,NUR 210 Exam 4 | Principles of Pharmacology | Actual
Questions and Answers (PDF) | Galen Nursing
1. A patient hospitalized with profuse watery diarrhea from confirmed C. difficile
asks for an antidiarrheal "to slow things down." The provider orders
diphenoxylate-atropine. What is the nurse's priority action?
• A. Administer as ordered to reduce fluid loss
• B. Ask for the dose to be increased because diarrhea is severe
• C. Hold the medication and question the order with the provider
• D. Give with milk to reduce GI irritation
Answer C: Hold the medication and question the order with the provider
Rationale: Diphenoxylate-atropine slows peristalsis and is contraindicated in infectious
diarrhea such as C. diff, as diarrhea helps eliminate the organism. Giving it would trap
organisms and toxins, worsening infection .
2. Which patient receiving diphenoxylate-atropine for acute diarrhea should the
nurse assess most frequently for adverse effects?
• A. A 25-year-old with viral gastroenteritis
• B. A 40-year-old with a history of glaucoma
• C. A 30-year-old who drinks 2 L of water daily
• D. A 50-year-old who uses fiber supplements
Answer B: A 40-year-old with a history of glaucoma
Rationale: Diphenoxylate-atropine has anticholinergic effects that can increase
intraocular pressure, making it dangerous for patients with glaucoma
3. A patient with chronic constipation and low fluid intake asks which laxative is
safest for long-term use. Which medication should the nurse anticipate discussing?
, • A. Bisacodyl
• B. Polyethylene glycol (osmotic)
• C. Psyllium (bulk-forming)
• D. Magnesium hydroxide
Answer C: Psyllium (bulk-forming)
Rationale: Bulk-forming laxatives (e.g., fiber products like Metamucil) are the safest for
long-term use, as they mimic natural fiber and have minimal systemic effects when
taken with adequate fluids .
4. While assessing a patient prior to giving bisacodyl, which finding requires the
nurse to hold the medication and notify the provider?
• A. Mild constipation for two days
• B. Complaint of diffuse, severe abdominal pain with rebound tenderness
• C. Reports of low appetite the last few days
• D. History of occasional heartburn
Answer B: Complaint of diffuse, severe abdominal pain with rebound tenderness
Rationale: Severe abdominal pain with rebound suggests appendicitis, obstruction, or
inflammatory bowel conditions—all contraindications to bisacodyl .
5. A patient taking oral bisacodyl asks how to take it with evening medications and
a glass of milk. Which teaching is most appropriate?
• A. "You can take bisacodyl with milk for better absorption."
• B. "Take bisacodyl at the same time as your antacid to prevent cramps."
• C. "Do not take bisacodyl within 1 hour of milk, antacids, or acid-reducing drugs."
• D. "Crush the tablets and mix them with milk to avoid stomach upset."
Answer C: "Do not take bisacodyl within 1 hour of milk, antacids, or acid-reducing drugs."
, Rationale: Bisacodyl interacts with antacids, H2 blockers, PPIs, and milk, which can alter
the enteric coating and cause gastric irritation. These should be separated by at least 1
hour .
6. A patient has used bisacodyl tablets daily for several months. Which laboratory
finding would be most consistent with this pattern of use?
• A. Hemoglobin increased
• B. Potassium 3.0 mEq/L
• C. Sodium 145 mEq/L
• D. Calcium slightly low
Answer B: Potassium 3.0 mEq/L
Rationale: Stimulant laxatives like bisacodyl can cause fluid and electrolyte losses,
including hypokalemia, because much of free potassium is excreted in stool .
7. An older adult reports taking aluminum hydroxide several times daily for
heartburn. Which adverse effect should the nurse assess for first?
• A. Constipation
• B. Diarrhea
• C. Weight loss
• D. Tremors
Answer A: Constipation
Rationale: Aluminum-containing antacids cause constipation, while magnesium products
cause diarrhea. This is particularly relevant with chronic daily use .
8. An older adult receiving famotidine for GERD becomes acutely disoriented and
confused. What is the nurse's best interpretation?
Questions and Answers (PDF) | Galen Nursing
1. A patient hospitalized with profuse watery diarrhea from confirmed C. difficile
asks for an antidiarrheal "to slow things down." The provider orders
diphenoxylate-atropine. What is the nurse's priority action?
• A. Administer as ordered to reduce fluid loss
• B. Ask for the dose to be increased because diarrhea is severe
• C. Hold the medication and question the order with the provider
• D. Give with milk to reduce GI irritation
Answer C: Hold the medication and question the order with the provider
Rationale: Diphenoxylate-atropine slows peristalsis and is contraindicated in infectious
diarrhea such as C. diff, as diarrhea helps eliminate the organism. Giving it would trap
organisms and toxins, worsening infection .
2. Which patient receiving diphenoxylate-atropine for acute diarrhea should the
nurse assess most frequently for adverse effects?
• A. A 25-year-old with viral gastroenteritis
• B. A 40-year-old with a history of glaucoma
• C. A 30-year-old who drinks 2 L of water daily
• D. A 50-year-old who uses fiber supplements
Answer B: A 40-year-old with a history of glaucoma
Rationale: Diphenoxylate-atropine has anticholinergic effects that can increase
intraocular pressure, making it dangerous for patients with glaucoma
3. A patient with chronic constipation and low fluid intake asks which laxative is
safest for long-term use. Which medication should the nurse anticipate discussing?
, • A. Bisacodyl
• B. Polyethylene glycol (osmotic)
• C. Psyllium (bulk-forming)
• D. Magnesium hydroxide
Answer C: Psyllium (bulk-forming)
Rationale: Bulk-forming laxatives (e.g., fiber products like Metamucil) are the safest for
long-term use, as they mimic natural fiber and have minimal systemic effects when
taken with adequate fluids .
4. While assessing a patient prior to giving bisacodyl, which finding requires the
nurse to hold the medication and notify the provider?
• A. Mild constipation for two days
• B. Complaint of diffuse, severe abdominal pain with rebound tenderness
• C. Reports of low appetite the last few days
• D. History of occasional heartburn
Answer B: Complaint of diffuse, severe abdominal pain with rebound tenderness
Rationale: Severe abdominal pain with rebound suggests appendicitis, obstruction, or
inflammatory bowel conditions—all contraindications to bisacodyl .
5. A patient taking oral bisacodyl asks how to take it with evening medications and
a glass of milk. Which teaching is most appropriate?
• A. "You can take bisacodyl with milk for better absorption."
• B. "Take bisacodyl at the same time as your antacid to prevent cramps."
• C. "Do not take bisacodyl within 1 hour of milk, antacids, or acid-reducing drugs."
• D. "Crush the tablets and mix them with milk to avoid stomach upset."
Answer C: "Do not take bisacodyl within 1 hour of milk, antacids, or acid-reducing drugs."
, Rationale: Bisacodyl interacts with antacids, H2 blockers, PPIs, and milk, which can alter
the enteric coating and cause gastric irritation. These should be separated by at least 1
hour .
6. A patient has used bisacodyl tablets daily for several months. Which laboratory
finding would be most consistent with this pattern of use?
• A. Hemoglobin increased
• B. Potassium 3.0 mEq/L
• C. Sodium 145 mEq/L
• D. Calcium slightly low
Answer B: Potassium 3.0 mEq/L
Rationale: Stimulant laxatives like bisacodyl can cause fluid and electrolyte losses,
including hypokalemia, because much of free potassium is excreted in stool .
7. An older adult reports taking aluminum hydroxide several times daily for
heartburn. Which adverse effect should the nurse assess for first?
• A. Constipation
• B. Diarrhea
• C. Weight loss
• D. Tremors
Answer A: Constipation
Rationale: Aluminum-containing antacids cause constipation, while magnesium products
cause diarrhea. This is particularly relevant with chronic daily use .
8. An older adult receiving famotidine for GERD becomes acutely disoriented and
confused. What is the nurse's best interpretation?
