Chapter 39: Lower Gastrointestinal System Drugs Introductory Clinical Pharmacology 12th Edition by Susan M Ford

Introductory Clinical Pharmacology 12th Edition by Susan M Ford 1. A nurse is preparing to administer sulfasalazine to a client with inflammatory bowel disease. The nurse should question this order if the client's record indicates a hypersensitivity to which drug? a. Enalapril b. Doxycycline c. Azithromycin d. Sulfamethoxazole/trimethoprim Answer: D Rationale: Sulfasalazine is an aminosalicylate. The use of aminosalicylates is contraindicated in clients with hypersensitivity to sulfonamides and sulfites, which includes sulfamethoxazole/trimethoprim. There are no recognized interactions between sulfonamides and sulfites and enalapril, doxycycline, or azithromycin. Question Format: Multiple Choice Chapter: 39 Learning Objective: 3 Cognitive Level: Apply Client Needs: Physiological Integrity: Reduction of Risk Potential Integrated Process: Clinical Problem-solving Process (Nursing Process) Reference: p. 512, Antidiarrheals 2. After teaching a group of nursing students about laxatives, the instructor determines that the teaching was successful when the students correctly choose which drug as producing the laxative effect by promoting water retention and softening the stool? a. Docusate b. Methylcellulose c. Bisacodyl d. Lactulose Answer: A Rationale: A stool softener, like docusate, produces its laxative effect by promoting water retention in the fecal mass and softening the stool. Methylcellulose is a bulk-producing laxative. Bisacodyl is a stimulant laxative. Lactulose is a hyperosmolar laxative. Question Format: Multiple Choice Chapter: 39 Learning Objective: 2 Cognitive Level: Remember Client Needs: Physiological Integrity: Pharmacological Therapies Integrated Process: Teaching/Learning Reference: p. 519, Summary Drug Table 3. A health care provider has prescribed simethicone to a client with postoperative abdominal distention. Which assessment finding should the nurse prioritize in this client? a. Heartburn b. Vomiting c. Fainting d. Nausea 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. Question Format: Multiple Choice Chapter: 39 Learning Objective: 3 Cognitive Level: Apply Client Needs: Physiological Integrity: Pharmacological Therapies Integrated Process: Clinical Problem-solving Process (Nursing Process) Reference: p. 519, Summary Drug Table 4. A nurse is preparing to administer polycarbophil to a client with irritable bowel syndrome. The nurse determines caution is warranted after discovering the history of which disorder in the client's history? a. Abdominal pain b. Pseudomembranous colitis c. Rectal bleeding d. Intestinal obstruction Answer: C Rationale: The nurse should administer polycarbophil with caution in clients with rectal bleeding, in pregnant women, and during lactation. Antidiarrheals are contraindicated in clients with abdominal pain and pseudomembranous colitis. Aminosalicylates are contraindicated in clients with intestinal obstruction. Question Format: Multiple Choice Chapter: 39 Learning Objective: 3 Cognitive Level: Apply Client Needs: Physiological Integrity: Pharmacological Therapies Integrated Process: Clinical Problem-solving Process (Nursing Process) Reference: p. 513, Laxatives 5. A health care provider has prescribed difenoxin with atropine to a client with acute diarrhea. The nurse will carefully monitor the client for which adverse reaction after noting the client is also prescribed a MAOI? a. Decreased effect of difenoxin b. Increased risk of hypertensive crisis c. Increased cholinergic blocking adverse reactions d. Increased risk of CNS depression Answer: B Rationale: The nurse should monitor the client for an increased risk of hypertensive crisis as an effect of the interaction between difenoxin with atropine and MAOI antidepressants. When the client is administered antihistamines, opioids, sedatives, or hypnotics with antidiarrheal drugs, there will be increased risk of CNS depression. When the client is administered antihistamines and general antidepressants with antidiarrheal drugs, there will be increased cholinergic blocking adverse reactions. There will not be a decreased effect of difenoxin when there is an interaction between difenoxin and MAOI antidepressants. Question Format: Multiple Choice Chapter: 39 Learning Objective: 4 Cognitive Level: Apply Client Needs: Physiological Integrity: Reduction of Risk Potential Integrated Process: Clinical Problem-solving Process (Nursing Process) Reference: p. 512, Other System Reactions 6. A health care provider has prescribed bisacodyl to a client with constipation. The client reports epigastric pain and a burning sensation after taking the drug. Which instructions should the nurse provide to the client? a. Immediately stop taking the drug.