A nurse is caring for a client with irritable bowel syndrome. The physician has prescribed polycarbophil to the client. The nurse would administer this drug cautiously if the client's history revealed which of the following?
- A. Abdominal pain
- B. Pseudomembranous colitis
- C. Rectal bleeding
- D. Intestinal obstruction
Correct Answer: C
Rationale: The nurse should administer polycarbophil with caution in clients with rectal bleeding, in pregnant women, and during lactation. Antidiarrheals are contraindicated in clients with abdominal pain and pseudomembranous colitis. Aminosalicylates are contraindicated in clients with intestinal obstruction.
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Which of the following drugs used to manage lower gastrointestinal disorders increase the risk of bleeding when administered to clients taking warfarin (Coumadin)?
- A. Mesalamine (Asacol)
- B. Bisacodyl (Dulcolax)
- C. Psyllium (Metamucil)
- D. Polyethylene glycol (MiraLAX)
- E. Olsalazine (Dipentum)
Correct Answer: A,E
Rationale: Aminosalicylates, like mesalamine (Asacol) and olsalazine (Dipentum), can increase the risk of bleeding in clients taking warfarin (Coumadin).
Antidiarrheals are contraindicated in clients whose diarrhea is associated with which of the following organisms that can harm the intestinal mucosa?
- A. Staphylococcus
- B. Shigella
- C. Salmonella
- D. Streptococcus
- E. Escherichia coli
Correct Answer: B,C,E
Rationale: Antidiarrheals are contraindicated in clients whose diarrhea is associated with Shigella, Salmonella, and Escherichia coli, which can harm the intestinal mucosa.
A client is using chamomile tea as a remedy to treat gastrointestinal upset. When discussing the use of this herb, the nurse would alert the client that contact dermatitis is a possibility if the client has a hypersensitivity to which of the following plants?
- A. Ragweed
- B. Fox glove
- C. Asters
- D. Lavender
- E. Chrysanthemums
Correct Answer: A,C,E
Rationale: Although chamomile is generally safe and nontoxic, the tea is prepared from the pollen-filled flower heads and has resulted in symptoms ranging from contact dermatitis to severe anaphylactic reactions in individuals hypersensitive to ragweed, asters, and chrysanthemums.
After teaching a group of nursing students about laxatives, the instructor determines that the teaching was successful when the students identify which drug as producing the laxative effect by promoting water retention in the fecal mass and softening the stool?
- A. Docusate sodium (Colace)
- B. Methylcellulose (Citrucel)
- C. Bisacodyl (Dulcolax)
- D. Lactulose (Chronulac)
Correct Answer: A
Rationale: Stool softeners, like docusate sodium (Colace) and docusate calcium (Surfak), produce their laxative effect by promoting water retention in the fecal mass and softening the stool. Methylcellulose is a bulk-producing laxative. Bisacodyl is a stimulant laxative. Lactulose is a hyperosmolar laxative.
When describing the drugs used as treatment for clients with ulcerative colitis to a group of nursing students, the instructor discusses aspirin-like compounds with anti-inflammatory properties. Which of the following would the instructor most likely include?
- A. Mesalamine (Asacol)
- B. Bisacodyl (Dulcolax)
- C. Magnesium oxide (Mag-Ox)
- D. Polyethylene glycol (MiraLAX)
- E. Olsalazine (Dipentum)
Correct Answer: A,E
Rationale: Aminosalicylates, like mesalamine (Asacol) and olsalazine (Dipentum), are aspirin-like compounds with anti-inflammatory properties used in the treatment of clients with ulcerative colitis.
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