Lilley: Pharmacology and the Nursing Process, 10th Edition
MULTIPLE CHOICE
1. The nurse is discussing the use of adsorbents such as bismuth
subsalicylate with a patient who has diar rhea. The nurse will warn the
patient about which possible adverse effects?
a. Dark stools and blue gums
b. Urinary hesitancy
c. Drowsiness and dizziness
d. Blurred vision and headache
ANS: A
Dark stools and blue gums are two of the possible adverse effects of
bismuth subsalicylate (see Table 51 -2). The other adverse effects listed
may occur with the use of other antidiarrheal drugs.
DIF: Cognitive Level: Understanding (Comprehension)
TOP: Nursing Process: Assessment
MSC: NC LEX: Physiological Integrit y: Pharmacologica l and
Parenteral Therapies
2. A patient who has been on antibiotic therapy for 2 weeks has developed
persistent diarrhea. The nurse expects which medication class to be
ordered to treat this diarrhea?
a. Lubricants
b. Adsorbents
c. Anticholinergics
, d. Probiotics
ANS: D
Probiotics work by replenishing bacteria that may have been destroyed
by antibiotic therapy, thus restoring the balance of normal flora and
suppressing the growth of diarrhea -causing bacteria.
DIF: Cognitive Level: Appl ying (Application)
TOP: Nursing Proc ess: Implementation
MSC: NC LEX: Physiological Integrit y: Pharmacological and
Parenteral Therapies
3. A patient will be taking bismuth subsalicylate to control diarrhea. When
reviewing the patient ’s other ordered medications, the nurse recognizes
that which m edication will interact significantl y with this drug?
a. Acetaminophen, an analgesic
b. Levothyroxine, a thyroid replacement drug
c. Warfarin, an anticoagulant
d. Fluoxetine, an antidepressant
ANS: C
The oral anticoagulant warfarin is more likel y to cause increased
bleeding times or bruising when co -administered with adsorbents. This
is thought to be because the adsorbents bind to vitamin K, which is
needed to make certain clotting factors. Vitamin K is synthesized by
the normal bacterial flora in the bowel. The other options are incorrect.
DIF: Cognitive Level: Appl ying (Application)
TOP: Nursing Process: Implementation
MSC: NC LEX: Physiological Integrit y: Reduction of Risk
Potential