Digestive & Gastrointestinal System Disorders | NCLEX Quiz 74

1. A client's ulcerative colitis symptoms have been present for longer than 1 week. The nurse recognizes that the client should be assessed carefully for signs of which of the following complications?

Heart failure

DVT

Hypokalemia

Hypocalcemia

Excessive diarrhea causes significant depletion of the body’s stores of sodium and potassium as well as fluid. The client should be closely monitored for hypokalemia and hyponatremia. Ulcerative colitis does not place the client at risk for heart failure. DVT. or hypocalcemia.

Explanation

Excessive diarrhea causes significant depletion of the body’s stores of sodium and potassium as well as fluid. The client should be closely monitored for hypokalemia and hyponatremia. Ulcerative colitis does not place the client at risk for heart failure. DVT. or hypocalcemia.

2. The nurse would teach patients that antacids are effective in treatment of hyperacidity because they:

Neutralize gastric acid

Decrease stomach motility

Decrease gastric pH

Decrease duodenal pH

Antacids work by neutralizing gastric acid. which would cause an increase in pH. They do not affect gastric motility.

Explanation

Antacids work by neutralizing gastric acid. which would cause an increase in pH. They do not affect gastric motility.

3. Which goal of the client's care should take priority during the first days of hospitalization for an exacerbation of ulcerative colitis?

Promoting self-care and independence

Managing diarrhea

Maintaining adequate nutrition

Promoting rest and comfort

Diarrhea is the primary symptom in an exacerbation of ulcerative colitis. and decreasing the frequency of stools is the first goal of treatment. The other goals are ongoing and will be best achieved by halting the exacerbation. The client may receive antidiarrheal medications. antispasmodic agents. bulk hydrophilic agents. or anti-inflammatory drugs.

Explanation

Diarrhea is the primary symptom in an exacerbation of ulcerative colitis. and decreasing the frequency of stools is the first goal of treatment. The other goals are ongoing and will be best achieved by halting the exacerbation. The client may receive antidiarrheal medications. antispasmodic agents. bulk hydrophilic agents. or anti-inflammatory drugs.

4. A client who has ulcerative colitis has persistent diarrhea. He is thin and has lost 12 pounds since the exacerbation of his ulcerative colitis. The nurse should anticipate that the physician will order which of the following treatment approaches to help the client meet his nutritional needs?

Initiate continuous enteral feedings

Encourage a high protein. high-calorie diet

Implement total parenteral nutrition

Provide six small meals a day.

Food will be withheld from the client with severe symptoms of ulcerative colitis to rest the bowel. To maintain the client’s nutritional status. the client will be started on TPN. Enteral feedings or dividing the diet into 6 small meals does not allow the bowel to rest. A high-calorie. high-protein diet will worsen the client’s symptoms.

Explanation

Food will be withheld from the client with severe symptoms of ulcerative colitis to rest the bowel. To maintain the client’s nutritional status. the client will be started on TPN. Enteral feedings or dividing the diet into 6 small meals does not allow the bowel to rest. A high-calorie. high-protein diet will worsen the client’s symptoms.

5. Digoxin preparations and absorbents should not be given simultaneously. As a nurse. you are aware that if these agents are given simultaneously. which of the following will occur?

Increased absorption of digoxin

Decreased absorption of digoxin

Increased absorption of the absorbent

Decreased absorption of the absorbent

When digoxin preparations and absorbents are given simultaneously, the absorption of digoxin is decreased. This is because absorbents have the ability to bind to digoxin in the gastrointestinal tract, preventing its absorption into the bloodstream. As a result, less digoxin is available for therapeutic effects, potentially leading to a decrease in its effectiveness. It is important to avoid giving these agents together to ensure proper absorption and efficacy of digoxin.

Explanation

When digoxin preparations and absorbents are given simultaneously, the absorption of digoxin is decreased. This is because absorbents have the ability to bind to digoxin in the gastrointestinal tract, preventing its absorption into the bloodstream. As a result, less digoxin is available for therapeutic effects, potentially leading to a decrease in its effectiveness. It is important to avoid giving these agents together to ensure proper absorption and efficacy of digoxin.

6. The nurse would monitor for which of the following adverse reactions to aluminum-containing antacids such as aluminum hydroxide (Amphojel)?

Diarrhea

Constipation

GI upset

Fluid retention

Aluminum- and calcium-containing antacids cause constipation. magnesium-containing antacids cause diarrhea and sodium-containing antacids cause sodium and fluid retention.

Explanation

Aluminum- and calcium-containing antacids cause constipation. magnesium-containing antacids cause diarrhea and sodium-containing antacids cause sodium and fluid retention.

7. The nurse would monitor a patient using sodium bicarbonate to treat gastric hyperacidity for signs and symptoms of:

Metabolic alkalosis

Metabolic acidosis

Hyperkalemia

Hypercalcemia

Solutions containing sodium bicarbonate (a base) can cause metabolic alkalosis. Serum K and serum calcium would decrease with alkalosis. not increase.

Explanation

Solutions containing sodium bicarbonate (a base) can cause metabolic alkalosis. Serum K and serum calcium would decrease with alkalosis. not increase.

8. One of your patients is receiving digitalis orally and is also to receive an antacid at the same time. Your most appropriate action. based on the pharmacokinetics of antacids. is to:

Delay the digitalis for 1 to 2 hours until the antacid is absorbed

Give the antacid at least 2 to 4 hours before administering the digitalis

Administer both medications as ordered and document in nurse’s notes

Contact the physician regarding the drug interaction and request a change in the time of dosing of the drugs.

The most appropriate action in this situation is to contact the physician regarding the drug interaction and request a change in the time of dosing of the drugs. Digitalis and antacids can interact with each other and affect their absorption and effectiveness. Therefore, it is important to consult the physician to ensure the proper administration and avoid any potential adverse effects or reduced therapeutic effects.

Explanation

The most appropriate action in this situation is to contact the physician regarding the drug interaction and request a change in the time of dosing of the drugs. Digitalis and antacids can interact with each other and affect their absorption and effectiveness. Therefore, it is important to consult the physician to ensure the proper administration and avoid any potential adverse effects or reduced therapeutic effects.

9. When used with hyperacidic disorders of the stomach. antacids are given to elevate the gastric pH to:

2

4

6

>8.0

Antacids are typically given to neutralize stomach acid and raise the gastric pH to a less acidic level, which is generally around 4. This pH level is less irritating to the gastric lining than the lower, more acidic pH levels typical of hyperacidic disorders. A pH of 2 would still be considered too acidic, and a pH of 6 or higher than 8 is less common for antacid treatment goals because it could excessively neutralize stomach acid, potentially leading to other digestive issues.

Explanation

Antacids are typically given to neutralize stomach acid and raise the gastric pH to a less acidic level, which is generally around 4. This pH level is less irritating to the gastric lining than the lower, more acidic pH levels typical of hyperacidic disorders. A pH of 2 would still be considered too acidic, and a pH of 6 or higher than 8 is less common for antacid treatment goals because it could excessively neutralize stomach acid, potentially leading to other digestive issues.

10. The nurse would question an order for which type of antacid in patients with chronic renal failure?

Aluminum-containing antacids

Calcium-containing antacids

Magnesium-containing antacids

All of the above.

Magnesium-containing antacids can cause hypermagnesemia in patients with chronic renal failure. Aluminum-containing antacids may be used as a phosphate binder in patients with chronic renal failure. Calcium-containing antacids are also appropriate because these patients may be hypocalcemic.

Explanation

Magnesium-containing antacids can cause hypermagnesemia in patients with chronic renal failure. Aluminum-containing antacids may be used as a phosphate binder in patients with chronic renal failure. Calcium-containing antacids are also appropriate because these patients may be hypocalcemic.