Pharmacology - Gastrointestinal Medications

A client with Crohn's disease is scheduled to receive an infusion of infliximab (Remicade). What intervention by the nurse will determine the effectiveness of treatment?
1. Monitoring the leukocyte count for 2 days after the infusion
2. Checking the frequency and consistency of bowel movements
3. Checking serum liver enzyme levels before and after the infusion
4. Carrying out a Hematest on gastric fluids after the infusion is completed

A client has a PRN prescription for loperamide hydrochloride (Imodium). For which condition should the nurse administer this medication?
1. Constipation
2. Abdominal pain
3. An episode of diarrhea
4. Hematest-positive nasogastric tube drainage

A client has a PRN prescription for ondansetron (Zofran). For which condition should the nurse administer this medication to the postoperative client?
1. Paralytic ileus
2. Incisional pain
3. Urinary retention
4. Nausea and vomiting

A client has begun medication therapy with pancrelipase (Pancrease MT). The nurse evaluates that the medication is having the optimal intended benefit if which effect is observed?
1. Weight loss
2. Relief of heartburn
3. Reduction of steatorrhea
4. Absence of abdominal pain

An older client recently has been taking cimetidine (Tagamet). The nurse monitors the client for which most frequent central nervous system side effect of this medication?
1. Tremors
2. Dizziness
3. Confusion
4. Hallucinations

A client with a gastric ulcer has a prescription for sucralfate (Carafate), 1 g by mouth four times daily. The nurse should schedule the medication for which times?
1. With meals and at bedtime
2. Every 6 hours around the clock
3. One hour after meals and at bedtime
4. One hour before meals and at bedtime

A client who chronically uses nonsteroidal antiinflammatory drugs (NSAIDs) has been taking misoprostol (Cytotec). The nurse determines that the medication is having the intended therapeutic effect if which finding is noted?
1. Resolved diarrhea
2. Relief of epigastric pain
3. Decreased platelet count
4. Decreased white blood cell count

A client has been taking omeprazole (Prilosec) for 4 weeks. The ambulatory care nurse evaluates that the client is receiving the optimal intended effect of the medication if the client reports the absence of which symptom?
1. Diarrhea
2. Heartburn
3. Flatulence
4. Constipation

A client with a peptic ulcer is diagnosed with aHelicobacter pylori infection. The nurse is teaching the client about the medications prescribed, including clarithromycin (Biaxin), esomeprazole (Nexium), and amoxicillin (Amoxil). Which statement by the client indicates the best understanding of the medication regimen?
1. "My ulcer will heal because these medications will kill the bacteria."
2. "These medications are only taken when I have pain from my ulcer."
3. "The medications will kill the bacteria and stop the acid production."
4. "These medications will coat the ulcer and decrease the acid production in my stomach."

A client has a new prescription for metoclopramide (Reglan). On review of the chart, the nurse identifies that this medication can be safely administered with which condition?
1. Intestinal obstruction
2. Peptic ulcer with melena
3. Diverticulitis with perforation
4. Vomiting following cancer chemotherapy

A histamine (H2)-receptor antagonist will be prescribed for a client. The nurse understands that which medications are H2-receptor antagonists? Select all that apply.
1. Nizatidine (Axid)
2. Ranitidine (Zantac)
3. Famotidine (Pepcid)
4. Cimetidine (Tagamet)
5. Esomeprazole (Nexium)
6. Lansoprazole (Prevacid)

The nurse has given instructions to a client who has just been prescribed cholestyramine (Questran). Which statement by the client indicates a need for further instructions?
1. "I will continue taking vitamin supplements."
2. "This medication will help lower my cholesterol."
3. "This medication should only be taken with water."
4. "A high-fiber diet is important while taking this medication."

Dicyclomine hydrochloride (Bentyl) has been prescribed for a client with irritable bowel syndrome, and the nurse provides instructions to the client about how to take this medication. Which statement, if made by the client, best indicates an understanding of how to take this medication?
1. "I should take the pill with food and at meal times."
2. "I should take the pill 30 minutes before each meal."
3. "I should take the pill after I have finished eating my meal."
4. "I should take the pill when I first wake up in the morning and right before I go to bed."

The nurse instructs a client taking aluminum hydroxide (Amphojel) that the most common side effect associated with administration of this medication is which effect?
1. Diarrhea
2. Headache
3. Constipation
4. Muscle weakness

The nurse is preparing to administer prescribed medications to a client with hepatic encephalopathy. The nurse anticipates that the health care provider's prescriptions will include which medication?
1. Bisacodyl (Dulcolax)
2. Lactulose (Chronulac)
3. Magnesium hydroxide (Milk of Magnesia)
4. Psyllium hydrophilic mucilloid (Metamucil)

A client with gastrointestinal hypermotility has a prescription to receive atropine sulfate. The nurse should withhold the medication and question the prescription if the client has a history of which disease process?
1. Biliary colic
2. Sinus bradycardia
3. Peptic ulcer disease
4. Narrow-angle glaucoma

A client has a prescription for sucralfate (Carafate), orally four times daily. The nurse writes which schedule for this medication on the medication administration record?
1. Every 6 hours
2. With meals and at bedtime
3. 1 hour after meals and at bedtime
4. 1 hour before meals and at bedtime

A client who has had a myocardial infarction has a prescription to take a powdered form of psyllium (Metamucil) after discharge. The nurse should plan to include which information when teaching the client about this medication?
1. Mix the medication with applesauce.
2. Mix the medication with a full glass of water or juice.
3. Decrease fluid intake following administration of the medication.
4. Decrease the amount of fiber in the diet when taking this medication.

A client admitted to the medical nursing unit has a diagnosis of gastroesophageal reflux disease (GERD). Metoclopramide (Reglan) has been prescribed four times a day. The nurse should schedule administration of the medication for which times?
1. Every 8 hours
2. With meals and at bedtime
3. Right after meals and at bedtime
4. 30 minutes before meals and at bedtime

Oral neomycin has been prescribed for a client with a diagnosis of portosystemic encephalopathy. The nurse reviews the health care provider's prescription and determines that this medication has been prescribed for which purpose?
1. Prevent infection.
2. Prevent restlessness in the client.
3. Prevent fluid retention and ascites.
4. Destroy normal bacteria found in the bowel.

Lactulose (Chronulac) is prescribed for a client with a diagnosis of hepatic encephalopathy. The nurse should determine that this medication has had a therapeutic effect if assessment reveals which finding?
1. Increased protein level
2. Increased red blood cell count
3. Decreased serum ammonia level
4. Decreased white blood cell count

A client has received a dose of dimenhydrinate (Dramamine). The nurse should observe relief of what symptom to evaluate that the medication has been effective?
1. Chills
2. Headache
3. Nausea and vomiting
4. Buzzing sound in the ears

A client has been taking omeprazole (Prilosec) for 4 weeks. The ambulatory care nurse evaluates medication effectiveness by asking the client if relief was obtained from which symptom?
1. Diarrhea
2. Heartburn
3. Flatulence
4. Constipation

A client has been given lansoprazole (Prevacid) for the chronic management of Zollinger-Ellison syndrome. The nurse instructs the client to take which product for pain while taking this medication?
1. Ibuprofen (Motrin IB)
2. Acetaminophen (Tylenol)
3. Naproxen sodium (Aleve)
4. Acetylsalicylic acid (aspirin)

A health care provider has written a prescription for ranitidine (Zantac) 300 mg once daily. The client indicates understanding of use of this medication by stating that the prescribed dose is best taken at what time?
1. At bedtime
2. After lunch
3. With supper
4. Before breakfast

A client who has been chronically taking acetylsalicylic acid (aspirin) for arthritis has been given a prescription for misoprostol (Cytotec). The nurse determines that the new medication is effective if the client states relief from which problem?
1. Diarrhea
2. Bleeding
3. Joint aches
4. Epigastric pain

A preoperative client receives a dose of scopolamine. The nurse determines that which sign or symptom later displayed by the client is a result of medication side effects?
1. Dry mouth
2. Diaphoresis
3. Excessive urination
4. Pupillary constriction

A client in the postanesthesia care unit (PACU) has a prescription for droperidol (Inapsine). The nurse determines that this medication has been prescribed to treat which condition?
1. Pain
2. Nausea
3. Headache
4. Confusion

A client with peptic ulcer disease who has been given a prescription for propantheline (Pro-Banthine) asks the nurse how to take the medication. The nurse explains that this medication should be taken in which way?
1. With meals
2. With antacids
3. Just after meals
4. 30 minutes before meals

The nurse has administered a dose of docusate (Colace). The nurse later evaluates that the medication has the intended effect if the client experiences which finding?
1. Decreased heartburn
2. Decrease in fatty stools
3. Relief of sharp abdominal pain
4. Bowel movement with soft formed stool

A client has begun taking cascara sagrada. In monitoring the client for medication side effects, the nurse is likely to note which finding?
1. Abdominal cramps
2. Peptic ulcer disease
3. Gastrointestinal bleeding
4. Partial bowel obstruction

A client with constipation has been directed to take oral bisacodyl (Dulcolax). The nurse instructs the client on how to receive the most rapid effect from the medication. The client demonstrates understanding of use of this medication by stating that which method will produce the most rapid effect?
1. At bedtime
2. With a large meal
3. On an empty stomach
4. With two glasses of milk

The nurse is administering senna (Senokot) to an older client for the treatment of constipation. The client's spouse asks the nurse how the medication works. The nurse incorporates which information in formulating a reply?
1. It increases peristalsis
2. It lines the wall of the bowel.
3. It adds fiber and bulk to the stool.
4. It stimulates the vagus nerve to improve bowel tone.

The nurse has just given a client a dose of a PRN medication called loperamide (Imodium). The nurse documents in the client's record that the client received this medication for complaints of what symptom?
1. Diarrhea
2. Tarry stools
3. Constipation
4. Abdominal pain

A client has just been given a prescription for diphenoxylate with atropine (Lomotil). The nurse determines that the client understands important information about this medication if the client makes what statement?
1. "It's best to take this medication with a laxative."
2. "This medication contains a habit-forming ingredient."
3. "Drooling may occur while I am taking this medication."
4. "Irritability may occur while I am taking this medication."

A client has been told by a health care provider to take psyllium (Metamucil) daily. The nurse should tell the client to take the medication with which item?
1. A dose of antacid
2. A total of two glasses of liquid
3. Gelatin, applesauce, or pudding
4. A multivitamin and mineral supplement

A client has a PRN prescription for trimethobenzamide (Tigan). The nurse should assess the client for which sign or symptom to determine whether the client needs a dose of this medication?
1. Heartburn
2. Constipation
3. Abdominal pain
4. Nausea and vomiting

A client who is in the postanesthesia care unit (PACU) has received a dose of ondansetron (Zofran). The nurse evaluates that this medication was effective if relief was obtained from which problem?
1. Paralytic ileus
2. Incisional pain
3. Urinary retention
4. Nausea and vomiting

A client has a prescription for magnesium citrate to prevent constipation after undergoing barium studies of the gastrointestinal tract. How should the nurse administer the magnesium citrate?
1. With fruit juice only
2. At room temperature
3. With a full glass of water
4. After it is chilled in the refrigerator

The nurse has administered prochlorperazine to a client for relief of nausea and vomiting. The nurse should then assess the client for which frequent side effect of this medication?
1. Diarrhea
2. Drooling
3. Blurred vision
4. Excessive tearing

A client has begun medication therapy with pancrelipase (Pancrease MT). Which finding indicates that the medication is effective?
1. Relief of heartburn
2. Elimination of abdominal pain
3. Stabilization of blood glucose levels
4. A decrease in the amount of fat in the stools

The nurse is preparing to give a client directions for proper use of aluminum hydroxide tablets. Which instruction by the nurse is appropriate?
1. "Take the tablet at the same time as an antacid."
2. "Swallow the tablet whole with a full glass of water."
3. "Take each dose with a laxative to prevent constipation."
4. "Chew the tablet thoroughly and then drink 8 ounces of water."

The nurse notes in the medication record that a client is taking calcium carbonate chewable tablets. Based on this data, the nurse should ask the client about a history of which symptom?
1. Flatus
2. Heartburn
3. Rectal pain
4. Muscle twitching

A client reports frequent use of sodium bicarbonate to relieve heartburn after meals. The nurse should monitor the client for which condition that the client is at risk for with long-term frequent use of this medication?
1. Urinary calculi
2. Chronic bronchitis
3. Metabolic alkalosis
4. Respiratory acidosis

A client rings the call bell and asks for medication to relieve postoperative gas pains. The nurse selects which medication to be given as prescribed on the medication sheet?
1. Droperidol
2. Simethicone (Mylicon)
3. Acetaminophen (Tylenol)
4. Magnesium hydroxide (MOM)

An older client has recently been started on cimetidine (Tagamet). The nurse updates the care plan to include assessment for central nervous system (CNS) effects of this medication. Which is the most frequent CNS side effect of cimetidine?
1. Tremors
2. Dizziness
3. Confusion
4. Hallucinations

Sucralfate (Carafate) is prescribed for a client with a gastric ulcer. The nurse determines that the client understands the instructions for medication administration if the client states to take the medication at what time?
1. At bedtime only
2. Every 6 hours around the clock
3. 1 hour after meals and at bedtime
4. 1 hour before meals and at bedtime

A client is told by the health care provider to take aluminum hydroxide (Amphojel) as needed for heartburn. The nurse advises the client to watch for which common side effect of this medication?
1. Dizziness
2. Excitability
3. Muscle pain
4. Constipation

A home health nurse is visiting a client with a diagnosis of gastric ulcer. The nurse is providing instructions to the client regarding the administration of sucralfate (Carafate). The nurse instructs the client to take the medication four times daily and to take the medication at which times?
1. 1 hour before meals and at bedtime
2. After meals and at bedtime with a snack
3. With meals and at bedtime with a glass of milk
4. Spaced around the clock, taking it every 6 hours

An older client takes cascara sagrada for ongoing management of chronic constipation. The nurse assesses the client's laboratory results for which electrolyte imbalance related to long-term use of this medication?
1. Hypokalemia
2. Hyperkalemia
3. Hyponatremia
4. Hypernatremia

A client is complaining of gas pains after surgery and requests medication. The nurse selects which agent from the list of medications prescribed on an as-needed basis to give to the client?
1. Droperidol (Inapsine)
2. Simethicone (Mylicon)
3. Acetaminophen (Tylenol)
4. Magnesium hydroxide (Milk of Magnesia)

Mineral oil has been prescribed for a child with constipation, and the nurse teaches the mother about administration of the mineral oil. Which statement by the mother indicates effective teaching?
1. "I will administer the mineral oil before each meal."
2. "I will administer the mineral oil followed by a glass of warm water."
3. "I will mix the mineral oil with a chilled drink before administration."
4. "I will mix the mineral oil with 8 ounces of warm juice before administration."

The adult client with hepatic encephalopathy has a serum ammonia level of 95 mcg/dL and receives treatment with lactulose (Chronulac). The nurse determines that the client had the best and most realistic response if the serum ammonia level changed to which value after medication administration?
1. 5 mcg/dL
2. 10 mcg/dL
3. 40 mcg/dL
4. 90 mcg/dL

A client is taking docusate sodium (Colace). The nurse monitors for which finding to determine whether the client is having a therapeutic effect from this medication?
1. Reduction in steatorrhea
2. Hematest-negative stools
3. Regular bowel movements
4. Absence of abdominal pain

A client is taking cascara sagrada and develops abdominal cramps. What interpretation by the nurse is most likely correct?
1. The client has peptic ulcer disease.
2. The client is experiencing a case of influenza.
3. This is a common side effect of this medication.
4. The client may have a partial bowel obstruction.

A client taking an oral laxative wants to obtain a rapid effect from the medication. How should the nurse instruct the client to take the medication?
1. At bedtime
2. With breakfast
3. With the noon meal
4. On an empty stomach

The nurse reads that metoclopramide (Reglan) is prescribed for a client. Based on this prescription, the nurse expects to note that which diagnosis documented?
1. Asthma
2. Gastroparesis
3. Allergic rhinitis
4. Chronic kidney disease

A client has just taken a dose of trimethobenzamide hydrochloride (Tigan). Which finding indicates that this client has had a therapeutic response to the medication?
1. Relief of constipation
2. Decrease in heartburn
3. Absence of abdominal pain
4. Relief of nausea and vomiting

A calcium carbonate antacid (such as Tums) has been prescribed for a client, and the nurse provides instructions to the client about the medication. The nurse should tell the client that it is best to take with the antacid with which item?
1. Milk
2. Water
3. Yogurt
4. Cheese

A nurse is giving the client directions for proper use of aluminum hydroxide (Amphojel) tablets. What should the nurse tell the client?
1. Swallow the tablets whole with a full glass of water.
2. Take the tablets at the same time as other medications.
3. Take each dose with a laxative to prevent constipation.
4. Chew the tablets thoroughly and follow with 4 oz of water.

A client with a history of duodenal ulcer is taking calcium carbonate (Tums) chewable tablets. Which finding indicates that the client is experiencing optimal effects of the medication?
1. Heartburn is relieved.
2. Muscle twitching stops.
3. The serum calcium level increases.
4. The serum phosphorus level decreases.

A hospitalized client asks the nurse for sodium bicarbonate to relieve heartburn after a meal. The nurse reviews the client's medical record, knowing that the medication is contraindicated in which condition?
1. Urinary calculi
2. Chronic bronchitis
3. Metabolic alkalosis
4. Respiratory acidosis

The health care provider has written a prescription for ranitidine (Zantac), 300 mg once daily. Which time should the nurse schedule the medication?
1. At bedtime
2. After lunch
3. With supper
4. Before breakfast

A client is taking lansoprazole (Prevacid) for the chronic management of peptic ulcer disease. The nurse expects that the health care provider will advise the client to take which product if needed for a headache?
1. Naproxen (Aleve)
2. Ibuprofen (Motrin IB)
3. Acetaminophen (Tylenol)
4. Acetylsalicylic acid (aspirin)

Which finding suggests to the nurse that a client with bleeding esophageal varices is experiencing an adverse effect of vasopressin therapy?
1. Complaints of chest pain
2. Temperature of 102° F
3. Bounding peripheral pulses
4. Blood urea nitrogen (BUN) of 20 mg/dL

A client with portal-systemic encephalopathy is receiving oral lactulose (Chronulac) daily. The nurse should check which item to determine the effectiveness of this medication?
1. Lung sounds
2. Blood pressure
3. Blood ammonia level
4. Serum potassium level

A nurse notes that a client is taking lansoprazole (Prevacid). On assessment of the client, the nurse should ask which question to determine the effectiveness of this medication?
1. "Has your appetite increased?"
2. "Are you experiencing any heartburn?"
3. "Do you have any problems with vision?"
4. "Do you experience any leg pain when walking?"

The client has a prescription for sucralfate (Carafate) four times daily. The nurse teaches the client to administer the medication at which best times?
1. Every 6 hours starting at 6:00 am
2. With breakfast, lunch, dinner, and at bedtime
3. One hour before breakfast, lunch, dinner, and at bedtime
4. One hour after breakfast, lunch, dinner, and with an evening snack

The client who chronically uses nonsteroidal anti-inflammatory drugs (NSAIDs) has begun taking misoprostol (Cytotec). Which statement by the client indicates that the misoprostol is effective?
1. "I have fewer muscle aches."
2. "My joint mobility has improved."
3. "I no longer have pain above my stomach."
4. "I am no longer experiencing constipation."

The client in the preoperative holding area has been given a dose of scopolamine. The nurse should assess the client for which side effect of the medication?
1. Dry mouth
2. Diaphoresis
3. Excessive urination
4. Pupillary constriction

The client with gastroesophageal reflux disease (GERD) has a new prescription for pantoprazole (Protonix). Which instruction should the nurse provide to the client?
1. Chew the pill thoroughly.
2. Swallow the tablet whole.
3. Headache is expected to occur.
4. Crush the pill if it is difficult to swallow.

A client is experiencing diarrhea. The nurse reviews the client's PRN medication prescription sheet and should plan to administer which medication for this problem?
1. Psyllium (Metamucil)
2. Sennosides (Senokot)
3. Loperamide (Imodium)
4. Bisacodyl (Dulcolax Bowel Prep Kit)

A client with recurrent constipation has been prescribed psyllium (Metamucil). Teaching provided by the nurse should include which instruction?
1. Mix the psyllium powder with any cold beverage.
2. Mix the psyllium powder with 4 oz of a hot beverage.
3. Mix the psyllium powder with gelatin, applesauce, or pudding.
4. Mix the psyllium powder with 8 oz of water or juice followed by drinking an additional 8 oz of liquid.

The nurse is reading the medication list for a postoperative client and notes that a PRN prescription for ondansetron was administered. Evaluation of the effectiveness of the medication is determined by the nurse if the client makes which statement?
1. "My headache is gone."
2. "I no longer feel nauseous."
3. "The dizziness has stopped."
4. "The pain at my incision has decreased."

An older client has been receiving cimetidine (Tagamet). The nurse should report to the health care provider (HCP) that the client is experiencing a side effect of the medication if which finding is noted during the assessment?
1. Tremors
2. Confusion
3. Stiff joints
4. Constipation