Chapter 47: Drugs for Gastrointestinal Tract Disorders Nursing School Test Banks

Chapter 47: Drugs for Gastrointestinal Tract Disorders
Test Bank

MULTIPLE CHOICE

1. 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
ANS: C
Motion sickness medication has its onset in 30 minutes. The patient should be instructed to take the medication a half hour prior to takeoff. It is not used as needed.

DIF: COGNITIVE LEVEL: Understanding (Comprehension) REF: Page 677
TOP: NURSING PROCESS: Nursing Intervention: Patient Teaching
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

2. 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. Non-prescription antiemetics
d. Prescription antiemetics
ANS: B
Antiemetics can mask the underlying cause of vomiting and should not be used until the cause is determined unless vomiting is so severe that dehydration and electrolyte imbalance occurs. Nonpharmacologic measures, such as fluid and electrolyte replacement, should be used. Antibiotics are only used if an infectious cause is determined.

DIF: COGNITIVE LEVEL: Applying (Application) REF: Page 677
TOP: NURSING PROCESS: Nursing Intervention
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

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
ANS: B
The child is not dehydrated as evidenced by adequate wet diapers, so nonpharmacologic measures, such as oral fluids, are recommended. Antiemetics are not recommended unless dehydration occurs. Intravenous fluids are given when dehydration is present.

DIF: COGNITIVE LEVEL: Applying (Application) REF: Page 677
TOP: NURSING PROCESS: Nursing Intervention
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

4. 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 mediation.
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.
ANS: A
Drowsiness is a common side effect of dimenhydrinate, so patients should be cautioned against driving while taking this drug. Dry mouth is a common side effect and not a sign of toxicity. The drug should be taken 30 minutes prior to travel. The maximum recommended dose is 400 mg per day.

DIF: COGNITIVE LEVEL: Applying (Application) REF: Page 678
TOP: NURSING PROCESS: Nursing Intervention: Patient Teaching
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

5. The nurse is caring for a patient who has postoperative nausea and vomiting. The surgeon has ordered promethazine HCl (Phenergan). Which aspect of this patients health history would be of concern?
a. Asthma
b. Diabetes
c. GERD
d. Glaucoma
ANS: D
Promethazine is contraindicated in patients with glaucoma since it is an anticholinergic medication. It should be used with caution in patients with asthma. The other two conditions are not concerning with this medication.

DIF: COGNITIVE LEVEL: Understanding (Comprehension) REF: Page 680
TOP: NURSING PROCESS: Assessment
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

6. 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
a. in smaller doses.
b. less frequently.
c. with anticholinergics.
d. with antihistamines.
ANS: A
Antipsychotic medications have antiemetic properties in smaller doses.

DIF: COGNITIVE LEVEL: Understanding (Comprehension) REF: Page 681
TOP: NURSING PROCESS: Nursing Intervention: Patient Teaching
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

7. 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?
a. Before and after the chemotherapy
b. During chemotherapy
c. Immediately prior to chemotherapy
d. 24 hours prior to chemotherapy
ANS: A
Cannabinoids are given prior to chemotherapy and for 24 hours after chemotherapy.

DIF: COGNITIVE LEVEL: Applying (Application) REF: Page 679
TOP: NURSING PROCESS: Nursing Intervention: Patient Teaching
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

8. 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 take which action first?
a. Contact the provider to discuss a possible need for intravenous fluids.
b. Contact the provider to discuss a prescription antiemetic.
c. Use nonpharmacologic measures such as saltines.
d. Take over-the-counter antiemetics such as diphenhydramine.
ANS: C
Pregnant women should avoid antiemetics during the first trimester of pregnancy because of possible teratogenic effects. The nurse should recommend nonpharmacologic measures such as saltines. If this is not effective, intravenous fluids may become necessary. Pregnant women should consult with their provider before taking prescription or over-the-counter antiemetics.

DIF: COGNITIVE LEVEL: Applying (Application) REF: Page 677
TOP: NURSING PROCESS: Nursing Intervention: Patient Teaching
MSC: NCLEX: Health Promotion and Maintenance

9. 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 effect?
a. Excess sedation
b. Extrapyramidal symptoms
c. Paralytic ileus
d. Vertigo
ANS: B
Metoclopramide can cause extrapyramidal symptoms, and these effects are more likely in children. Children are not more prone to sedative effects, paralytic ileus, or vertigo while taking this drug.

DIF: COGNITIVE LEVEL: Understanding (Comprehension) REF: Page 679
TOP: NURSING PROCESS: Evaluation/Teaching
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

10. The child who is a candidate for treatment with syrup of ipecac after ingestion of a toxic substance or overdose is the child who has ingested which substance?
a. Acetaminophen elixir
b. Chlorine bleach
c. Kerosene
d. Toilet cleanser
ANS: A
Ipecac should not be given to patients who have ingested caustic substances or petroleum distillates since regurgitation carries a risk of aspiration. Acetaminophen is not a caustic substance or a petroleum distillate. Chlorine bleach and toilet cleanser are caustic substances. Kerosene is a petroleum distillate.

DIF: COGNITIVE LEVEL: Applying (Application) REF: Page 683
TOP: NURSING PROCESS: Nursing Intervention
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

11. The nurse is teaching a group of parents about the use of syrup of ipecac. Which instruction will the nurse provide?
a. Do not administer ipecac without consulting a poison control center.
b. Expect the onset of emesis to be immediate.
c. Give ipecac with a glass of milk to increase its emetic effect.
d. Use ipecac fluid extract and not ipecac syrup.
ANS: A
Ipecac should not be used for caustic substances or petroleum distillates. Ipecac should be given only after determining whether it is safe. The onset of emesis is in 15 to 30 minutes. Ipecac should not be given with milk or carbonated beverages. Ipecac syrup should be used.

DIF: COGNITIVE LEVEL: Applying (Application) REF: Page 683
TOP: NURSING PROCESS: Nursing Intervention: Patient Teaching
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

12. A patient asks the nurse about using loperamide (Imodium) to treat infectious diarrhea. Which response will the nurse give?
a. Loperamide results in many central nervous system (CNS) side effects.
b. Loperamide has no effect on infectious diarrhea.
c. Loperamide is taken once daily.
d. Loperamide may prolong the symptoms.
ANS: D
Patients with infectious diarrhea should be cautioned about using loperamide since slowing transit through the intestines may prolong the exposure to the infectious agent. Loperamide causes less CNS depression than other antidiarrheals. It is taken after each loose stool.

DIF: COGNITIVE LEVEL: Understanding (Comprehension) REF: Page 683
TOP: NURSING PROCESS: Nursing Intervention: Patient Teaching
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

13. 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.
ANS: A
Activated charcoal is used when patients have ingested a caustic substance or a petroleum distillate in a patient who is alert and awake. Gastric lavage is no longer used as therapy. Syrup of ipecac is not recommended.

DIF: COGNITIVE LEVEL: Applying (Application) REF: Page 683
TOP: NURSING PROCESS: Nursing Intervention
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

14. 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 to
a. decrease abdominal cramping.
b. increase intestinal motility.
c. minimize nausea and vomiting.
d. provide analgesia.
ANS: A
Atropine is added to decrease abdominal cramping and intestinal motility. It does not affect nausea and vomiting or pain.

DIF: COGNITIVE LEVEL: Understanding (Comprehension) REF: Page 684
TOP: NURSING PROCESS: Implementation/Teaching
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

15. 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?
a. Bradycardia
b. Fluid retention
c. Nervousness and tremors
d. Respiratory depression
ANS: D
Diphenoxylate is an opium agonist and can cause respiratory depression. Children and older adults are more susceptible to this effect. It contains atropine, so it will increase heart rate. It does not contribute to fluid retention. Lomotil causes central nervous system depression and will not cause nervousness and tremors.

DIF: COGNITIVE LEVEL: Applying (Application) REF: Page 684
TOP: NURSING PROCESS: Evaluation
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

16. A patient asks the nurse the best way to prevent travelers diarrhea. The nurse will provide which recommendation to the patient?
a. Ask your provider for prophylactic antibiotics.
b. Drink bottled water and eat only well-cooked meats.
c. Eat fresh, raw fruits and vegetables.
d. Take loperamide (Imodium) every day.
ANS: B
Patients traveling to areas with potential travelers diarrhea should be taught to drink bottled water and eat meats that are well-cooked. Prophylactic antibiotics are not recommended. Patients should eat cooked, washed fruits and vegetables. Loperamide can increase exposure to pathogens by slowing motility.

DIF: COGNITIVE LEVEL: Applying (Application) REF: Page 683
TOP: NURSING PROCESS: Nursing Intervention: Patient Teaching
MSC: NCLEX: Health Promotion and Maintenance

17. An appropriate goal when teaching a patient who has diarrhea is that the patient
a. will have less frequent, more formed stools.
b. will not have a stool for 1 to 2 days.
c. will receive adequate intravenous fluids.
d. will receive appropriate antibiotic therapy.
ANS: A
An appropriate goal is that patients will have formed, less frequent stools not an absence of stools. Receiving adequate intravenous fluids or antibiotic therapy are interventions not goals.

DIF: COGNITIVE LEVEL: Applying (Application) REF: Page 685
TOP: NURSING PROCESS: Planning MSC: NCLEX: Health Promotion and Maintenance

18. A patient reports having three to four stools, which are sometimes hard, per week. The nurse will perform which action?
a. Recommend increased fluids and dietary fiber.
b. Request an order for a laxative as needed.
c. Request an order for a stool softener.
d. Suggest discussing chronic constipation with the provider.
ANS: A
This patient is having stools that are within the normal range for frequency. Nonpharmacologic measures should be used first to help soften stools.

DIF: COGNITIVE LEVEL: Applying (Application) REF: Page 686
TOP: NURSING PROCESS: Nursing Intervention
MSC: NCLEX: Health Promotion and Maintenance

19. The nurse is instructing a patient who will take psyllium (Metamucil) to treat constipation. What information will the nurse include when teaching this patient?
a. The importance of consuming adequate amounts of water
b. The need to monitor for systemic side effects
c. The onset of action of 30 to 60 minutes after administration
d. The need to use the dry form of Metamucil to prevent cramping
ANS: A
Insufficient fluid intake can cause the drug to solidify in the gastrointestinal tract. Psyllium is not digestible, so it does not have systemic side effects. Onset of action for psyllium is between 10 and 24 hours. The dry form can cause cramping.

DIF: COGNITIVE LEVEL: Understanding (Comprehension) REF: Page 686
TOP: NURSING PROCESS: Planning
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

Test Bank

MULTIPLE CHOICE

1. 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
ANS: C
Motion sickness medication has its onset in 30 minutes. The patient should be instructed to take the medication a half hour prior to takeoff. It is not used as needed.

DIF: COGNITIVE LEVEL: Understanding (Comprehension) REF: Page 677
TOP: NURSING PROCESS: Nursing Intervention: Patient Teaching
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

2. 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. Non-prescription antiemetics
d. Prescription antiemetics
ANS: B
Antiemetics can mask the underlying cause of vomiting and should not be used until the cause is determined unless vomiting is so severe that dehydration and electrolyte imbalance occurs. Nonpharmacologic measures, such as fluid and electrolyte replacement, should be used. Antibiotics are only used if an infectious cause is determined.

DIF: COGNITIVE LEVEL: Applying (Application) REF: Page 677
TOP: NURSING PROCESS: Nursing Intervention
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

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
ANS: B
The child is not dehydrated as evidenced by adequate wet diapers, so nonpharmacologic measures, such as oral fluids, are recommended. Antiemetics are not recommended unless dehydration occurs. Intravenous fluids are given when dehydration is present.

DIF: COGNITIVE LEVEL: Applying (Application) REF: Page 677
TOP: NURSING PROCESS: Nursing Intervention
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

4. 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 mediation.
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.
ANS: A
Drowsiness is a common side effect of dimenhydrinate, so patients should be cautioned against driving while taking this drug. Dry mouth is a common side effect and not a sign of toxicity. The drug should be taken 30 minutes prior to travel. The maximum recommended dose is 400 mg per day.

DIF: COGNITIVE LEVEL: Applying (Application) REF: Page 678
TOP: NURSING PROCESS: Nursing Intervention: Patient Teaching
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

5. The nurse is caring for a patient who has postoperative nausea and vomiting. The surgeon has ordered promethazine HCl (Phenergan). Which aspect of this patients health history would be of concern?
a. Asthma
b. Diabetes
c. GERD
d. Glaucoma
ANS: D
Promethazine is contraindicated in patients with glaucoma since it is an anticholinergic medication. It should be used with caution in patients with asthma. The other two conditions are not concerning with this medication.

DIF: COGNITIVE LEVEL: Understanding (Comprehension) REF: Page 680
TOP: NURSING PROCESS: Assessment
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

6. 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
a. in smaller doses.
b. less frequently.
c. with anticholinergics.
d. with antihistamines.
ANS: A
Antipsychotic medications have antiemetic properties in smaller doses.

DIF: COGNITIVE LEVEL: Understanding (Comprehension) REF: Page 681
TOP: NURSING PROCESS: Nursing Intervention: Patient Teaching
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

7. 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?
a. Before and after the chemotherapy
b. During chemotherapy
c. Immediately prior to chemotherapy
d. 24 hours prior to chemotherapy
ANS: A
Cannabinoids are given prior to chemotherapy and for 24 hours after chemotherapy.

DIF: COGNITIVE LEVEL: Applying (Application) REF: Page 679
TOP: NURSING PROCESS: Nursing Intervention: Patient Teaching
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

8. 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 take which action first?
a. Contact the provider to discuss a possible need for intravenous fluids.
b. Contact the provider to discuss a prescription antiemetic.
c. Use nonpharmacologic measures such as saltines.
d. Take over-the-counter antiemetics such as diphenhydramine.
ANS: C
Pregnant women should avoid antiemetics during the first trimester of pregnancy because of possible teratogenic effects. The nurse should recommend nonpharmacologic measures such as saltines. If this is not effective, intravenous fluids may become necessary. Pregnant women should consult with their provider before taking prescription or over-the-counter antiemetics.

DIF: COGNITIVE LEVEL: Applying (Application) REF: Page 677
TOP: NURSING PROCESS: Nursing Intervention: Patient Teaching
MSC: NCLEX: Health Promotion and Maintenance

9. 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 effect?
a. Excess sedation
b. Extrapyramidal symptoms
c. Paralytic ileus
d. Vertigo
ANS: B
Metoclopramide can cause extrapyramidal symptoms, and these effects are more likely in children. Children are not more prone to sedative effects, paralytic ileus, or vertigo while taking this drug.

DIF: COGNITIVE LEVEL: Understanding (Comprehension) REF: Page 679
TOP: NURSING PROCESS: Evaluation/Teaching
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

10. The child who is a candidate for treatment with syrup of ipecac after ingestion of a toxic substance or overdose is the child who has ingested which substance?
a. Acetaminophen elixir
b. Chlorine bleach
c. Kerosene
d. Toilet cleanser
ANS: A
Ipecac should not be given to patients who have ingested caustic substances or petroleum distillates since regurgitation carries a risk of aspiration. Acetaminophen is not a caustic substance or a petroleum distillate. Chlorine bleach and toilet cleanser are caustic substances. Kerosene is a petroleum distillate.

DIF: COGNITIVE LEVEL: Applying (Application) REF: Page 683
TOP: NURSING PROCESS: Nursing Intervention
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

11. The nurse is teaching a group of parents about the use of syrup of ipecac. Which instruction will the nurse provide?
a. Do not administer ipecac without consulting a poison control center.
b. Expect the onset of emesis to be immediate.
c. Give ipecac with a glass of milk to increase its emetic effect.
d. Use ipecac fluid extract and not ipecac syrup.
ANS: A
Ipecac should not be used for caustic substances or petroleum distillates. Ipecac should be given only after determining whether it is safe. The onset of emesis is in 15 to 30 minutes. Ipecac should not be given with milk or carbonated beverages. Ipecac syrup should be used.

DIF: COGNITIVE LEVEL: Applying (Application) REF: Page 683
TOP: NURSING PROCESS: Nursing Intervention: Patient Teaching
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

12. A patient asks the nurse about using loperamide (Imodium) to treat infectious diarrhea. Which response will the nurse give?
a. Loperamide results in many central nervous system (CNS) side effects.
b. Loperamide has no effect on infectious diarrhea.
c. Loperamide is taken once daily.
d. Loperamide may prolong the symptoms.
ANS: D
Patients with infectious diarrhea should be cautioned about using loperamide since slowing transit through the intestines may prolong the exposure to the infectious agent. Loperamide causes less CNS depression than other antidiarrheals. It is taken after each loose stool.

DIF: COGNITIVE LEVEL: Understanding (Comprehension) REF: Page 683
TOP: NURSING PROCESS: Nursing Intervention: Patient Teaching
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

13. 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.
ANS: A
Activated charcoal is used when patients have ingested a caustic substance or a petroleum distillate in a patient who is alert and awake. Gastric lavage is no longer used as therapy. Syrup of ipecac is not recommended.

DIF: COGNITIVE LEVEL: Applying (Application) REF: Page 683
TOP: NURSING PROCESS: Nursing Intervention
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

14. 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 to
a. decrease abdominal cramping.
b. increase intestinal motility.
c. minimize nausea and vomiting.
d. provide analgesia.
ANS: A
Atropine is added to decrease abdominal cramping and intestinal motility. It does not affect nausea and vomiting or pain.

DIF: COGNITIVE LEVEL: Understanding (Comprehension) REF: Page 684
TOP: NURSING PROCESS: Implementation/Teaching
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

15. 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?
a. Bradycardia
b. Fluid retention
c. Nervousness and tremors
d. Respiratory depression
ANS: D
Diphenoxylate is an opium agonist and can cause respiratory depression. Children and older adults are more susceptible to this effect. It contains atropine, so it will increase heart rate. It does not contribute to fluid retention. Lomotil causes central nervous system depression and will not cause nervousness and tremors.

DIF: COGNITIVE LEVEL: Applying (Application) REF: Page 684
TOP: NURSING PROCESS: Evaluation
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

16. A patient asks the nurse the best way to prevent travelers diarrhea. The nurse will provide which recommendation to the patient?
a. Ask your provider for prophylactic antibiotics.
b. Drink bottled water and eat only well-cooked meats.
c. Eat fresh, raw fruits and vegetables.
d. Take loperamide (Imodium) every day.
ANS: B
Patients traveling to areas with potential travelers diarrhea should be taught to drink bottled water and eat meats that are well-cooked. Prophylactic antibiotics are not recommended. Patients should eat cooked, washed fruits and vegetables. Loperamide can increase exposure to pathogens by slowing motility.

DIF: COGNITIVE LEVEL: Applying (Application) REF: Page 683
TOP: NURSING PROCESS: Nursing Intervention: Patient Teaching
MSC: NCLEX: Health Promotion and Maintenance

17. An appropriate goal when teaching a patient who has diarrhea is that the patient
a. will have less frequent, more formed stools.
b. will not have a stool for 1 to 2 days.
c. will receive adequate intravenous fluids.
d. will receive appropriate antibiotic therapy.
ANS: A
An appropriate goal is that patients will have formed, less frequent stools not an absence of stools. Receiving adequate intravenous fluids or antibiotic therapy are interventions not goals.

DIF: COGNITIVE LEVEL: Applying (Application) REF: Page 685
TOP: NURSING PROCESS: Planning MSC: NCLEX: Health Promotion and Maintenance

18. A patient reports having three to four stools, which are sometimes hard, per week. The nurse will perform which action?
a. Recommend increased fluids and dietary fiber.
b. Request an order for a laxative as needed.
c. Request an order for a stool softener.
d. Suggest discussing chronic constipation with the provider.
ANS: A
This patient is having stools that are within the normal range for frequency. Nonpharmacologic measures should be used first to help soften stools.

DIF: COGNITIVE LEVEL: Applying (Application) REF: Page 686
TOP: NURSING PROCESS: Nursing Intervention
MSC: NCLEX: Health Promotion and Maintenance

19. The nurse is instructing a patient who will take psyllium (Metamucil) to treat constipation. What information will the nurse include when teaching this patient?
a. The importance of consuming adequate amounts of water
b. The need to monitor for systemic side effects
c. The onset of action of 30 to 60 minutes after administration
d. The need to use the dry form of Metamucil to prevent cramping
ANS: A
Insufficient fluid intake can cause the drug to solidify in the gastrointestinal tract. Psyllium is not digestible, so it does not have systemic side effects. Onset of action for psyllium is between 10 and 24 hours. The dry form can cause cramping.

DIF: COGNITIVE LEVEL: Understanding (Comprehension) REF: Page 686
TOP: NURSING PROCESS: Planning
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

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