NCLEX Prep II Gastrointestinal Medications

NCLEX Prep II Gastrointestinal Medications The nurse is administering senna to an older client. What is the expected result of this medication?

• It increases peristalsis.
• It lines the wall of the bowel.
• It adds fiber and bulk to the stool.
• It stimulates the vagus nerve to improve bowel tone.

(ANS - It increases peristalsis.

Rationale:Senna works by altering the transport of water and electrolytes in the large intestine, which causes accumulation of water in the mass of stool and increased peristalsis. The other options are incorrect actions for this medication.

The nurse has given instructions to a client who has just been prescribed cholestyramine. Which statement by the client indicates a need for further instruction?

1."I will continue taking vitamin supplements." 2."This medication will help to lower my cholesterol." 3."This medication should only be taken with water." 4."A high-fiber diet is important while taking this medication." (ANS - "This medication should only be taken with water."

Rationale: Cholestyramine is a bile acid sequestrant used to lower the cholesterol level, and client compliance is a problem because of its taste and palatability. The use of flavored products or fruit juices can improve the taste. Some side effects of bile acid sequestrants include constipation and decreased vitamin absorption.

A client admitted to the medical nursing unit has a diagnosis of gastroesophageal reflux disease (GERD). Metoclopramide has been prescribed 4 times a day. When should the nurse schedule administration of the medication?

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1.Every 8 hours 2.With meals and at bedtime 3.Right after meals and at bedtime 4.30 minutes before meals and at bedtime (ANS - 30 minutes before meals and at bedtime

Rationale: Metoclopramide is a gastrointestinal stimulant. Administration should be scheduled 30 minutes before meals and at bedtime to allow the medication time to begin working before food intake and digestion. The other options are incorrect.

A client taking an oral laxative wants to obtain a rapid effect from the medication.How should the nurse instruct the client to take the medication?

1.At bedtime 2.With breakfast 3.With the noon meal 4.On an empty stomach (ANS - On an empty stomach

Rationale: Most rapid results from an oral laxative occur when it is taken on an empty stomach. If taken at bedtime, the client will have a bowel movement in the morning. It will not have a rapid effect if taken with a meal.

A client has an as needed prescription for loperamide hydrochloride. For which condition should the nurse administer this medication?

1.Constipation 2.Abdominal pain 3.An episode of diarrhea 4.Hematest-positive nasogastric tube drainage (ANS - An episode of diarrhea

Rationale: Loperamide is an antidiarrheal agent. It is used to manage acute and

chronic diarrhea in conditions such as inflammatory bowel disease. Loperamide 2 / 4

also can be used to reduce the volume of drainage from an ileostomy. It is not used for the conditions in options 1, 2, and 4.

The client with peptic ulcer disease is prescribed medication therapy. The nurse explains the medications to the client and explains that sucralfate will help to heal the ulcer by doing what?

• Eradicate Helicobacter pylori.
• Reduce gastric acidity.
• Treat bacterial infection.
• Enhance mucosal defenses.

(ANS - Enhance mucosal defenses.

Rationale: Medication therapy is used to treat peptic ulcer disease by 3

mechanisms: eradicating H. pylori (or other bacterial infections), reducing gastric acidity, and enhancing mucosal defenses. Sucralfate works by enhancing mucosal defenses. Antibiotics treat infection and eradicate H. pylori. Antisecretory agents, misoprostol, and antacids work by reducing gastric acidity.

A client has a new prescription for metoclopramide. On review of the chart, the nurse identifies that this medication can be safely administered with which condition?

• Intestinal obstruction
• Peptic ulcer with melena
• Diverticulitis with perforation
• Vomiting following cancer chemotherapy

(ANS - Vomiting following cancer chemotherapy

Rationale: Metoclopramide is a gastrointestinal stimulant and antiemetic. Because it is a gastrointestinal stimulant, it is contraindicated with gastrointestinal obstruction, hemorrhage, or perforation. It is used in the treatment of vomiting after surgery, chemotherapy, or radiation.

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The nurse notes that a client is taking lansoprazole. Which question by the nurse helps to determine that this medication is effective?

1."Has your appetite increased?" 2."Are you experiencing any heartburn?" 3."Do you have any problems with vision?" 4."Do you experience any leg pain when walking?" (ANS - "Are you experiencing any heartburn?"

Rationale: Lansoprazole is a gastric acid proton pump inhibitor that is used to treat gastric and duodenal ulcers, erosive esophagitis, and hypersecretory conditions. It also is used to treat gastroesophageal reflux disease (GERD). It is not used to treat problems with appetite, visual problems, or leg pain.

The nurse is reviewing a client's medication reconciliation form in the medical record and notes that the client is taking tamsulosin at home. Which medication, if started in the hospital, should the nurse question?

1.Lisinopril 2.Valsartan 3.Metoprolol 4.Cimetidine (ANS - Cimetidine

Rationale: Tamsulosin is used most commonly for the treatment of benign prostatic hyperplasia. This medication should not be used concurrently with cimetidine because of the risk of tamsulosin toxicity. The other medications noted do not cause interactions with this medication.

Oral rifaximin has been prescribed for a client with portosystemic encephalopathy.The nurse reviews the health care provider's prescription and determines that this medication has been prescribed for which purpose?

1.Prevent infection.

2.Prevent restlessness in the client.

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