Gastrointestinal Medications
1. A client with Crohn's disease is scheduled to receive an infusion of infliximab. 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
Correct answer: 2
Rationale: The principal manifestations of Crohn's disease are diarrhea and abdominal pain.
Infliximab is an immunomodulator that reduces the degree of inflammation in the colon,
thereby reducing the diarrhea. Options 1, 3, and 4 are unrelated to this medication.
2. A client has an as needed prescription for loperamide hydrochloride. 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
Correct answer: 3
Rationale: Loperamide is an antidiarrheal agent. It is used to manage acute and chronic
diarrhea in conditions such as inflammatory bowel disease. Loperamide also can be used to
reduce the volume of drainage from an ileostomy. It is not used for the conditions in options 1, 2,
and 4.
3. A client has an as needed prescription for ondansetron. For which condition(s) should thenurse
administer this medication?
1. Paralytic ileus
2. Incisional pain
3. Urinary retention
4. Nausea and vomiting
,Correct answer: 4
Rationale: Ondansetron is an antiemetic used to treat postoperative nausea and vomiting, as well
as nausea and vomiting associated with chemotherapy. The other options are incorrect reasons
for administering this medication.
5. An older client recently has been taking cimetidine. The nurse monitors the client for which
most frequent central nervous system side effect of this medication?
1. Tremors
2. Dizziness
3. Confusion
4. Hallucination
s Correct answer: 3
Rationale: Cimetidine is a histamine (H2)-receptor antagonist. Older clients are especially
susceptible to central nervous system side effects of cimetidine. The most frequent of these is
confusion. Less common central nervous system side effects include headache, dizziness,
drowsiness, and hallucinations.
6. A client with a gastric ulcer has a prescription for sucralfate 1 gram by mouth 4 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
Correct answer: 4
Rationale: Sucralfate is a gastric protectant. The medication should be scheduled for
administration 1 hour before meals and at bedtime. The medication is timed to allow it to form a
protective coating over the ulcer before food intake stimulates gastric acid production and
mechanical irritation. The other options are incorrect.
7. A client who uses nonsteroidal antiinflammatory drugs (NSAIDs) has been taking
misoprostol. The nurse determines that the misoprostol 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
Correct answer: 2
Rationale: The client who uses NSAIDs is prone to gastric mucosal injury. Misoprostol is a
gastric protectant and is given specifically to prevent this occurrence in clients taking NSAIDs
frequently. Diarrhea can be a side effect of the medication but is not an intended effect. Options 3
and 4 are unrelated to the purpose of misoprostol.
8. A client has been taking omeprazole 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
Correct answer: 2
Rationale: Omeprazole is a proton pump inhibitor classified as an antiulcer agent. The intended
effect of the medication is relief of pain from gastric irritation, often called heartburn by clients.
Omeprazole is not used to treat the conditions identified in options 1, 3, and 4.
9. A client with a peptic ulcer is diagnosed with a Helicobacter pylori infection. The nurse is
teaching the client about the medications prescribed, including clarithromycin, esomeprazole, and
amoxicillin. 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 decrease the acid production."
4. "These medications will coat the ulcer and decrease the acid production in my stomach."
Correct answer: 3
Rationale: Triple therapy for H. pylori infection usually includes 2 antibacterial medications and
a proton pump inhibitor. Clarithromycin and amoxicillin are antibacterials. Esomeprazole is a
proton pump inhibitor. These medications will kill the bacteria and decrease acid production.
10. A client has a new prescription for metoclopramide. 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
1. A client with Crohn's disease is scheduled to receive an infusion of infliximab. 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
Correct answer: 2
Rationale: The principal manifestations of Crohn's disease are diarrhea and abdominal pain.
Infliximab is an immunomodulator that reduces the degree of inflammation in the colon,
thereby reducing the diarrhea. Options 1, 3, and 4 are unrelated to this medication.
2. A client has an as needed prescription for loperamide hydrochloride. 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
Correct answer: 3
Rationale: Loperamide is an antidiarrheal agent. It is used to manage acute and chronic
diarrhea in conditions such as inflammatory bowel disease. Loperamide also can be used to
reduce the volume of drainage from an ileostomy. It is not used for the conditions in options 1, 2,
and 4.
3. A client has an as needed prescription for ondansetron. For which condition(s) should thenurse
administer this medication?
1. Paralytic ileus
2. Incisional pain
3. Urinary retention
4. Nausea and vomiting
,Correct answer: 4
Rationale: Ondansetron is an antiemetic used to treat postoperative nausea and vomiting, as well
as nausea and vomiting associated with chemotherapy. The other options are incorrect reasons
for administering this medication.
5. An older client recently has been taking cimetidine. The nurse monitors the client for which
most frequent central nervous system side effect of this medication?
1. Tremors
2. Dizziness
3. Confusion
4. Hallucination
s Correct answer: 3
Rationale: Cimetidine is a histamine (H2)-receptor antagonist. Older clients are especially
susceptible to central nervous system side effects of cimetidine. The most frequent of these is
confusion. Less common central nervous system side effects include headache, dizziness,
drowsiness, and hallucinations.
6. A client with a gastric ulcer has a prescription for sucralfate 1 gram by mouth 4 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
Correct answer: 4
Rationale: Sucralfate is a gastric protectant. The medication should be scheduled for
administration 1 hour before meals and at bedtime. The medication is timed to allow it to form a
protective coating over the ulcer before food intake stimulates gastric acid production and
mechanical irritation. The other options are incorrect.
7. A client who uses nonsteroidal antiinflammatory drugs (NSAIDs) has been taking
misoprostol. The nurse determines that the misoprostol 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
Correct answer: 2
Rationale: The client who uses NSAIDs is prone to gastric mucosal injury. Misoprostol is a
gastric protectant and is given specifically to prevent this occurrence in clients taking NSAIDs
frequently. Diarrhea can be a side effect of the medication but is not an intended effect. Options 3
and 4 are unrelated to the purpose of misoprostol.
8. A client has been taking omeprazole 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
Correct answer: 2
Rationale: Omeprazole is a proton pump inhibitor classified as an antiulcer agent. The intended
effect of the medication is relief of pain from gastric irritation, often called heartburn by clients.
Omeprazole is not used to treat the conditions identified in options 1, 3, and 4.
9. A client with a peptic ulcer is diagnosed with a Helicobacter pylori infection. The nurse is
teaching the client about the medications prescribed, including clarithromycin, esomeprazole, and
amoxicillin. 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 decrease the acid production."
4. "These medications will coat the ulcer and decrease the acid production in my stomach."
Correct answer: 3
Rationale: Triple therapy for H. pylori infection usually includes 2 antibacterial medications and
a proton pump inhibitor. Clarithromycin and amoxicillin are antibacterials. Esomeprazole is a
proton pump inhibitor. These medications will kill the bacteria and decrease acid production.
10. A client has a new prescription for metoclopramide. 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
