GI HW Qs

Question 1

A client who has returned from surgery reports feeling nauseated and later has an emesis. The nurse administers promethazine per standing orders. In addition to relief from nausea, what other effects of this medication does the nurse expect? Select all that apply.
A. Dry mouth
B. Sedation
C. Pinpoint pupils
D. Heart palpitations
E. Rhinorrhea

Answer 1

A. Dry mouth
B. Sedation
D. Heart palpitations

Question 2

A client is to receive metoclopramide intravenously 30 minutes before initiating chemotherapy for cancer of the colon. The nurse explains that metoclopramide is given for which purpose?
A. To stimulate production of gastrointestinal (GI) secretions
B. To stimulate peristalsis of the upper gastrointestinal (GI) tract
C. To prolong excretion of the chemotherapeutic medication
D. To increase absorption of the chemotherapeutic medication

Answer 2

B. To stimulate peristalsis of the upper gastrointestinal (GI) tract

Question 3

The nurse is providing teaching to the client taking metoclopramide. Serious side effects that should be reported to the provider are included in the teaching plan. Which of the following side effects is the priority?
A. Involuntary muscle movements
B. Report of increased fatigue
C. Onset of headaches
D. Difficulty with sleep

Answer 3

A. Involuntary muscle movements

Question 4

How can the nurse prevent vomiting in a client who reports feeling nauseated after cataract surgery?
A. Administer the prescribed antiemetic medication.
B. Provide some dry crackers for the client to eat.
C. Explain that this is expected after surgery.
D. Teach how to breathe deeply until the nausea subsides.

Answer 4

A. Administer the prescribed antiemetic medication.

Question 5

Why would lactulose be prescribed for a client with a history of cirrhosis of the liver?
A. The desire to drink alcohol is decreased.
B. Diarrhea is controlled and prevented.
C. Elevated ammonia levels are lowered.
D. Abdominal distension secondary to ascites is decreased.

Answer 5

C. Elevated ammonia levels are lowered.

Question 6

The nurse administers lactulose to a client with cirrhosis of the liver. Which laboratory test change leads the nurse to determine that the lactulose is effective?
A. Decreased amylase
B. Decreased ammonia
C. Increased potassium
D. Increased hemoglobin

Answer 6

B. Decreased ammonia

Question 7

In evaluating the effects of lactulose (Cephulac), which outcome would indicate that the drug is performing as intended?
A. An increase in urine output.
B. Two or three soft stools per day.
C. Watery, diarrhea stools.
D. Increased serum bilirubin.

Answer 7

B. Two or three soft stools per day.

Question 8

The nurse is preparing to administer a prescribed dose of lactulose to a client who has cirrhosis. Which lab value will the nurse monitor to evaluate the therapeutic effect of the medication?
A. Glucose
B. Ammonia
C. Potassium
D. Bicarbonate

Answer 8

B. Ammonia

Question 9

A client with cirrhosis of the liver asks the nurse about the purpose of taking lactulose. How should the nurse respond?
A. “It is used to control portal hypertension.”
B. “It adds dietary fiber to your diet.”
C. “It helps to regenerate your liver.”
D. “It helps to reduce ammonia levels in your blood.”

Answer 9

D. “It helps to reduce ammonia levels in your blood.”

Question 10

Which statement is important for the nurse to include in the teaching plan of a client with irritable bowel syndrome who has instructions to take psyllium for constipation?
A. “Urine may be discolored.”
B. “Stop taking the laxative once a bowel movement occurs.”
C. “Each dose should be taken with a full glass of water or juice.”
D. “Daily use may inhibit the absorption of some fat-soluble vitamins.”

Answer 10

C. “Each dose should be taken with a full glass of water or juice.”

Question 11

Which statement is important for the nurse to teach a client prescribed psyllium 3.5 g twice a day for constipation?
A. “Urine may be discolored.”
B. “Each dose should be taken with a full glass of water.”
C. “Use only when necessary because it can cause dependence.”
D. “Daily use may inhibit the absorption of some fat-soluble vitamins.”

Answer 11

B. “Each dose should be taken with a full glass of water.”

Question 12

The nurse in the primary care office is following up with a client who has been experiencing frequent constipation. Which statement by the client about using psyllium indicates that additional teaching is needed?
A. “I will take it in the morning with lots of water.”
B. “I will only take it until my constipation is relieved.”
C. “I will take it together with my other medications.”
D. “I may notice some bloating while I am taking it.”

Answer 12

C. “I will take it together with my other medications.”

Question 13

Which action is responsible for the therapeutic effect of docusate sodium?
A. Lubricates the feces
B. Creates an osmotic effect
C. Stimulates motor activity
D. Softens the feces

Answer 13

D. Softens the feces

Question 14

Which potential side effect of docusate sodium would a nurse include in discharge teaching of a client who had repair of an inguinal hernia?
A. Rectal bleeding
B. Fecal impaction
C. Nausea and vomiting
D. Mild abdominal cramping

Answer 14

D. Mild abdominal cramping

Question 15

The nurse is administering docusate sodium to a postpartum client. Which of the following should the nurse include in the medication teaching?
A. This medication will help with your uterine cramping
B. Breastfeeding is contraindicated while taking this medication
C. Report to the healthcare provider if you experience diarrhea
D. This medication lowers your risk of hemorrhage

Answer 15

C. Report to the healthcare provider if you experience diarrhea

Question 16

A client has had a recent brain attack (cerebrovascular accident/stroke). Which preventative would the nurse anticipate will be prescribed daily to avoid straining due to constipation?
A. Stimulant laxatives such as bisacodyl
B. Tap-water enemas
C. Stool softener
D. Saline laxatives such as magnesium citrate

Answer 16

C. Stool softener

Question 17

A client is scheduled for discharge after surgery. The medical record indicates that the client has not had a bowel movement since before surgery, which was 4 days ago. Which prescribed medication will the nurse administer to ensure a bowel movement before discharge?
A. Lactulose
B. Docusate sodium
C. Bisacodyl suppository
D. Psyllium

Answer 17

C. Bisacodyl suppository

Question 18

A health care provider prescribes bisacodyl for a client with constipation. The nurse explains to the client that this medication acts by which mechanism?
A. Producing bulk
B. Softening feces
C. Lubricating feces
D. Stimulating peristalsis

Answer 18

D. Stimulating peristalsis

Question 19

The nurse observes a new nurse administering a rectal suppository to a client. Which actions are appropriate for the new nurse to implement? Select all that apply.
A. The nurse places the client on the left side during insertion.
B. The nurse pushes the suppository in, up to the second knuckle.
C. After 10 minutes, the nurse turns the client to the right side.
D. The nurse applies water-soluble lubricant to the suppository.
E. The nurse instructs clients to hold their breath and bear down.

Answer 19

A. The nurse places the client on the left side during insertion.
B. The nurse pushes the suppository in, up to the second knuckle.
C. After 10 minutes, the nurse turns the client to the right side.
D. The nurse applies water-soluble lubricant to the suppository.

Question 20

Which antidiarrheal agent should be used with caution in clients taking high dosages of aspirin for arthritis?
A. Loperamide (Imodium).
B. Probanthine (Propantheline).
C. Bismuth subsalicylate (Pepto Bismol).
D. Diphenoxylate hydrochloride with atropine (Lomotil).

Answer 20

C. Bismuth subsalicylate (Pepto Bismol).

Question 21

A client calls the clinic and states to the triage nurse, “I had an upset stomach and took Pepto-Bismol and now my tongue looks black. What’s happening to me?” What would be the nurse’s best response?
A. “This is a common and temporary side effect of this medication.”
B. “How long have you had an upset stomach?”
C. “Come to the clinic so you can be seen by the health care provider.”
D. “Are your stools also black?”

Answer 21

A. “This is a common and temporary side effect of this medication.”

Question 22

Which antidiarrheal medication would the nurse anticipate administering to a client with severe diarrhea who is prescribed intravenous fluids, sodium bicarbonate, and an antidiarrheal medication?
A. Psyllium
B. Bisacodyl
C. Loperamide
D. Docusate sodium

Answer 22

C. Loperamide

Question 23

The nurse is collecting the health history of a client with heart disease who reports experiencing episodes of diarrhea. The client reports taking loperamide at home. Which of the following statements should the nurse make?
A. Taking this medication may increase your risk of an abnormal heart rhythm
B. It is safe to drink alcohol while using this medication
C. Using this medication may cause dependence
D. Stop taking this medication if your symptoms do not improve by tomorrow

Answer 23

A. Taking this medication may increase your risk of an abnormal heart rhythm

Question 24

Which intervention is indicated for treatment of a client admitted to the hospital with a diagnosis of acute salmonellosis?
A. Cathartics
B. Electrolytes
C. Antidiarrheals
D. Antispasmodics

Answer 24

B. Electrolytes

Question 25

A health care provider prescribes oral antacids and intravenous ranitidine for a client with burns and crushing injuries caused by an accident. The client asks how these medications work. Which explanation would the nurse provide?
A. ‘These medications work together to decrease bowel irritability.’
B. ‘They limit acidity in the gastrointestinal tract.’
C. ‘They are very effective in clients with multiple trauma.’
D. ‘These medications decrease nausea and vomiting.’

Answer 25

B. ‘They limit acidity in the gastrointestinal tract.’

Question 26

A health care provider prescribes famotidine for a client with dyspepsia. Which statement is important to include in a teaching session about famotidine?
A. Lowers the stress level
B. Neutralizes gastric acidity
C. Reduces gastrointestinal peristalsis
D. Decreases secretions in the stomach

Answer 26

D. Decreases secretions in the stomach

Question 27

Famotidine is prescribed for a client with peptic ulcer disease. Which mechanism of action is a characteristic of this medication?
A. Increases gastric motility
B. Neutralizes gastric acidity
C. Facilitates histamine release
D. Inhibits gastric acid secretion

Answer 27

D. Inhibits gastric acid secretion

Question 28

The nurse is providing medication teaching for a client prescribed famotidine for the treatment of gastroesophageal reflux disease (GERD). Which statement by the client indicates an understanding of the teaching?
A. I will take this medication once a day in the morning
B. I will no longer have discomfort at night once I begin this medication
C. This medication will both prevent and treat heartburn
D. My treatment will be done in one week

Answer 28

C. This medication will both prevent and treat heartburn

Question 29

The nurse is counseling a client with gastroesophageal reflux disease (GERD) who has been taking prescribed famotidine for two days. Which statement would require immediate follow up by a healthcare provider?
A. I take digoxin for my heart failure
B. I use calcium carbonate if I have symptoms after meals
C. I use alendronate for my osteoporosis
D. I’m still having some symptoms of heartburn.

Answer 29

A. I take digoxin for my heart failure

Question 30

The nurse administers cimetidine to a 75-year-old client diagnosed with a gastric ulcer. The nurse should monitor the client for which adverse reaction?
A. Mental status change
B. Increased liver enzymes
C. Constipation
D. Hearing loss

Answer 30

A. Mental status change

Question 31

A nurse administers cimetidine to a 79-year-old male with a gastric ulcer. Which parameter may be affected by this drug and should be closely monitored by the nurse?
A. Blood pressure
B. Liver enzymes
C. Mental status
D. Hemoglobin

Answer 31

C. Mental status

Question 32

Which mechanism is specifically responsible for the action of the medication ranitidine?
A. Inhibiting proton pumps
B. Promoting the release of gastrin
C. Regenerating the gastric mucosa
D. Inhibiting the histamine at H2 receptors

Answer 32

D. Inhibiting the histamine at H2 receptors

Question 33

Which administration instruction would the nurse give a client prescribed ranitidine 150 mg daily to treat peptic ulcer disease (PUD)?
A. As needed
B. With meals
C. At bedtime
D. Before meals

Answer 33

C. At bedtime

Question 34

Which information would the nurse include when teaching a client about the administration of ranitidine?
A. Ranitidine increases gastrointestinal peristalsis.
B. Ranitidine reduces gastric acidity in the stomach.
C. Ranitidine neutralizes the acid that is present in the stomach.
D. Ranitidine stops the production of hydrochloric acid in the stomach.

Answer 34

B. Ranitidine reduces gastric acidity in the stomach.

Question 35

Which concern would prompt the nurse to contact the health care provider when a client with gastric ulcers receives a prescription for ranitidine 150 mg twice a day?
A. Ranitidine can increase the risk for gastrointestinal bleeding.
B. An administration route is not specified.
C. Ranitidine is contraindicated for gastric ulcers.
D. Ranitidine should be given with an adjuvant.

Answer 35

B. An administration route is not specified.

Question 36

Which medication is classified as an H2 receptor antagonist? Select all that apply. One, some, or all responses may be correct.
A. Nizatidine
B. Ranitidine
C. Famotidine
D. Lansoprazole
E. Metoclopramide

Answer 36

A. Nizatidine
B. Ranitidine
C. Famotidine

Question 37

Which nursing intervention would prevent stimulation of the pancreas in a client with acute pancreatitis?
A. Maintain the gastric pH at a level of less than 3.5.
B. Encourage the resumption of activities of daily living.
C. Administer the histamine H2 receptor antagonist as prescribed.
D. Ensure that the nasogastric tube remains in the fundus of the stomach.

Answer 37

C. Administer the histamine H2 receptor antagonist as prescribed.

Question 38

The nurse is administering a histamine H2 antagonist to a client who has extensive burns. Which complication will it prevent?
A. Colitis
B. Gastritis
C. Stress ulcer
D. Metabolic acidosis

Answer 38

C. Stress ulcer

Question 39

The nurse in a primary care clinic is reviewing the medical record of a client with chronic gastroesophageal reflux disease (GERD). Which findings are risk factors for developing GERD? Select all that apply.
A. Being overweight or obese
B. Diabetes mellitus type 2
C. Helicobacter pylori infection
D. Taking a calcium channel blocker
E. Smoking
F. Essential hypertension

Answer 39

A. Being overweight or obese
C. Helicobacter pylori infection
D. Taking a calcium channel blocker
E. Smoking

Question 40

A health care provider prescribes bed rest, loperamide, and esomeprazole for a client who just had major surgery. After several days of this regimen, the client complains of diarrhea. Which treatment strategy would the nurse conclude is the cause of the diarrhea?
A. Loperamide
B. Esomeprazole
C. Bed rest
D. Diet alteration

Answer 40

B. Esomeprazole

Question 41

A client prescribed omeprazole for gastroesophageal reflux disease reports a new occurrence of significant diarrhea. Which response by the nurse is most appropriate?
A. ‘Stop taking your omeprazole.’
B. ‘This is a normal side effect of omeprazole.’
C. ‘We are going to collect a stool sample for testing.’
D. ‘Antidiarrheal medication can be used to decrease this.’

Answer 41

C. ‘We are going to collect a stool sample for testing.’

Question 42

The nurse is preparing to administer prescribed IV pantoprazole to the hospitalized client. The medication has been stocked in tablet form. Which action by the nurse is appropriate?
A . Administer the medication to the client in oral form
B. Call the pharmacy to stock the correct form of the medication
C. Request that the healthcare provider change the order to tablets
D. Ask the pharmacist if it is safe to give the client oral pantoprazole

Answer 42

B. Call the pharmacy to stock the correct form of the medication

Question 43

The nurse is assessing a client who began taking omeprazole a month ago. Which finding by the nurse indicates that the drug has had the desired effect?
A. Blood pressure readings are lower
B. Feelings of depression are not as severe
C. Chronic pain level is markedly decreased
D. Heartburn discomfort is lessened

Answer 43

D. Heartburn discomfort is lessened

Question 44

Which condition is treated with a proton pump inhibitor (PPI)?
A. Diarrhea
B. Vomiting
C. Cardiac dysrhythmias
D. Gastroesophageal reflux disease (GERD)

Answer 44

D. Gastroesophageal reflux disease (GERD)

Question 45

Which advantage does aluminum and magnesium hydroxide have over baking soda (sodium bicarbonate) for the treatment of heartburn?
A. They can be used for short-term relief.
B. Absorption by the stomach mucosa is markedly enhanced.
C. There is no direct effect on the systemic acid–base balance when taken as directed.
D. Fewer side effects, such as diarrhea or constipation, are experienced when they are used properly.

Answer 45

C. There is no direct effect on the systemic acid–base balance when taken as directed.

Question 46

The nurse is reviewing a plan of care for a client who was admitted with dehydration as a result of prolonged watery diarrhea. Which new prescription will the nurse question?
A. Oral psyllium
B. Oral potassium supplement
C. Intravenous normal saline
D. Magnesium citrate

Answer 46

D. Magnesium citrate

Question 47

Which effect may be experienced by a client who reports frequently taking calcium carbonate?
A. Diarrhea
B. Water retention
C. Rebound hyperacidity
D. Bone demineralization

Answer 47

C. Rebound hyperacidity

Question 48

Which mechanism of action explains how aluminum hydroxide decreases serum phosphorus?
A. Binding with phosphorus in the intestine
B. Promoting excretion of phosphorus
C. Promoting excretion of excessive urinary phosphates
D. Dissolving stones as they pass through the urinary tract

Answer 48

A. Binding with phosphorus in the intestine

Question 49

A client is prescribed aluminum hydroxide for peptic ulcer disease. Which statement by the client demonstrates an understanding of the action of the medication?
A. It decreases the production of gastric secretions.
B. It produces an adherent barrier over the ulcer.
C. It helps maintain a gastric pH of 3.5 or above.
D. It slows down the gastric motor activity.

Answer 49

C. It helps maintain a gastric pH of 3.5 or above.

Question 50

The nurse is educating a client with end-stage renal failure about newly prescribed aluminum hydroxide. Which statement should the nurse include in the teaching?
A. “This medication binds with phosphates from food to decrease absorption.”
B. “This medication is used to decrease urea to prevent urticaria.”
C. “This medication will coat the lining of the stomach to decrease acid production.”
D. “This medication treats hyperkalemia by exchanging sodium for potassium in the intestines.”

Answer 50

A. “This medication binds with phosphates from food to decrease absorption.”

Question 51

The nurse is reinforcing teaching for a client with chronic kidney disease about the prescribed aluminum hydroxide. Which is the best statement by the nurse about this medication?
A. “It decreases phosphate levels.”
B. “It increases urine output.”
C. “It reduces potassium levels.”
D. “It controls stomach acid secretions.”

Answer 51

A. “It decreases phosphate levels.”

Question 52

The nurse is teaching a client with chronic renal failure about their medications. The client questions the purpose of taking aluminum hydroxide. How should the nurse respond?
A. “It increases your urine output.”
B. “It decreases your blood’s phosphate levels.”
C. “It is taken to control gastric acid secretions.”
D. “It will reduce your blood’s calcium levels.”

Answer 52

B. “It decreases your blood’s phosphate levels.”

Question 53

Which statement by a client who has a gastric ulcer and asks what to do if epigastric pain occurs indicates that teaching was effective?
A. “Eliminating fluids with meals will prevent pain.”
B. “I will increase my food intake to avoid an empty stomach.”
C. “Taking an aspirin with milk will relieve my pain and coat my ulcer.”
D. “Taking an antacid preparation will decrease pain due to gastric acid.”

Answer 53

D. “Taking an antacid preparation will decrease pain due to gastric acid.”

Question 54

Which statement indicates that a client understands how to take antacids appropriately?
A. “I will take this antacid at the onset of pain.”
B. “I will take this antacid 30 minutes after meals.”
C. “I will take this antacid every 4 hours around the clock.”
D. “I will take this antacid each time I have something to eat.”

Answer 54

B. “I will take this antacid 30 minutes after meals.”

Question 55

Which information would the nurse include when teaching a client about antacid tablets?
A. “Take them at 4-hour intervals.”
B. “Take them 1 hour before meals.”
C. “They are as effective as the liquid forms.”
D. “They interfere with the absorption of other medications.”

Answer 55

D. “They interfere with the absorption of other medications.”

Question 56

A client diagnosed with gastroesophageal reflux disease (GERD) is being treated with antacid therapy. When teaching the client about the antacids, which information would the nurse reinforce?
A. Antacids should be taken 1 hour before meals.
B. These should be scheduled at 4-hour intervals.
C. Antacid tablets are just as fast and effective as the liquid form.
D. Antacids commonly interfere with the absorption of other medications.

Answer 56

D. Antacids commonly interfere with the absorption of other medications.

Question 57

Which medication for treatment of gastroesophageal reflux disease would be contraindicated in the pregnant client?
A. Ranitidine
B. Misoprostol
C. Esomeprazole
D. Calcium carbonate

Answer 57

B. Misoprostol

Question 58

A female client with rheumatoid arthritis takes ibuprofen (Motrin) 600 mg PO 4 times a day. To prevent gastrointestinal bleeding, misoprostol (Cytotec) 100 mcg PO is prescribed. Which information is most important for the nurse to include in client teaching?
A. Use contraception during intercourse.
B. Ensure the Cytotec is taken on an empty stomach.
C. Encourage oral fluid intake to prevent constipation.
D. Take Cytotec 30 minutes prior to Motrin.

Answer 58

A. Use contraception during intercourse.

Question 59

How does sodium biphosphate, prescribed for a client before a colonoscopy, accomplish its therapeutic effect?
A. Irritates the intestinal mucosa
B. Provides water-absorbing bulk
C. Softens stool by exerting a detergent effect
D. Increases osmotic pressure in the intestines

Answer 59

D. Increases osmotic pressure in the intestines

Question 60

The nurse gave a client the prescribed sodium polystyrene sulfonate. Which assessment finding indicates that the medication has been effective?
A. Control of diarrhea
B. An increase in serum sodium level
C. An increase in serum calcium level
D. A decrease in serum potassium level

Answer 60

D. A decrease in serum potassium level

Question 61

The nurse teaches a client about the dangers of using sodium bicarbonate regularly. Which effect of sodium bicarbonate is the nurse trying to prevent?
A. Gastric distention
B. Metabolic alkalosis
C. Chronic constipation
D. Cardiac dysrhythmias

Answer 61

B. Metabolic alkalosis

Question 62

Which information would be included in the teaching plan for the older adult client with peptic ulcer disease who is taking an antacid and sucralfate?
A. Antacids should be taken 30 minutes before a meal.
B. Sucralfate should be taken on an empty stomach 1 hour before meals.
C. Sucralfate is prescribed for the long-term maintenance of peptic ulcer disease.
D. Sodium bicarbonate is an inexpensive over-the-counter antacid with few adverse effects.

Answer 62

B. Sucralfate should be taken on an empty stomach 1 hour before meals.

Question 63

A client with advanced liver disease has been taking rifaximin. Which assessment finding would indicate that the medication is being effective?
A. Less jaundice
B. Increased appetite
C. Less confusion
D. Less edema

Answer 63

C. Less confusion

Question 64

The nurse is reviewing discharge instructions with the parent of a 3-year-old client who was admitted for poisoning after ingesting cherry-flavored acetaminophen. Which statement by the parent would require follow up by the nurse?
A. “I should use non-flavored medications.”
B. “I will reach out to the poison control center if this happens again.”
C. “I will use ipecac syrup to induce vomiting.”
D. “I will have all medications in a locked cabinet.”

Answer 64

C. “I will use ipecac syrup to induce vomiting.”