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Chapter 28: Laxatives Test Bank

Chapter 28: Laxatives Test Bank

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Chapter 28: Laxatives
Test Bank
MULTIPLE CHOICE
1.   A primary care nurse practitioner (NP) sees a patient who is concerned about constipation. The NP learns that the patient has three to four bowel movements per week with occasional hard stools but no straining with defecation. The NP should recommend:
a.

increased intake of fluids and fiber.

b.

docusate sodium (Colace) as needed.

c.

psyllium (Metamucil) on a daily basis.

d.

polyethylene glycol (MiraLAX) as needed.

2.   A patient reports having occasional acute constipation with large, hard stools and pain and asks the primary care NP about medication to treat this condition. The NP learns that the patient drinks 1500 mL of water daily; eats fruits, vegetables, and bran; and exercises regularly. The NP should recommend:
a.

a daily bulk laxative.

b.

long-term docusate sodium.

c.

a saline laxative as needed.

d.

glycerin suppositories as needed.

3.   A 5-year-old child has chronic constipation. The primary care NP plans to prescribe a laxative for long-term management. In addition to pharmacologic therapy, the NP should also recommend _____ g of fiber per day.
a.

10

b.

15

c.

20

d.

25

4.   A patient who has cerebral palsy is wheelchair dependent and receives enteral nutrition via a gastrostomy tube. The patient has infrequent, hard bowel movements despite using a high-fiber formula and receiving 1500 mL of fluid per day. The NP should order:
a.

bisacodyl (Dulcolax).

b.

docusate sodium (Colace).

c.

polyethylene glycol (MiraLAX).

d.

sodium phosphate (Fleets) enema.

5.   A primary care NP sees a patient who reports having decreased frequency of stools over the past few months. In the clinic today, the patient has severe abdominal cramping and an abdominal radiograph shows an increased stool load in the sigmoid colon and rectum. The NP should:
a.

give magnesium hydroxide (Milk of Magnesia).

b.

start daily methylcellulose (Citrucel) and increased fluids.

c.

order a sodium phosphate enema and psyllium (Metamucil).

d.

recommend polyethylene glycol (MiraLAX) and 2000 mL of fluid daily.

6.   A female patient who is underweight tells the primary care NP that she has been using bisacodyl (Dulcolax) daily for several years. The NP should:
a.

prescribe docusate sodium (Colace) and decrease bisacodyl gradually.

b.

suggest she use polyethylene glycol (MiraLAX) on a daily basis instead.

c.

tell her that long-term use of suppositories is safer than long-term laxative use.

d.

counsel the patient to discontinue the laxative and increase fluid and fiber intake.

7.   A patient who has a history of chronic constipation uses a bulk laxative to prevent episodes of acute constipation. The patient reports having an increased frequency of episodes. The primary care NP should recommend:
a.

adding docusate sodium (Colace).

b.

polyethylene glycol (MiraLAX) and bisacodyl (Dulcolax).

c.

lactulose (Chronulac) and polyethylene glycol (MiraLAX).

d.

adding nonpharmacologic measures such as biofeedback.

8.   A patient who takes digoxin reports taking psyllium (Metamucil) three or four times each month for constipation. The primary care NP should counsel this patient to:
a.

decrease fluid intake to avoid cardiac overload.

b.

change the laxative to docusate sodium (Colace).

c.

take the digoxin 2 hours before taking the psyllium.

d.

ask the cardiologist about taking an increased dose of digoxin.


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