Deck 19: Drugs for Nausea, vomiting, diarrhea, and Constipation

Question 1

How do osmotic laxatives reduce constipation?

A) They cause retention of fluid in the bowel, increasing the water content in stool.
B) They add bulk to the stool, which increases stool mass that stimulates peristalsis.
C) They soften stool, allowing the stool to mix with fatty substances, making it easier to eliminate.
D) They cause chemical irritation of nerve receptors in the intestinal lining, which then triggers peristalsis.

Answer 1

They cause retention of fluid in the bowel, increasing the water content in stool.

Question 2

What is the most important assessment question for the nurse to ask a patient before administering intravenous metoclopramide (Reglan)?

A) "Are you being treated for depression?"
B) "Is your type 1 diabetes well controlled?"
C) "Do you have a gastric or duodenal ulcer?"
D) "Are you taking aspirin or any aspirin-containing products?"

Answer 2

"Are you being treated for depression?"

Question 3

The nurse is instructing a patient about how to help prevent the spread of diarrhea.Which point does the nurse include in the teaching plan?

A) "When travelling internationally it is best to drink bottled water with ice cubes."
B) "Be sure to wash your hands after using the bathroom or changing diapers."
C) "Always wear clean gloves when handling raw meat or poultry."
D) "Cut down on your fluid intake to decrease the number of diarrhea episodes."

Answer 3

"Be sure to wash your hands after using the bathroom or changing diapers."

Question 4

The nurse is administering a patient's first dose of cyclizine (Marezine).What safety action does the nurse take for this patient?

A) Instruct the patient to call for help when getting out of bed.
B) Raise all four side rails to the upright position.
C) Give the patient a full glass of water with the medication.
D) Tell the patient to avoid eating for at least 2 hours.

Question 5

A patient receiving chemotherapy and prescribed ondansetron (Zofran)asks the nurse why the drug is given before meals.What is the nurse's best response?

A) "Ondansetron is given 30 minutes before your meals to prevent nausea."
B) "The purpose of this drug is to move food rapidly through your GI tract."
C) "This drug works by preventing nausea caused by morphine given for your pain."
D) "If this drug were given after your meals, the food would interfere with its absorption."

Question 6

The spouse of a patient who is prescribed promethazine (Phenergan)as part of her antiemetic therapy with chemotherapy reports that after the last dose the patient did not remember the drive home.What is the nurse's best action?

A) Thank the spouse for reporting the problem, and document the adverse drug reaction.
B) Hold the dose of promethazine for this round of chemotherapy until the patient is seen by the prescriber.
C) Reassure the patient and spouse that this is a normal response to the drug and that the patient should not drive home.
D) Perform a mini-mental status exam and assess the patient's pupillary reflexes before administering the promethazine.

Question 7

A patient who is prescribed prochlorperazine (Compazine)for postoperative nausea and vomiting has all of the following changes.For which change does the nurse immediately contact the prescriber?

A) Systolic blood pressure decrease of 12 mm Hg
B) Increased sleepiness but arouses with light shaking
C) Oral temperature increase of 2 ^$\circ$ F
D) Urine color change from yellow to reddish-brown

Question 8

The wife of an inpatient who is prescribed dexamethasone (Decadron)tells the nurse over the phone that she has developed a cold with a low-grade fever.What is the nurse's best advice at this time?

A) "If you come in to visit you must wear an isolation gown."
B) "Hospital rules do not allow visitors with colds or fevers for any patients."
C) "It would be best to speak with your husband by phone and stay home today."
D) "You must take care of yourself so that you can take care of your husband when he comes home."

Question 9

The mother of a 6-year-old child receiving diphenoxylate (Lomotil)for the last 4 days for diarrhea reports by telephone that the diarrhea has stopped and that the child's pants cannot be zipped or buttoned today.What is the nurse's best advice?

A) "Give the child only half the dose of the drug today."
B) "Do not give the child fluids for the next 24 hours."
C) "Stop the drug and go immediately to the prescriber's office."
D) "When diarrhea is cured the stool enlarges the abdomen."

Question 10

A patient who is prescribed promethazine (Phenergan)currently has a respiratory rate of 8 breaths per minute.What is the nurse's best action?

A) Place the patient on oxygen at 2 L per nasal cannula.
B) Document this as an expected side effect of the drug.
C) Hold the drug and notify the prescriber.
D) Raise the head of the bed 90 degrees.

Question 11

The nurse is instructing a patient on how to prevent constipation.Which point does the nurse plan to include in the teaching plan?

A) "Be sure to eat a diet that is low in fiber."
B) "Use a laxative on a daily basis to prevent constipation."
C) "Physical inactivity will not affect your bowel function."
D) "You should drink plenty of fluids every day to prevent constipation."

Question 12

The nurse is instructing a patient who is experiencing chronic nausea and vomiting about antiemetic therapy.What is the most important precaution the nurse teaches the patient?

A) "Rinse your mouth frequently to reduce the unpleasant sensation of dry mouth."
B) "Report any constipation lasting two days or longer to your prescriber."
C) "Wear sunscreen and protective clothing when going outdoors."
D) "Avoid drinking alcoholic beverages while taking this drug."

Question 13

A 10-year-old child is prescribed cyclizine (Marezine)25 mg orally for motion sickness.The drug is available as a 50 mg tablet.How many tablets does the nurse instruct the parent to give the child?

A) One fourth
B) One half
C) Two
D) Four

Question 14

Which action is most important for the nurse to perform after giving a patient bisacodyl (Dulcolax)?

A) Comparing daily urine output with fluid intake
B) Assessing pulse rate and regularity every 4 hours
C) Ensuring that the patient complies with a low-sodium diet
D) Testing the patient's blood glucose level at least every shift

Question 15

An older male patient with nausea is prescribed scopolamine (L-hyoscine).Which nursing assessment does the nurse perform to determine whether he is experiencing a serious side effect?

A) Checking capillary refill
B) Measuring abdominal girth
C) Evaluating handgrip strength
D) Evaluating daily intake and output

Question 16

A patient prescribed metoclopramide (Reglan)tells the nurse that his abdomen is making gurgling sounds.What is the nurse's best action?

A) Instruct the patient that this is an expected effect of the drug.
B) Document this finding as the only action.
C) Hold the drug and notify the prescriber.
D) Give the drug and notify the prescriber.

Question 17

Which statement about the vomiting reflex is accurate?

A) The vomiting process consists of four phases.
B) Retching precedes vomiting in the process.
C) Nausea usually occurs prior to vomiting.
D) Vomiting may be a reflex or a voluntary action.

Question 18

The mother of a 9-month-old child reports that the child has a bowel movement only every 2 or 3 days and that the stool is small and hard,"like marbles." What does the nurse recommend as starting treatment for this problem?

A) Use castor oil every 3 days
B) Increase the child's fluid intake
C) Ensure that the child gets adequate exercise
D) Mix a bulk-forming laxative in with the child's cereal

Question 19

A patient prescribed metoclopramide (Reglan)reports having difficulty sleeping,difficulty concentrating,tiredness,and feeling hopeless.What is the nurse's best action?

A) Instruct the patient that these are expected side effects of the drug.
B) Document these findings as the only action.
C) Check the patient's chart history of depression.
D) Hold the drug and notify the prescriber.

Question 20

Which statement about normal bowel function is true?

A) Bowel movements should occur once a day every day.
B) Frequency of bowel movements is more important than their consistency.
C) Bowel movements are very simple processes.
D) Bowel movements should be soft and easily pass out of the bowel.

Question 21

Which laboratory value must the nurse monitor after a patient takes bisacodyl (Dulcolax)for constipation?

A) Sodium
B) Potassium
C) Creatinine
D) Blood urea nitrogen

Question 22

Which are potential complications of nausea and vomiting?

A) Bleeding
B) Aortic aneurysm
C) Aspiration pneumonia
D) Bowel perforation
E) Reopening of surgical wounds

Question 23

Which are symptoms of diarrhea?

A) Weight loss
B) Bowels still feeling full after a bowel movement
C) Abdominal pain and cramping
D) Fever, chills, and feeling ill
E) Feeling bloated

Question 24

A patient reports taking an over-the-counter laxative for constipation daily for the past 3 weeks.What is the nurse's best action?

A) Remind the patient about the importance of adequate fluid intake and exercise to prevent constipation.
B) Instruct the patient that these drugs should not be used for more than a week without consulting the prescriber.
C) Ask the patient about usual fluid intake, urinary and bowel habits, and have the patient describe the nature of stools.
D) Contact the prescriber about an order for a stronger laxative because the one the patient is taking is not working.

Question 25

Which are symptoms of constipation?

A) Having less than one bowel movement a day
B) Stools that are harder than normal
C) Sudden increase in frequency of bowel movements
D) Bowels that feel full after a bowel movement
E) Sensation of feeling bloated

Question 26

What primary assessment does the nurse make for a patient who is prescribed loperamide (Immodium)?

A) Tachycardia
B) Abdominal distention
C) Peripheral edema
D) Respiratory crackles

Question 27

A patient reports taking attapulgite (Kaopectate)for diarrhea over the past 4 days.What is the nurse's best action?

A) Send a stool specimen to the lab for analysis.
B) Instruct the patient to notify nursing staff about all episodes of diarrhea and save the stool for assessment.
C) Check the patient's blood pressure and heart rate.
D) Teach the patient that antidiarrheal drugs should not be taken for more than 2 days unless instructed to by their prescriber.

Question 28

Which teaching points are included in a care plan for a patient who is taking laxatives for constipation?

A) Drink between 1500 and 2000 mL of fluids every day.
B) Avoid bulk foods such as whole grain bread and vegetables.
C) Use the bathroom right away when you feel the urge to have a bowel movement.
D) Try to get some regular exercise each day to prevent constipation.
E) Take your laxative with at least 4 ounces of water so it can be effective.

Question 29

A patient reports taking psyllium (Metamucil)every morning to prevent constipation.What is the nurse's best action?

A) Remind the patient that over-the-counter laxatives should not be taken for more than one week.
B) Instruct the patient that long-term use of psyllium can cause health problems.
C) Hold the drug and notify the prescriber immediately.
D) Document this information as the only action.

Question 30

A child is prescribed metoclopramide (Reglan)8 mg by oral solution.The available drug solution is 5 mg per 5 milliliters of solution.How many milliliters does the nurse administer?
_____ mL