Nokea
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.
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A client is prescribed an antidiarrheal drug. The nurse reviews the client's medical record for possible contraindications for use. Which of the following would alert the nurse to a possible contraindication?
- A. Pseudomembranous colitis
- B. Type 1 diabetes
- C. Abdominal pain of unknown origin
- D. Liver disease
- E. Obstructive jaundice
Correct Answer: A,C,E
Rationale: Clients with pseudomembranous colitis, abdominal pain of unknown origin, and obstructive jaundice should not take antidiarrheals.
A physician has prescribed simethicone to a client with postoperative abdominal distention. After administering the drug, the nurse would assess the client for the possibility of which of the following?
- A. Heartburn
- B. Vomiting
- C. Fainting
- D. Nausea
Correct Answer: A
Rationale: The nurse should monitor for heartburn, bloating, constipation, and diarrhea in the client after administering simethicone. Vomiting, fainting, and nausea are adverse reactions to methylcellulose, which is administered for the relief of constipation.
A client has been diagnosed with ulcerative colitis. The physician has prescribed sulfasalazine to the client. Based on the nurse's understanding of this condition, the nurse would monitor the client for which of the following?
- A. Mild symptoms of contact dermatitis
- B. Abdominal pain and distention
- C. Severe blood- and mucus-filled diarrhea
- D. Frequent loose or watery stools
Correct Answer: C
Rationale: The nurse should monitor for severe blood- and mucus-filled diarrhea in the client with ulcerative colitis. Pain and fatigue also accompany this disorder. Abdominal pain and distention are clinical manifestations of Crohn's disease. When clients are hypersensitive to ragweed, asters, and chrysanthemums are administered the chamomile herb, mild symptoms of contact dermatitis are observed. Frequent loose or watery stools are not associated with ulcerative colitis.
A physician has prescribed difenoxin with atropine to a client with acute diarrhea. The client informs the nurse that he is also taking MAOI antidepressants. The nurse would assess the client for which of the following that might result from the interaction of the two drugs?
- A. Decreased effect of difenoxin
- B. Increased risk of hypertensive crisis
- C. Increased cholinergic blocking adverse reactions
- D. Increased risk of CNS depression
Correct Answer: B
Rationale: The nurse should monitor the client for an increased risk of hypertensive crisis as an effect of the interaction between difenoxin with atropine and MAOI antidepressants. When the client is administered antihistamines, opioids, sedatives, or hypnotics with antidiarrheal drugs, there will be increased risk of CNS depression. When the client is administered antihistamines and general antidepressants with antidiarrheal drugs, there will be increased cholinergic blocking adverse reactions. There will not be a decreased effect of difenoxin when there is an interaction between difenoxin and MAOI antidepressants.
A client is prescribed diphenoxylate. The nurse informs the client that he may experience which of the following effects?
- A. Euphoric effects
- B. Analgesic effects
- C. Anti-inflammatory effects
- D. Sedative effects
- E. Slowed GI effects
Correct Answer: A,D,E
Rationale: Because diphenoxylate (Lomotil) is opioid related, it may have sedative, slowed GI, and euphoric effects but no analgesic or anti-inflammatory activity.