications to treat this problem. The nurse will recommend that the patient try which intervention first?

A) Discuss a possible need for intravenous fluids with her provider.
B) Contacting the provider to discuss prescribing a prescription antiemetic.
C) Use nonpharmacologic measures, such as eating crackers or dry toast.
D) Take over-the-counter antiemetics such as diphenhydramine.

Accepted Answer

The answer of A woman who is 2 months pregnant...

Question 15

The nurse is caring for a patient who has unexplained, recurrent vomiting and who is unable to keep anything down. Until the cause of the vomiting is determined, the nurse will anticipate administering which medications?

A) Antibiotics and antiemetics
B) Intravenous fluids and electrolytes
C) Nonprescription antiemetics
D) Prescription antiemetics

Accepted Answer

The answer of The nurse is caring for a patient...

Question 16

A child has been prescribed activated charcoal. What is the likely reason this is being ordered?&#10;A) Ingestion of a toxic substance&#10;B) Severe vomiting&#10;C) Nausea&#10;D) Motion sickness

Accepted Answer

The answer of A child has been prescribed activated charcoal....

Question 17

A patient asks the nurse the best way to prevent traveler's diarrhea. The nurse will provide which recommendation to the patient?&#10;A) &#34;Ask your provider for prophylactic antibiotics.&#34;&#10;B) &#34;Drink bottled water and eat only well-cooked meats.&#34;&#10;C) &#34;Eat fresh, raw fruits and vegetables.&#34;&#10;D) &#34;Take loperamide (Imodium) every day.&#34;

Accepted Answer

The answer of A patient asks the nurse the best...

Question 18

An appropriate goal when teaching a patient who has diarrhea is that the patient:&#10;A) will have less frequent, more formed stools.&#10;B) will not have a stool for 1 to 2 days.&#10;C) will receive adequate intravenous fluids.&#10;D) will receive appropriate antibiotic therapy.

Accepted Answer

The answer of An appropriate goal when teaching a patient...

Deck 42: Gastrointestinal Tract Disorders