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Mount St. Marys College - NURSING 30

Chapter 42: Gastrointestinal Tract Disorders

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?

1. 1. As needed, at the first sign of nausea
   2. At 0700, before leaving for the airport
   3. At 0830, just prior to boarding the plane
   4. When seated, just prior to takeoff
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?
   1. Antibiotics and antiemetics
   2. Intravenous fluids and electrolytes
   3. Nonprescription antiemetics
   4. Prescription antiemetics
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?
   1. Administering an OTC antiemetic medication such as diphenhydramine
   2. Giving frequent, small amounts of Pedialyte
   3. Keeping the child NPO until vomiting subsides
   4. Taking the child to the emergency department for IV fluids
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?

1. “Do not drive while taking this medication.”
2. “Dry mouth is a sign of toxicity with this medication.”
3. “Take the medication 1 to 2 hours prior to beginning the trip.”
4. “Take 100 mg up to 6 times daily for best effect.”

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 patient’s health history would be of concern? a.    Asthma
   2. Diabetes
   3. GERD
   4. Glaucoma
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
   1. in smaller doses.
   2. less frequently.
   3. with anticholinergics.
   4. with antihistamines.
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?
   1. Before and after the chemotherapy
   2. During chemotherapy
   3. Immediately prior to chemotherapy
   4. 24  hours prior to chemotherapy
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?
   1. Contact the provider to discuss a possible need for intravenous fluids.
   2. Contact the provider to discuss a prescription antiemetic.
   3. Use nonpharmacologic measures such as saltines.
   4. Take over-the-counter antiemetics such as diphenhydramine.
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?
   1. Excess sedation
   2. Extrapyramidal symptoms
   3. Paralytic ileus
   4. Vertigo
10. The child who is a candidate for treatment with an emetic after ingestion of a toxic substance or overdose is the child who has ingested which substance?
    1. Acetaminophen elixir
    2. Chlorine bleach
    3. Kerosene
    4. Toilet cleanser
11. The nurse is teaching a group of parents about the use of syrup of ipecac. Which instruction will the nurse provide?
    1. “Do not administer ipecac without consulting a poison control center.”
    2. “Expect the onset of emesis to be immediate.”
    3. “Give ipecac with a glass of milk to increase its emetic effect.”
    4. “Use ipecac fluid extract and not ipecac syrup.”
12. A patient asks the nurse about using loperamide (Imodium) to treat infectious diarrhea. Which response will the nurse give?
    1. “Loperamide results in many central nervous system (CNS) side effects.”
    2. “Loperamide has no effect on infectious diarrhea.”
    3. “Loperamide is taken once daily.”
    4. “Loperamide may prolong the symptoms.”
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
    1. activated charcoal.
    2. an anticholinergic antiemetic.
    3. gastric lavage.
    4. syrup of ipecac.
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
    1. decrease abdominal cramping.
    2. increase intestinal motility.
    3. minimize nausea and vomiting.
    4. provide analgesia.
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?
    1. Bradycardia
    2. Fluid retention
    3. Nervousness and tremors
    4. Respiratory depression
16. A patient asks the nurse the best way to prevent traveler’s diarrhea. The nurse will provide which recommendation to the patient?
    1. “Ask your provider for prophylactic antibiotics.”
    2. “Drink bottled water and eat only well-cooked meats.”
    3. “Eat fresh, raw fruits and vegetables.”
    4. “Take loperamide (Imodium) every day.”
17. An appropriate goal when teaching a patient who has diarrhea is that the patient
    1. will have less frequent, more formed stools.
    2. will not have a stool for 1 to 2 days.
    3. will receive adequate intravenous fluids.
    4. will receive appropriate antibiotic therapy.
18. A patient reports having three to four stools, which are sometimes hard, per week. The nurse will perform which action?
    1. Recommend increased fluids and dietary fiber.
    2. Request an order for a laxative as needed.
    3. Request an order for a stool softener.
    4. Suggest discussing chronic constipation with the provider.