Chapter 37 Drug Therapy for Constipation and Elimination Problems

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Chapter 37  Drug Therapy for Constipation and Elimination Problems

 

 

Complete chapter Questions And Answers
 

Sample Questions

 

 

1. Defecation is normally stimulated by what physiologic trigger?

  1. A)  Movements and reflexes in the gastrointestinal tract
  2. B)  Stimulation from the medulla oblongata
  3. C)  Synthesis and release of digestive enzymes
  4. D)  Changes in the osmolarity of bowel contents

Ans: A
Feedback:
Defecation is normally stimulated by movements and reflexes in the gastrointestinal tract. It does not result from changes in osmolarity, CNS stimulation, or the release of enzymes.

2. Constipation is defined as

  1. A)  the passage of fewer than three stools in any 7-day period.
  2. B)  the passage of fewer than five stools in any 7-day period.
  3. C)  the infrequent and painful expulsion of hard, dry stools.
  4. D)  a subjective sensation of bowel fullness.

Ans: C
Feedback:
Constipation is the infrequent and painful expulsion of hard, dry stools. It is not defined by a particular number of stools or in terms of an individual’s subjective sensation.

3. A patient is using psyllium hydrophilic mucilloid (Metamucil) to promote evacuation of stool. What is the action of this medication?

  1. A)  It reduces the surface tension of bowel contents.
  2. B)  It irritates the intestinal mucosa, thus increasing intestinal motility.
  3. C)  It increases mass and water content of stool, promoting evacuation.
  4. D)  It creates a barrier between the colon wall and feces.

Ans: C Feedback:

Bulk-forming laxatives increase mass and water content of the stool, promoting evacuation. Bulk-forming laxatives do not reduce surface tension of bowel contents. Bulk-forming laxatives do not irritate the intestinal mucosa to increase intestinal motility. Bulk-forming laxatives do not create a barrier between the colon wall and feces.

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4. Which of the following statements by your patient leads you to believe that he has understood how to safely and effectively use bulk-forming laxatives?

  1. A)  “I will mix the medication with around a cup of fluid and then drink the mixture.”
  2. B)  “I will mix the dry medication with applesauce and then eat prunes before

    bedtime.”

  3. C)  “I will use milk of magnesia in conjunction with Metamucil until I have a bowel

    movement.”

  4. D)  “I will decrease the roughage in my diet while I am taking the bulk-forming

    laxative and eat rice.”

Ans: A

Feedback:

Bulk-forming laxatives increase mass and water content of the stool, promoting evacuation. Mixing the bulk-forming laxative with applesauce will not provide the needed fluid, and the applesauce can have a binding effect. It is not necessary to mix milk of magnesia with Metamucil. The patient should not decrease roughage in the diet or eat rice, which is binding.

5. Your patient is taking psyllium hydrophilic mucilloid (Metamucil) daily. What information should be included in the discharge plan?

  1. A)  Drink at least 8 ounces of fluid with the medication.
  2. B)  Mix the medication with your food at the evening meal.
  3. C)  Combine all of your medications with the mucilloid.
  4. D)  Discontinue the mucilloid if you do not have a bowel movement daily.

Ans: A
Feedback:
Bulk-forming laxatives increase mass and water content of the stool, promoting evacuation. The patient should drink at least 8 ounces of fluid with the medication. The patient should not mix the medication with food or other medications. The mucilloid should not be discontinued if the patient does not have a bowel movement.

6. When assessing a patient’s bowel habits, which of the following descriptions is the best indication of normal bowel elimination?

  1. A)  One bowel movement daily in the AM
  2. B)  One bowel movement daily in the PM
  3. C)  Soft, formed stool
  4. D)  Liquid stool

Ans: C Feedback:

Normal bowel elimination should produce soft, formed stool. One bowel movement in the AM or PM may not be a regular bowel pattern for all patients. Liquid stool is not an indication of normal bowel elimination.

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