Week 6: The Digestive System: Part 1

1. Antacids that contain aluminum salts may result in which adverse effect?
   a. Diarrhea
   b. Constipation
   c. Intestinal flatulence

   d. Abdominal cramping

b. Consitpation

2. Antacids containing magnesium should be used cautiously in patients with which condition?
   a. Peptic ulcer disease

   b. Renal failure

   c. Hypertension

   d. Heart failure

b. Renal Failure

3. H2 antagonists, such as cimetidine, may inhibit the absorption of drugs that require an acidic gastrointestinal environment. Which drug requires an acidic gastrointestinal environment?
   a. Nonsteroidal anti-inflammatory drugs
   b. Ranitidine (Zantac®)
   c. Tetracycline

   d. Ketoconazole

d. Ketoconazole

4. A patient has been taking cimetidine for hyperacidity but says that the medication has not been effective. What is the patient doing that may be influencing the effectiveness of this drug?
   a. The patient is taking the cimetidine with meals.
   b. The patient is smoking two packs of cigarettes a day.
   c. The patient is avoiding caffeine, alcohol, and harsh spices.
   d. The patient is taking an antacid 1 hour before or after taking the cimetidine dose.

b. The patient is smoking two packs of cigarettes a day.

8. A patient with motion sickness is planning a cross-country car trip to attend a family reunion. What medication will the nurse tell the patient prevents motion sickness?

a. scopolamine

b. ondansetron

c. promethazine

d. prochlorperazine

c. promethazine

5. A patient is taking omeprazole (Losec®) for the treatment of gastroesophageal reflux disease. What important information should the nurse give the patient about this medication?
   a. The medication is taken once a day after meals.
   b. The patient will be taking this medication for long-term therapy.
   c. The medication may be dissolved in a liquid for better absorption.
   d. The entire capsule should be taken whole and not crushed, chewed, or opened.

d. The entire capsule should be taken whole and not crushed, chewed, or opened.

6. Which drug is used for the management of conditions associated with excessive gas production?
   a. famotidine (Pepcid®)
   b. aluminum hydroxide and magnesium hydroxide (Maalox®)
   c. calcium carbonate
   d. simethicone (Oval®)

d. simethicone (Oval®)

7. A 75-year-old woman reports experiencing indigestion, stomach pain, and frequent belching. She tells the nurse that she has been taking sodium bicarbonate five or six times a day for the past 3 weeks. Which hazard does the nurse know can possibly result from excessive use of sodium bicarbonate?
   a. Excess belching
   b. Constipation
   c. Systemic alkalosis
   d. Stomach secretion of excess mucus

c. Systemic alkalosis

8. A patient has been diagnosed with a peptic ulcer caused by Helicobacter pylori. The physician has recommended 2 weeks of combination therapy with omeprazole and an antibiotic. Which antibiotic will be chosen for this therapy?
   a. cephalexin hydrochloride
   b. ampicillin sodium
   c. sulfisoxazole
   d. clarithromycin

d. clarithromycin

9. A patient asks why calcium carbonate is not often used as an antacid. What is the nurse’s best explanation to the patient?
   a. Its use may result in kidney stones.
   b. It causes decreased gastric acid production.
   c. It often causes severe constipation.
   d. It may result in fluid retention and edema.

a. Its use may result in kidney stones.

10. A patient is taking several medications, including twice-daily dosages of antacids. What important information about taking the antacids should the nurse give this patient?
    a. The medications can be taken with the antacids.
    b. The antacids should be taken 1 to 2 hours before or after the other medications.
    c. The antacids should be taken at least 4 hours apart from the other medications.
    d. The patient will not be able to take the antacid therapy at this time.

b. The antacids should be taken 1 to 2 hours before or after the other medications.

11. Which classification of medications is considered triple therapy for treatment of erosive esophagitis?
    a. H2 antagonists
    b. Proton pump inhibitors
    c. General antacids
    d. Prostaglandin inhibitors

b. Proton pump inhibitors

1. Which are true statements about antacids? (Select all that apply.)
   a. Antacids prevent the overproduction of acid in the stomach.

   b. Antacids neutralize acid in the stomach.

   c. Antacids promote a mucous barrier in the stomach.

   d. Rebound hyperacidity may occur with calcium-based antacids.

   e. Aluminum-based antacids cause diarrhea.

   f. Magnesium-based antacids cause diarrhea.

   g. Stomach acidity is reduced by 90% if the pH is raised an entire point.

B,C,D,F,G

1. A patient is on laxative therapy. What important information about this therapy should the nurse provide the patient?
   a. All laxative tablets should be crushed for improved action.
   b. Bisacodyl should be given with water only.
   c. A normal bowel pattern is when a bowel movement occurs daily.
   d. Psyllium (Metamucil® preparations) can be mixed in food, such as applesauce, or stirred into fruit juice.

b. Bisacodyl should be given with water only.

2. What type of laxative is glycerin?
   a. A saline laxative
   b. An emollient laxative
   c. A hyperosmotic laxative
   d. A stimulant/irritant laxative

c. A hyperosmotic laxative

3. When preparing the bulk-forming laxative methylcellulose for administration, the nurse will mix the medication with how much water to avoid possible obstruction?
   a. 100 mL
   b. 12 mL
   c. 240 mL
   d. 360 mL

c. 240 mL

4. The nurse advises a patient to try bismuth subsalicylate (Pepto-Bismol®) to control diarrhea. Which medication will interact significantly with the Pepto-Bismol?
   a. digoxin
   b. Antacids
   c. acetaminophen (Tylenol®)
   d. tricyclic antidepressants

a. digoxin

5. Which drug is commonly used to induce total cleansing of the bowel before diagnostic or surgical bowel procedures?
   a. polyethylene glycol
   b. lactulose
   c. mineral oil
   d. milk of magnesia

a. polyethylene glycol

6. While recovering from surgery, a 74-year-old woman started taking senna (Senokot®) to relieve constipation caused by the pain medications. She is also taking digoxin and tetracycline. She tells the nurse that she likes how “regular” her bowel movements are now that she is taking the laxative. What important information should the nurse give to this patient?
   a. Use of a stimulant laxative will not affect the absorption of her other medications.
   b. It is important to have a daily bowel movement to promote bowel health.
   c. Long-term use of laxatives often results in decreased bowel tone and may lead to
   dependency.
   d. She should switch to glycerin suppositories to continue having daily bowel
   movements.

c. Long-term use of laxatives often results in decreased bowel tone and may lead to
dependency.

7. What is a major difference between diphenoxylate with atropine (Lomotil®) and loperamide (Imodium®)?
   a. Lomotil acts faster.
   b. Loperamide does not cause dependence.
   c. Lomotil is available as a parenteral form.
   d. Loperamide is a natural antidiarrheal drug.

b. Loperamide does not cause dependence.

8. Which type of laxatives is most likely to cause dependence if overused?
   a. Emollient laxatives
   b. Bulk-forming laxatives
   c. Hyperosmotic laxatives
   d. Stimulant laxatives

d. Stimulant laxatives

9. Mineral oil can interfere with the absorption of which vitamin?
   a. Vitamin A
   b. Vitamin B2
   c. Vitamin B12
   d. Vitamin C

a. Vitamin A

10. Which type of antidiarrheal medication works by decreasing the intestinal muscle tone and peristalsis of the intestines?
    a. Adsorbents
    b. Anticholinergics
    c. Intestinal flora modifiers
    d. Lubricants

b. Anticholinergics

11. A patient is taking an adsorbent, such as bismuth subsalicylate (Pepto-Bismol). What possible adverse effects should the nurse warn this patient about?
    a. Darkened stools
    b. Urinary hesitancy
    c. Drowsiness
    d. Blurred vision

a. Darkened stools

12. A patient who has been on antibiotic therapy for 2 weeks has developed persistent diarrhea. Which drug will likely be recommended for this patient?
    a. Which drug will likely be recommended for this patient?
    a. Mineral oil
    b. An adsorbent
    c. An anticholinergic
    d. An intestinal flora modifier

d. An intestinal flora modifier

1. Regarding the uses for laxatives, which conditions are general contraindications to the use of oral laxatives? (Select all that apply.)
    a. High ammonia levels due to liver failure

   b. The presence of parasites and intestinal worms

   c. Abdominal pain of unknown origin

   d. Nausea and vomiting

   e. Pregnancy

   f. Ingestion of toxic substance

   g. Acute surgical abdomen

C,D,G

1. The nurse has just completed the intravenous administration of a drug to a patient for the prevention of chemotherapy-induced nausea and vomiting. What antiemetic drug has the patient received?
   a. granisetron
   b. lorazepam
   c. dexamethasone

   d. prochlorperazine

a. granisetron

2. Which primary anticholinergic medication is used as an antiemetic?
   a. Meclizine hydrochloride
   b. Prochlorperazine
   c. Scopolamine hydrobromide
   d. Metoclopramide hydrochloride

c. Scopolamine hydrobromide

3. A patient receiving chemotherapy is prescribed ondansetron (Zofran) for treatment of nausea. Which is an adverse effect of this antiemetic drug?
   a. Dizziness
   b. Headache
   c. Dry mouth
   d. Blurred vision

b. Headache

4. A patient is experiencing intractable hiccups. Which drug will the nurse expect to administer to this patient?

   a. metoclopramide
   b. prochlorperazine
   c. scopolamine
   d. granisetron
   ANS: B

b. prochlorperazine

6. Which statement is correct regarding the management of nausea and vomiting?
   a. Give antiemetics immediately after chemotherapy is administered.
   b. Antiemetics are often administered 30 to 60 minutes before a chemotherapy drug
   is given.
   c. Taking antiemetics at night may cause restlessness and interfere with sleep.
   d. Antiemetics may be taken with a glass of wine to help settle the stomach.

b. Antiemetics are often administered 30 to 60 minutes before a chemotherapy drug
is given.

7. Which antiemetic drug is effective in preventing chemotherapy-induced and postoperative nausea and vomiting?

   a. meclizine

   b. ondansetron

   c. scopolamine

   d. diphenhydramine

b. ondansetron

9. Tetrahydrocannabinol (THC) is an antiemetic used for treatment of nausea and vomiting associated with which situation?
   a. Ménière’s disease
   b. Motion sickness
   c. Chemotherapy treatment
   d. Surgical treatment

c. Chemotherapy treatment

10. A patient who has been newly diagnosed with vertigo will be taking an antihistamine antiemetic drug. What is important for the nurse to emphasize when teaching the patient about this drug?
    a. Doses may be skipped if the patient is feeling well.
    b. Because of possible drowsiness, the patient should avoid driving.
    c. The patient may experience transient taste problems.
    d. It is safe to take the dose with a glass of wine in the evening to help settle the
    stomach.

b. Because of possible drowsiness, the patient should avoid driving.