Nokea
A laxative has been ordered for a patient. The nurse checks the patient's medical history and would be concerned if which condition is present?
- A. High ammonia levels due to liver failure
- B. Diverticulosis
- C. Abdominal pain of unknown origin
- D. Chronic constipation
Correct Answer: C
Rationale: All categories of laxatives share the same general contraindications and precautions, including avoidance in cases of drug allergy and the need for cautious use in the presence of these: acute surgical abdomen; appendicitis symptoms such as abdominal pain, nausea, and vomiting; fecal impaction (mineral oil enemas excepted); intestinal obstruction; and undiagnosed abdominal pain. The other options are possible indications for laxatives.
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The nurse is discussing the use of adsorbents such as bismuth subsalicylate with a patient who has diarrhea. The nurse will warn the patient about which possible adverse effects?
- A. Dark stools and blue gums
- B. Urinary hesitancy
- C. Drowsiness and dizziness
- D. Blurred vision and headache
Correct Answer: A
Rationale: Dark stools and blue gums are two of the possible adverse effects of bismuth subsalicylate. The other adverse effects listed may occur with the use of other antidiarrheal drugs.
The nurse is reviewing the mechanism of action of antidiarrheal drugs. Which type of antidiarrheal medication works by decreasing the intestinal muscle tone and peristalsis of the intestines?
- A. Adsorbents
- B. Anticholinergics
- C. Probiotics
- D. Lubricants
Correct Answer: B
Rationale: Anticholinergic drugs work to slow peristalsis by reducing the rhythmic contractions and the smooth muscle tone of the gastrointestinal tract. The other options are incorrect.
When administering mineral oil, the nurse recognizes that it can interfere with the absorption of which substance?
- A. Fat-soluble vitamins
- B. Water-soluble vitamins
- C. Minerals
- D. Electrolytes
Correct Answer: A
Rationale: Mineral oil can decrease the absorption of fat-soluble vitamins (A, D, E, and K). The other options are incorrect.
A patient is severely constipated and needs immediate relief. The nurse knows that which class of laxative will provide the most rapid results?
- A. Bulk-forming laxative, such as psyllium
- B. Stool softener, such as docusate salts
- C. Magnesium hydroxide
- D. Magnesium oxide tablets
Correct Answer: C
Rationale: Saline laxatives such as magnesium hydroxide produce a watery stool, usually within 3 to 6 hours of ingestion. Bulk-forming laxatives such as psyllium do not produce a bowel movement rapidly. Stool softeners such as docusate salts do not cause patients to defecate; they simply soften the stool to ease its passage. Magnesium oxide tablets are used as magnesium supplements, not as laxatives.
A patient is receiving lactulose three times a day. The nurse knows that the patient is not constipated and is receiving this drug for which reason?
- A. High ammonia levels due to liver failure
- B. Prevention of constipation
- C. Chronic renal failure
- D. Chronic diarrhea
Correct Answer: A
Rationale: Lactulose produces a laxative effect but also works to reduce blood ammonia levels by converting ammonia to ammonium. Ammonium is a water-soluble cation that is trapped in the intestines and cannot be reabsorbed into the systemic circulation. This effect has proved helpful in reducing elevated serum ammonia levels in patients with severe liver disease. The other options are incorrect.