Nokea
A patient is taking linaclotide to treat irritable bowel syndrome (IBS). The nurse will monitor this patient for which adverse effect?
- A. Chest pain
- B. Chronic constipation
- C. Abdominal pain
- D. Elevated blood glucose levels
Correct Answer: C
Rationale: Common adverse effects of linaclotide (Linzess) are diarrhea, abdominal pain, and flatulence. Elevated blood glucose levels, chest pain, and chronic constipation are not adverse effects of linaclotide.
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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 has been treated with alosetron for severe irritable bowel syndrome for 2 weeks. She calls the clinic and tells the nurse that she has been experiencing constipation for 3 days. The nurse will take which action?
- A. Advise the patient to increase intake of fluids and fiber.
- B. Advise the patient to hold the drug for 2 days.
- C. Instruct the patient to stop taking the drug and to come to the clinic right away to be evaluated.
- D. Instruct the patient to continue the alosetron and to take milk of magnesia for the constipation.
Correct Answer: C
Rationale: Alosetron must be discontinued immediately if constipation or signs of ischemic colitis occur. The other options are incorrect.
A patient who has been on antibiotic therapy for 2 weeks has developed persistent diarrhea. The nurse expects which medication class to be ordered to treat this diarrhea?
- A. Lubricants
- B. Adsorbents
- C. Anticholinergics
- D. Probiotics
Correct Answer: D
Rationale: Probiotics work by replenishing bacteria that may have been destroyed by antibiotic therapy, thus restoring the balance of normal flora and suppressing the growth of diarrhea-causing bacteria.
The nurse is reviewing the uses of oral laxatives. Which conditions are general contraindications to or cautions about the use of oral laxatives? (Select all that apply.)
- A. Irritable bowel syndrome
- B. Undiagnosed abdominal pain
- C. Nausea and vomiting
- D. Fecal impaction
- E. Ingestion of toxic substances
- F. Acute surgical abdomen
Correct Answer: B,C,D,F
Rationale: Cautious use of laxatives is recommended in the presence of these: acute surgical abdomen; appendicitis symptoms, such as abdominal pain, nausea, and vomiting; intestinal obstruction; and undiagnosed abdominal pain. Oral laxatives must not be used with fecal impaction; mineral oil enemas are indicated for fecal impaction. The other options are indications for other laxative use.
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.