Nokea
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.
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A patient will be receiving docusate sodium, 120 mg/day PO, divided into 3 doses. Identify how many milligrams will this patient receive per dose.
Correct Answer: 40 mg
Rationale: 120 mg/day ?· 3 doses/day = 40 mg.
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.
When administering a bulk-forming laxative, the nurse instructs the patient to drink the medication mixed in a full 8-ounce glass of water. Which statement best explains the rationale for this instruction?
- A. The water acts to stimulate bowel movements.
- B. The water will help to reduce the bulk of the intestinal contents.
- C. These laxatives may cause esophageal obstruction if taken with insufficient water.
- D. The water acts as a lubricant to produce bowel movements.
Correct Answer: C
Rationale: Bulk-forming drugs increase water absorption, which results in greater total volume (bulk) of the intestinal contents. Bulk-forming laxatives tend to produce normal, formed stools. Their action is limited to the gastrointestinal tract, so there are few, if any, systemic effects. However, they need to be taken with liberal amounts of water to prevent esophageal obstruction and/or fecal impaction.
A patient will be taking bismuth subsalicylate to control diarrhea. When reviewing the patient's other ordered medications, the nurse recognizes that which medication will interact significantly with this drug?
- A. Acetaminophen, an analgesic
- B. Levothyroxine, a thyroid replacement drug
- C. Warfarin, an anticoagulant
- D. Fluoxetine, an antidepressant
Correct Answer: C
Rationale: The oral anticoagulant warfarin is more likely to cause increased bleeding times or bruising when co-administered with adsorbents. This is thought to be because the adsorbents bind to vitamin K, which is needed to make certain clotting factors. Vitamin K is synthesized by the normal bacterial flora in the bowel. The other options are incorrect.
While recovering from surgery, an elderly woman started taking a stimulant laxative, senna, to relieve constipation caused by the pain medications. Two weeks later, at her follow-up appointment, she tells the nurse that she likes how 'regular her bowel movements are now that she is taking the laxative.' Which teaching principle is appropriate for this patient?
- A. She needs to be sure to take this medication with plenty of fluids.
- B. It is important to have a daily bowel movement to promote bowel health.
- C. Long-term use of laxatives often results in decreased bowel tone and may lead to dependency.
- D. She needs to switch to glycerin suppositories to continue having daily bowel movements.
Correct Answer: C
Rationale: Long-term use of laxatives may lead to dependency. Patients need to be taught that daily bowel movements are not necessary for bowel health.