Chapter 51: Bowel Disorder Drugs Lilley: Pharmacology and the Nursing
Process, 10th Edition
1. A patient is about to undergo a diagnostic bowel procedure. The nurse expects
which drug to be used to induce total cleansing of the bowel?
A. Docusate sodium
B. Lactulose
C. Mineral oil
D. Polyethylene glycol 3350
Answer: D
Explanation: Polyethylene glycol is a potent osmotic laxative used for bowel cleansing
before diagnostic or surgical bowel procedures.
2. A patient is receiving lactulose three times a day. The nurse knows that the
patient is not constipated and is receiving this drug for which reason?
A. High ammonia levels due to liver failure
B. Prevention of constipation
C. Chronic renal failure
D. Chronic diarrhea
Answer: A
Explanation: Lactulose is used to reduce blood ammonia levels in patients with hepatic
encephalopathy by acidifying the colon and trapping ammonia in the stool.
3. The nurse is giving oral mineral oil as an ordered laxative dose. The nurse will
take measures to prevent which potential problem that may occur with mineral
oil?
A. Fecal impaction
B. Electrolyte imbalances
C. Lipid pneumonia
D. Esophageal blockage
Answer: C
Explanation: Mineral oil can cause lipid pneumonia if accidentally aspirated into the lungs.
The nurse should administer it carefully to prevent aspiration.
4. A patient wants to prevent problems with constipation and asks the nurse for
advice about which type of laxative is safe to use for this purpose. Which class of
laxative is considered safe to use on a long-term basis?
A. Emollient laxatives
B. Bulk-forming laxatives
, C. Hyperosmotic laxatives
D. Stimulant laxatives
Answer: B
Explanation: Bulk-forming laxatives are safe for long-term use because they work naturally
to increase stool bulk and are not associated with dependency or significant electrolyte
imbalances.
5. A patient is severely constipated and needs immediate relief. The nurse knows
that which class of laxative will provide the most rapid results?
A. Bulk-forming laxative, such as psyllium
B. Stool softener, such as docusate salts
C. Magnesium hydroxide
D. Magnesium oxide tablets
Answer: C
Explanation: Saline laxatives like magnesium hydroxide draw water into the intestines and
produce a watery stool within 3 to 6 hours, providing rapid relief.
6. When administering a bulk-forming laxative, the nurse instructs the patient to
drink the medication mixed in a full 8-ounce glass of water. Which statement
best explains the rationale for this instruction?
A. The water acts to stimulate bowel movements.
B. The water will help to reduce the bulk of the intestinal contents.
C. These laxatives may cause esophageal obstruction if taken with insufficient water.
D. The water acts as a lubricant to produce bowel movements.
Answer: C
Explanation: Bulk-forming laxatives absorb water and expand. If taken with insufficient
fluid, they can swell in the throat and cause esophageal obstruction.
7. A patient will be taking bismuth subsalicylate to control diarrhea. When
reviewing the patient's other ordered medications, the nurse recognizes that
which medication or medication class will interact significantly with this drug?
A. Hypoglycemic drugs
B. Antibiotics
C. Acetaminophen
D. Antidepressants
Answer: A
Explanation: Bismuth subsalicylate is an adsorbent and can bind to other medications in the
GI tract, reducing the absorption of drugs like oral hypoglycemics.
8. While recovering from surgery, an elderly woman started taking a stimulant
laxative, senna, to relieve constipation caused by the pain medications. Two
, weeks later, at her follow-up appointment, she tells the nurse that she likes how
"regular" her bowel movements are now that she is taking the laxative. Which
teaching principle is appropriate for this patient?
A. She needs to be sure to take this medication with plenty of fluids.
B. It is important to have a daily bowel movement to promote bowel health.
C. Long-term use of laxatives often results in decreased bowel tone and may lead to
dependency.
D. She needs to switch to glycerin suppositories to continue having daily bowel
movements.
Answer: C
Explanation: Long-term use of stimulant laxatives can lead to dependence and loss of
normal bowel function. Patients should be educated that daily bowel movements are not
necessary.
9. A patient asks the nurse about the difference between diphenoxylate with
atropine and the over-the-counter drug loperamide (Imodium). Which response
by the nurse is correct?
A. "Lomotil acts faster than Imodium."
B. "Imodium does not cause physical dependence."
C. "Lomotil is available in suppository form."
D. "Imodium is a natural antidiarrheal drug."
Answer: B
Explanation: Loperamide (Imodium) does not cause physical dependence, whereas
diphenoxylate with atropine (Lomotil) has a potential for dependence due to its opiate-like
properties.
10. When administering mineral oil, the nurse recognizes that it can interfere with
the absorption of which substance?
A. Fat-soluble vitamins
B. Water-soluble vitamins
C. Minerals
D. Electrolytes
Answer: A
Explanation: Mineral oil is a lubricant laxative that can impair the absorption of fat-soluble
vitamins (A, D, E, and K) by coating the GI tract and preventing their absorption.
11. The nurse is reviewing the mechanism of action of antidiarrheal drugs. Which
type of antidiarrheal medication works by decreasing the intestinal muscle tone
and peristalsis of the intestines?
A. Adsorbents
B. Anticholinergics
Process, 10th Edition
1. A patient is about to undergo a diagnostic bowel procedure. The nurse expects
which drug to be used to induce total cleansing of the bowel?
A. Docusate sodium
B. Lactulose
C. Mineral oil
D. Polyethylene glycol 3350
Answer: D
Explanation: Polyethylene glycol is a potent osmotic laxative used for bowel cleansing
before diagnostic or surgical bowel procedures.
2. A patient is receiving lactulose three times a day. The nurse knows that the
patient is not constipated and is receiving this drug for which reason?
A. High ammonia levels due to liver failure
B. Prevention of constipation
C. Chronic renal failure
D. Chronic diarrhea
Answer: A
Explanation: Lactulose is used to reduce blood ammonia levels in patients with hepatic
encephalopathy by acidifying the colon and trapping ammonia in the stool.
3. The nurse is giving oral mineral oil as an ordered laxative dose. The nurse will
take measures to prevent which potential problem that may occur with mineral
oil?
A. Fecal impaction
B. Electrolyte imbalances
C. Lipid pneumonia
D. Esophageal blockage
Answer: C
Explanation: Mineral oil can cause lipid pneumonia if accidentally aspirated into the lungs.
The nurse should administer it carefully to prevent aspiration.
4. A patient wants to prevent problems with constipation and asks the nurse for
advice about which type of laxative is safe to use for this purpose. Which class of
laxative is considered safe to use on a long-term basis?
A. Emollient laxatives
B. Bulk-forming laxatives
, C. Hyperosmotic laxatives
D. Stimulant laxatives
Answer: B
Explanation: Bulk-forming laxatives are safe for long-term use because they work naturally
to increase stool bulk and are not associated with dependency or significant electrolyte
imbalances.
5. A patient is severely constipated and needs immediate relief. The nurse knows
that which class of laxative will provide the most rapid results?
A. Bulk-forming laxative, such as psyllium
B. Stool softener, such as docusate salts
C. Magnesium hydroxide
D. Magnesium oxide tablets
Answer: C
Explanation: Saline laxatives like magnesium hydroxide draw water into the intestines and
produce a watery stool within 3 to 6 hours, providing rapid relief.
6. When administering a bulk-forming laxative, the nurse instructs the patient to
drink the medication mixed in a full 8-ounce glass of water. Which statement
best explains the rationale for this instruction?
A. The water acts to stimulate bowel movements.
B. The water will help to reduce the bulk of the intestinal contents.
C. These laxatives may cause esophageal obstruction if taken with insufficient water.
D. The water acts as a lubricant to produce bowel movements.
Answer: C
Explanation: Bulk-forming laxatives absorb water and expand. If taken with insufficient
fluid, they can swell in the throat and cause esophageal obstruction.
7. A patient will be taking bismuth subsalicylate to control diarrhea. When
reviewing the patient's other ordered medications, the nurse recognizes that
which medication or medication class will interact significantly with this drug?
A. Hypoglycemic drugs
B. Antibiotics
C. Acetaminophen
D. Antidepressants
Answer: A
Explanation: Bismuth subsalicylate is an adsorbent and can bind to other medications in the
GI tract, reducing the absorption of drugs like oral hypoglycemics.
8. While recovering from surgery, an elderly woman started taking a stimulant
laxative, senna, to relieve constipation caused by the pain medications. Two
, weeks later, at her follow-up appointment, she tells the nurse that she likes how
"regular" her bowel movements are now that she is taking the laxative. Which
teaching principle is appropriate for this patient?
A. She needs to be sure to take this medication with plenty of fluids.
B. It is important to have a daily bowel movement to promote bowel health.
C. Long-term use of laxatives often results in decreased bowel tone and may lead to
dependency.
D. She needs to switch to glycerin suppositories to continue having daily bowel
movements.
Answer: C
Explanation: Long-term use of stimulant laxatives can lead to dependence and loss of
normal bowel function. Patients should be educated that daily bowel movements are not
necessary.
9. A patient asks the nurse about the difference between diphenoxylate with
atropine and the over-the-counter drug loperamide (Imodium). Which response
by the nurse is correct?
A. "Lomotil acts faster than Imodium."
B. "Imodium does not cause physical dependence."
C. "Lomotil is available in suppository form."
D. "Imodium is a natural antidiarrheal drug."
Answer: B
Explanation: Loperamide (Imodium) does not cause physical dependence, whereas
diphenoxylate with atropine (Lomotil) has a potential for dependence due to its opiate-like
properties.
10. When administering mineral oil, the nurse recognizes that it can interfere with
the absorption of which substance?
A. Fat-soluble vitamins
B. Water-soluble vitamins
C. Minerals
D. Electrolytes
Answer: A
Explanation: Mineral oil is a lubricant laxative that can impair the absorption of fat-soluble
vitamins (A, D, E, and K) by coating the GI tract and preventing their absorption.
11. The nurse is reviewing the mechanism of action of antidiarrheal drugs. Which
type of antidiarrheal medication works by decreasing the intestinal muscle tone
and peristalsis of the intestines?
A. Adsorbents
B. Anticholinergics
