CH 37 Drugs for Peptic Ulcer Disease and Hyperacidity (E2)
Adverse effects of cimetidine include which of the following? SELECT ALL THAT APPLY. A) headache B) constipation C) gynecomastia D) diarrhea E) confusion
A, C, D, E
The client diagnosed with peptic ulcer disease states, "I've never been a really anxious type of person, so I never thought I'd develop ulcers." The nurse has responded with health education addressing the etiology of peptic ulcer disease (PUD). What causative factors should the nurse cite? SELECT ALL THAT APPLY. A) physiologic or psychological stress B) diabetes mellitus C) cigarette smoking D) infections E) nonsteroidal anti-inflammatory drugs
A, C, D, E
The nurse is caring for an adult client presenting with recent heartburn, which the client treated with over-the-counter omeprazole 20 mg PO daily. The nurse reviews the client's current list of medications and should report which of the following as drug interactions with the omeprazole? SELECT ALL THAT APPLY. A) phenytoin B) atorvastatin C) enteric-coated aspirin D) clopidogrel E) atenolol
A, D
A client is prescribed a proton pump inhibitor to treat erosive gastritis. How soon will the client's symptoms most likely be resolved? A) 1 to 2 weeks B) 4 weeks C) 1 month D) 6 weeks
A
A client is taking cimetidine for increased gastric pain and hypersecretion. Nurses should use extreme caution when administering cimetidine to clients with which condition? A) hepatic disease B) cancer C) hypertension D) diabetes mellitus
A
A client with a diagnosis of peptic ulcer disease has begun taking sucralfate. The nurse should caution the client against the concurrent use of which classification of medications? A) antacids B) NSAIDs C) acetaminophen D) probiotics
A
A nurse is caring for four clients who have PUD. The nurse should identify misoprostol is contraindicated for which of the following clients? A) Pregnant B) Osteoarthritis C) Kidney stone D) UTI
A
An adult client has been taking a calcium-based antacid on an increasingly frequent basis. When teaching this client, the nurse should include suggestions for the prevention of which adverse effect? A) constipation B) urinary frequency C) fatty stools D) nausea
A
How long will it take for ranitidine to reach peak blood levels when administered parenterally? A) 15 minutes B) 30 minutes C) 1 hour D) 2 hours
A
When taking a patient's history, the nurse notes that the patient is taking warfarin and cimetidine concurrently. The nurse should anticipate which of the following? A) Warfarin effects would be increased. B) Cimetidine effects would be increased. C) Warfarin effects would be decreased. D) Cimetidine effects would be decreased.
A
A client with ulcers has asked the nurse if it would be acceptable for him or her to take bismuth subsalicylate. Before recommending an over-the-counter (OTC) formulation of bismuth subsalicylate, the nurse should conduct which client assessment? A) immunization history B) allergy status C) cognition D) normal bowel pattern
B
A nurse is teaching a client who has a new prescription for omeprazole. Which of the following information should the nurse include in the teaching? A) Take this medication at bedtime. B) This medication decreases the production of gastric acid. C) Take this medication two hours after eating. D) This medicine can cause hyperkalemia.
B
A nurse is teaching a client who will begin taking aluminum hydroxide. Which of the following information should the nurse include in the teaching? A) If constipation develops, switch to a calcium-based antacid. B) Take this medication two hours before or after other medications. C) This medication increases the risk for pneumonia. D) Have your magnesium level monitored while taking this medication.
B
How should the critical care nurse most accurately titrate the dose and frequency of administration of an intragastric drip of an antacid through a nasogastric tube? A) by assessing the pH of a 24-hour urine sample B) by aspirating stomach contents and measuring the pH C) by measuring the pH of urine after each void D) by swabbing the client's buccal mucosa and testing for pH daily
B
A client has a magnesium-based antacid ordered for administration as needed. Which condition contraindicates the administration of this classification of medications? A) hypertension B) heart rate of 68 C) renal dysfunction D) stress ulcer
C
A client with a complex medical history states that the primary care provider has changed his proton pump inhibitor from omeprazole to esomeprazole. The client is unsure of the rationale for this change in medication and has raised this question with the nurse. What rationale is most plausible? A) Esomeprazole has fewer adverse effects. B) Esomeprazole can be used long term. C) Esomeprazole has fewer drug interactions. D) Esomeprazole can be taken on an outclient basis.
C
A patient is started on Mylanta for peptic ulcer disease. It is important for the nurse to inform the patient about which of the following adverse effects? A) nausea B) vomiting C) diarrhea D) constipation
C
The nurse would question the use of misoprostol (Cytotec) in which population? A) children under 5 years of age B) adults with concurrent use of antacid C) pregnant women at all stages of pregnancy D) older adults with concurrent use of cimetidine
C
Which adverse effect is more likely to occur with cimetidine than with other histamine2 receptor antagonists? A) hypoxia B) hypertension C) gynecomastia D) seizures
C
Which fact regarding administration should the nurse include in patient teaching about the drug sucralfate? A) Take sucralfate concurrently with an antacid. B) Take sucralfate after meals. C) Take sucralfate before meals. D) Take sucralfate 2 hours before meals.
C
Which teaching intervention is most important to share with the client prescribed misoprostol? A) Supplement therapy with magnesium antacids. B) Report postmenopausal bleeding. C) Use effective contraceptive measures. D) Administer the drug one time per day.
C
A nurse is teaching a client about cimetidine. Which of the following are adverse effects of this medication? SELECT ALL THAT APPLY. A) Increased libido B) Insomnia C) Enlargement of breast tissue D) Confusion E) Decreased sperm count
C, D, E
A client has been prescribed omeprazole by the primary care provider. When questioned by the nurse about the client's perceived effectiveness of the prescribed omeprazole, the client states, "I think it's working quite well, and I've gotten in the routine of taking it every morning before breakfast." How should the nurse respond? A) "That's good, but remember that you shouldn't take it on days when you're not having any symptoms." B) "I'm glad it's working for you, but you'll probably find it works even better if you take it after eating." C) "That's great. If you find later that it's not working as well, you might want to try taking it at bedtime." D) "I'm glad to hear that. It sounds like you're taking it exactly like it should be taken."
D
A client is diagnosed with peptic ulcer disease complicated by H. pylori. What is the rationale for adding bismuth to the client's medication regimen? A) increases pepsin activity B) decreases gastrin secretion C) prevents metabolic alkalosis D) protects gastric mucosa from stomach acid
D
The client, recently diagnosed with peptic ulcer disease, states achieving adequate symptom relief with the use of over-the-counter (OTC) antacids but has asked the nurse about the optimal schedule for taking these drugs. What action should the nurse recommend? A) taking the drugs at the earliest appearance of symptoms B) immediately prior to each meal and at bedtime C) every 4 hours during all waking hours D) 1 hour and 3 hours after each meal and at bedtime
D
Which disease is a result of cellular destruction of the gastrointestinal tract resulting from regular nonsteroidal anti-inflammatory therapy? A) esophageal cancer B) bowel obstruction C) liver cancer D) peptic ulcer disease
D
The nurse is educating a client diagnosed with peptic ulcer disease about the prescribed medications aluminum hydroxide-magnesium hydroxide-simethicone mixture and ranitidine. Which statement made by the client indicates the need for further clarification? A) "Antacids should relieve my epigastric pain within minutes, and ranitidine peaks in 1 to 3 hours after taking it." B) "To decrease interactions with other drugs I take, I will take the drug 30 minutes before taking the rest of my meds." C) "I will eat fresh fruits and whole grains and drink 2 to 3 L of fluids every day to prevent constipation." D) "I will set a timer to remind me when to take the Mylanta doses since it is important to take it exactly as prescribed."
B
The nurse practitioner instructs the client to use over-the-counter ranitidine instead of cimetidine. What risk is decreased when using ranitidine rather than cimetidine? A) headache B) drug-to-drug interaction C) diarrhea D) bradycardia
B
The nurse should be aware that ranitidine achieves a therapeutic effect by which mean? A) raising the pH of gastric secretions B) inhibiting the secretion of gastric acid C) binding to proton pumps D) decreasing gastric motility
B
