Nokea
When reviewing a client's history, a nurse determines that the use of laxatives would be contraindicated if the client has a history of which of the following?
- A. Chronic hepatitis
- B. Type 1 diabetes
- C. Acute appendicitis
- D. Intestinal obstruction
- E. Fecal impaction
Correct Answer: C,D,E
Rationale: Laxatives are contraindicated in clients with known hypersensitivity and those with persistent abdominal pain, nausea, vomiting, or pain of unknown cause or signs of acute appendicitis, fecal impaction, intestinal obstruction, or acute hepatitis.
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A nursing student is preparing a presentation on antidiarrheal drugs. Which of the following drugs would the student include as being chemically related to opioid drugs and used to treat diarrhea by decreasing intestinal peristalsis?
- A. Bisacodyl (Dulcolax)
- B. Difenoxin (Motofen)
- C. Alosetron (Lotronex)
- D. Diphenoxylate (Lomotil)
- E. Bismuth (Pepto-Bismol)
Correct Answer: B,D
Rationale: Difenoxin (Motofen) and diphenoxylate (Lomotil) are chemically related to opioid drugs and treat diarrhea by decreasing intestinal peristalsis.
A nurse is preparing to administer sulfasalazine (Azulfidine) to a client with inflammatory bowel disease. The nurse checks the clients medical record for a history of hypersensitivities, understanding that the drug should not be administered to a client with hypersensitivity to which of the following drugs?
- A. Enalapril (Vasotec)
- B. Doxycycline (Vibramycin)
- C. Azithromycin (Zithromax)
- D. Sulfamethoxazole/trimethoprim (Bactrim)
Correct Answer: D
Rationale: Sulfasalazine (Azulfidine) is an aminosalicylate. The use of aminosalicylates is contraindicated in clients with hypersensitivity to sulfonamides and sulfites, which includes sulfamethoxazole/trimethoprim (Bactrim).
The nurse is reviewing a client's history and finds that the client uses a laxative that produces its effects by dehydrating local tissues, which causes irritation and increased peristalsis, with consequent evacuation of the fecal mass. Which of the following would this be?
- A. Docusate sodium (Colace)
- B. Methylcellulose (Citrucel)
- C. Glycerin (Fleet Babylax)
- D. Bisacodyl (Dulcolax)
- E. Lactulose (Chronulac)
Correct Answer: C,E
Rationale: Hyperosmotic agents, like glycerin (Fleet Babylax) and lactulose (Chronulac), produce their laxative effect by dehydrating local tissues, which causes irritation and increased peristalsis, with consequent evacuation of the fecal mass. Docusate is a stool softener. Methylcellulose is a bulk-forming laxative. Bisacodyl is an irritant laxative.
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 nurse is caring for a client receiving bismuth subsalicylate for the relief of diarrhea. Which of the following interventions should the nurse perform to promote an optimal response to the prescribed drug therapy?
- A. Thoroughly mix and stir the drug before administering.
- B. Administer the drug after each loose bowel movement.
- C. Ensure the client receives adequate sunlight.
- D. Encourage the client to lightly exercise on a daily basis.
Correct Answer: B
Rationale: The nurse should administer the drug after each loose bowel movement to promote an optimal response to the prescribed drug therapy in the client with diarrhea. The nurse should inspect each bowel movement before making a decision to administer the drug. Laxatives that are in powder, flake, or granule form are mixed and stirred before being administered to the client with constipation. The nurse need not ensure that the client receives adequate sunlight or encourage the client to lightly exercise on a daily basis as these interventions will not help in promoting an optimal response to the prescribed drug therapy.