Drugs for Nausea, Vomiting, Diarrhea, and Constipation

Understanding Pharmacology Essentials for Medication Safety

Nursing
31
Questions
0
True/False
25
Choices
6
Essay
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Questions

Q1
Free

Which statement about normal bowel function is true?

Multiple Choice
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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.
Answer:
D) Bowel movements should be soft and easily pass out of the bowel.

Explanation:
Normal bowel function varies from person to person, from several times a day to several times a week. Consistency is more important than frequency. Stool should be soft enough to pass easily from the bowel, but not liquid. Bowel movements are a complex process involving several muscles and nerves located on the pelvic floor.
Q2
Free

Which statement about the vomiting reflex is accurate?

Multiple Choice
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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.
Answer:
C) Nausea usually occurs prior to vomiting.

Explanation:
The vomiting process involves three phases: nausea, vomiting, and retching. Nausea usually occurs before vomiting, and retching occurs after vomiting. Vomiting is a reflex, not a voluntary action.
Q3
Free

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

Multiple Choice
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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.
Answer:
D) You should drink plenty of fluids every day to prevent constipation.

Explanation:
To prevent constipation, a patient should be taught to consume a diet that is high in fiber, drink plenty of fluids, and be physically active. Misuse of laxatives can cause constipation because the body becomes dependent on these drugs, needing higher and higher doses until the bowel no longer works.
Q4

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?

Multiple Choice
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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.
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Q5

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

Multiple Choice
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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.
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Q6

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

Multiple Choice
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A) Instruct the patient that these are expected side effects of the drug.
B) Document these findings as the only action.
C) Check the patients chart history of depression.
D) Hold the drug and notify the prescriber.
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Q7

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

Multiple Choice
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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.
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Q8

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?

Multiple Choice
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A) One fourth
B) One half
C) Two
D) Four
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Q9

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 nurses best action?

Multiple Choice
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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 patients pupillary reflexes before administering the promethazine.
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Q10

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

Multiple Choice
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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?
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Q11

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?

Multiple Choice
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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.
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Q12

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?

Multiple Choice
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A) Checking capillary refill
B) Measuring abdominal girth
C) Evaluating handgrip strength
D) Evaluating daily intake and output
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Q13

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?

Multiple Choice
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A) Systolic blood pressure decrease of 12 mm Hg
B) Increased sleepiness but arouses with light shaking
C) Oral temperature increase of 2 F
D) Urine color change from yellow to reddish-brown
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Q14

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?

Multiple Choice
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A) Use castor oil every 3 days
B) Increase the childs fluid intake
C) Ensure that the child gets adequate exercise
D) Mix a bulk-forming laxative in with the childs cereal
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Q15

How do osmotic laxatives reduce constipation?

Multiple Choice
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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.
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Q16

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

Multiple Choice
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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 patients blood glucose level at least every shift
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Q17

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 childs pants cannot be zipped or buttoned today. What is the nurses best advice?

Multiple Choice
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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 prescribers office.
D) When diarrhea is cured the stool enlarges the abdomen.
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Q18

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

Multiple Choice
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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.
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Q19

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

Multiple Choice
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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.
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Q20

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 nurses best advice at this time?

Multiple Choice
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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.
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Q21

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

Multiple Choice
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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.
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Q22

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

Multiple Choice
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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.
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Q23

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

Multiple Choice
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A) Sodium
B) Potassium
C) Creatinine
D) Blood urea nitrogen
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Q24

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

Multiple Choice
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A) Tachycardia
B) Abdominal distention
C) Peripheral edema
D) Respiratory crackles
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Q25

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

Multiple Choice
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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 patients 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.
Answer:

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Q26

[Multiple Response] Which are potential complications of nausea and vomiting? (Select all that apply.)
a. Bleeding
b. Aortic aneurysm
c. Aspiration pneumonia
d. Bowel perforation
e. Reopening of surgical wounds

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Q27

[Multiple Response] Which are symptoms of constipation? (Select all that apply.)
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

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Q28

[Multiple Response] Which are symptoms of diarrhea? (Select all that apply.)
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

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Q29

[Multiple Response] Which teaching points are included in a care plan for a patient who is taking laxatives for constipation? (Select all that apply.)
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.

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Answer:

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Q30

[Multiple Response] Which teaching points are included in a care plan for a patient who is taking laxatives for constipation? (Select all that apply.)
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.

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Q31

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

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