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?

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?

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?

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?

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:

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?

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

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?

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?

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:

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?

Accepted Answer

The patient is likely experiencing constipation, which can be relieved by increasing intake of fluids and dietary fiber to promote easier bowel movements. Laxatives and stool softeners should only be used if these dietary changes do not improve the patient's symptoms. Magnesium citrate is an extreme measure and should only be used under medical supervision.

Question 12

A patient asks the nurse about using loperamide (Imodium) to treat infectious diarrhea. Which response will the nurse give?

Accepted Answer

Loperamide can be used to treat diarrheal symptoms by slowing down the intestinal motility. However, it can also slow the exit of infectious organisms which may prolong the infection. It is important for the patient to address the underlying cause of the infectious diarrhea and seek medical attention if symptoms persist or worsen.

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?

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?

Accepted Answer

Nonpharmacologic measures like eating crackers or dry toast can be effective in treating morning sickness and are often recommended as a first-line intervention in pregnancy. Intravenous fluids and prescription medications should only be recommended by a healthcare provider if nonpharmacologic measures do not work. Over-the-counter antiemetics like diphenhydramine are not recommended during pregnancy without consulting a healthcare provider.

Question 15

The nurse is caring for a patient who has postoperative nausea and vomiting. The surgeon has ordered promethazine HCl (Phenergan). Which aspect of this patient's health history would be of concern?

Accepted Answer

Promethazine can increase intraocular pressure and should be used with caution in patients with glaucoma.

Question 16

A child has been prescribed activated charcoal. What is the likely reason this is being ordered?

Accepted Answer

Activated charcoal is commonly used as a treatment for ingestion of a toxic substance. It works by binding to the substance in the digestive system, preventing it from being absorbed into the body.

Question 17

A patient asks the nurse the best way to prevent traveler's diarrhea. The nurse will provide which recommendation to the patient?

Accepted Answer

Drinking bottled water and eating only well-cooked meats is the best way to prevent traveler's diarrhea. Raw fruits and vegetables, and prophylactic antibiotics may not be effective or advisable, and taking loperamide every day is not recommended unless specifically prescribed by a healthcare provider.

Question 18

An appropriate goal when teaching a patient who has diarrhea is that the patient:

Accepted Answer

The appropriate goal when teaching a patient who has diarrhea is to have less frequent, more formed stools. It is not appropriate for the patient to not have a stool for 1 to 2 days as this could indicate constipation or other issues. Adequate intravenous fluids and appropriate antibiotic therapy may be necessary but are not the primary goal when teaching the patient about managing their diarrhea.

Quiz 42: Gastrointestinal Tract Disorders