A med-surg patient is scheduled to receive docusate (Colace) at 9am. The night nurse advises the patient had two loose stools during her shift. The nurse would anticipate:

Administering half of the scheduled dose of Colace

Administering the scheduled dose of Colace

Inserting a rectal tube to prevent excoriation

Holding the scheduled dose of Colace and notifying the ordering physician

Answer and Explanation

The Correct Answer is D

Choice A reason: Administering half of the scheduled dose of Colace is not the correct action for the nurse who is caring for a patient who had two loose stools during the night shift. Colace is the brand name of docusate, which is a stool softener that works by increasing the amount of water and fat in the stool, making it easier to pass. Colace is used to treat and prevent constipation, which is a condition of infrequent or hard bowel movements. Colace is not indicated for diarrhea, which is a condition of frequent and loose bowel movements. Administering half of the scheduled dose of Colace may not be enough to prevent constipation, and it may also worsen diarrhea by adding more water and fat to the stool.

Choice B reason: Administering the scheduled dose of Colace is not the correct action for the nurse who is caring for a patient who had two loose stools during the night shift. Colace is the brand name of docusate, which is a stool softener that works by increasing the amount of water and fat in the stool, making it easier to pass. Colace is used to treat and prevent constipation, which is a condition of infrequent or hard bowel movements. Colace is not indicated for diarrhea, which is a condition of frequent and loose bowel movements. Administering the scheduled dose of Colace may not be necessary to prevent constipation, and it may also worsen diarrhea by adding more water and fat to the stool.

Choice C reason: Inserting a rectal tube to prevent excoriation is not the correct action for the nurse who is caring for a patient who had two loose stools during the night shift. A rectal tube is a device that is inserted into the rectum and connected to a drainage bag, which collects the stool and prevents leakage and skin irritation. A rectal tube is used for patients who have fecal incontinence, which is the inability to control bowel movements. A rectal tube is not indicated for patients who have diarrhea, which is a condition of frequent and loose bowel movements. Inserting a rectal tube may not be effective to prevent excoriation, and it may also cause complications such as infection, bleeding, or perforation.

Choice D reason: Holding the scheduled dose of Colace and notifying the ordering physician is the correct action for the nurse who is caring for a patient who had two loose stools during the night shift. Colace is the brand name of docusate, which is a stool softener that works by increasing the amount of water and fat in the stool, making it easier to pass. Colace is used to treat and prevent constipation, which is a condition of infrequent or hard bowel movements. Colace is not indicated for diarrhea, which is a condition of frequent and loose bowel movements. Holding the scheduled dose of Colace may be appropriate to avoid further diarrhea, and notifying the ordering physician may be necessary to determine the cause and the treatment of diarrhea

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Correct Answer is A

Explanation

Choice A reason: This is correct. The kidneys are the main organs for excreting water-soluble substances, including most drugs and their metabolites. The kidneys filter the blood and remove waste products and excess fluid as urine. Drugs can be excreted by glomerular filtration, tubular secretion, or tubular reabsorption.

Choice B reason: This is incorrect. The pancreas is not involved in excretion of drugs. The pancreas is an organ that produces digestive enzymes and hormones, such as insulin and glucagon.

Choice C reason: This is incorrect. The gallbladder is not involved in excretion of drugs. The gallbladder is an organ that stores and concentrates bile, a fluid that helps digest fats.

Choice D reason: This is incorrect. The liver is not primarily responsible for excretion of drugs, although it plays an important role in drug metabolism. The liver is an organ that performs many functions, such as detoxifying substances, synthesizing proteins, and producing bile. The liver can transform drugs into more polar and water-soluble compounds, which can then be excreted by the kidneys or the biliary system.

A. Vitamin C supplements B. Caffeinated beverages C. Alcohol D. Dairy products

Correct Answer is C

Explanation

Choice A reason: Vitamin C supplements are not a concern for the concurrent use with Lorazepam, which is a medication that reduces anxiety and insomnia by enhancing the effects of a neurotransmitter called gammaaminobutyric acid (GABA) in the brain¹. Vitamin C is an essential nutrient that supports the immune system and the synthesis of collagen, a protein that forms the connective tissue in the body. Vitamin C does not interact with Lorazepam or affect its metabolism or clearance.

Choice B reason: Caffeinated beverages are not a concern for the concurrent use with Lorazepam, but they may reduce its effectiveness or cause unwanted effects. Caffeine is a stimulant that increases the activity of the central nervous system and counteracts the sedative and calming effects of Lorazepam. Caffeine may also cause side effects such as nervousness, insomnia, or palpitations, especially in high doses or in sensitive individuals. The nurse should advise the patient to limit or avoid caffeine intake while taking Lorazepam, and to monitor their response to the medication.

Choice C reason: Alcohol is a concern for the concurrent use with Lorazepam, as it can increase the risk of serious and potentially fatal side effects. Alcohol is a depressant that slows down the activity of the central nervous system and enhances the effects of Lorazepam. Alcohol can cause additive effects such as excessive sedation, respiratory depression, coma, or death when taken with Lorazepam. The nurse should advise the patient to avoid alcohol consumption while taking Lorazepam, and to seek immediate medical attention if they experience any signs of overdose or toxicity.

Choice D reason: Dairy products are not a concern for the concurrent use with Lorazepam, as they do not affect its absorption, distribution, metabolism, or excretion. Dairy products are a source of calcium, protein, and other nutrients that support the bone health and the muscle function. Dairy products do not interact with Lorazepam or alter its pharmacokinetics or pharmacodynamics.

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A med-surg patient is scheduled to receive docusate (Colace) at 9am. The night nurse advises the patient had two loose stools during her shift. The nurse would anticipate:

Nursing Test Bank

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Which organ is primarily responsible for excretion of a medication?

Correct Answer is A

Explanation

When educating a patient about Lorazepam (Ativan), the nurse should advise against the concurrent use of which substance?

Correct Answer is C

Explanation

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