Chapter 43: antiulcer drugs

The patient presents to the clinic with complaints of gnawing abdominal pain that occurs approximately 1 hour after eating. "I have tried everything, and it just won't stop". He has been diagnosed with an ulcer. The halth care provider prescribed nizatidine (Axid). What priority information should the nurse include in the teaching plan? Select all that apply. A. "Antacids should not be taken within 1 hour of taking your nizatidine." B. "Avoid alcoholic beverages and caffeine" C. "Eating small, frequent meals may be helpful" D. "This medication should be taken with meals and at bedtime" E. "You will need to take this for the rest of your life"

A, B, C

Which medication(s) will concern the nurse if prescribed for a patient who is taking esomeprazole? Select all that apply. A. Ampicillin B. Digoxin C. Ketoconazole D. Lisinopril E. Propranolol

A, B, C

Which drug(s) may be used in the treatment of ulcers? Select all that apply. A. Antibiotics B. Anticholinergics C. Antacids D.Histamine2 blockers E. Opiates F. Proton pump inhibitors

A, B, C, D, F

What priority information regarding nonpharmacologic treatment can the nurse provide in the health education plan to a patient who has been diagnosed with GERD? Select all that apply. A. decrease or stop smoking B. elevate the head of the bed C. Increase fluid intake D. NSAID's should be taken with food E. Spicy foods should be avoided

A, B, D, E

Which side effect(s) of ranitidine will the nurse monitor for in the patient? Select all that apply. A. Confusion B. Headache C. Hypertension D. Loss of libido E. Nausea

A, B, D, E

A patient who recently began having mild symptoms of GERD is reluctant to take medication. What measures will the nurse recommend to minimize this patient's symptoms? (Select all that apply.) a. Avoiding hot, spicy foods b. Avoiding tobacco products c. Drinking a glass of red wine with dinner d. Eating a snack before bedtime e. Taking ibuprofen with food f. Using a small pillow for sleeping g. Wearing well-fitted clothing

A, B, E

The patient has been diagnosed with an ulcer caused by H. pylori. Which drug(s) is/are likely to be used for treatment? Select all that apply. A. Amoxicillin B. Clarithromycin C. Famotidine D. Misoprostol E. Omeprazole

A, B, E

A patient is taking famotidine to inhibit gastric secretions. Which side effects of famotidine will the nurse teach the patient? Select all that apply. A. Dizziness B. Headaches C. Hypokalemia D. Hyperkalemia E. Blurred vision F. Erectile dysfunction

A, B, F

A patient has been diagnosed with erosive GERD. Which medication is likely to have the highest success rate? A. Esomeprazole B. Lasoprazole C. Omeprazole D. Rabeprazole

A. Esomeprazole

A patient is diagnosed with peptic ulcer disease. The nurse realizes that which of these is a predisposing factor for this condition? A. helicobacter pylori B. Hyposecretion of pepsin C. Decreased hydrochloric acid D. E. coli

A. helicobacter pylori

The patient has started taking an OTC antacid for "heartburn". He asks the nurse what is the best time to take it so it is the most effective. What is the best answer? A. 1-hour before meals B. 1-3 hours after meals and at bedtime C. With meals and at bedtime D. With meals and 1 hour after

B. 1-3 hours after meals and at bedtime

The patient presents to the clinic with a sore throat. He tells the nurse, "I just feel like a fire-breathing dragon. It is awful when I go to bed." He has been diagnosed with GERD. What medication(s) does the nurse know is/are used to treat GERD? Select all that apply. A. Antacids B. Anticholinergics C. Histamine2 blockers D. Pepsin inhibitors E. Proton pump inhibitors

C, E

A patient is taking ranitidine. What information should the nurse teach the patient about this drug? Select all that apply. A. Drug-induced erectile dysfunction is reversible B. The drug must be administered 30 minutes before meals C. The drug must be administered separately from an antacid by at least 1 hour D. The drug must always be administered with magnesium hydroxide E. Smoking should be avoided while taking this drug F. Foods high in vitamin b12 should be increased in the diet

C, E, F

The patient is taking high-dose NSAID therapy for arthritis. She is also taking sucralfate. What laboratory value would concern the nurse? A. Hgb 14.1 gm/dL B. Potassium 4.2 mEq/L C. Blood glucose 185 mg/dL D. INR 1.1

C. Blood glucose 185 mg/dL

The patient is taking esomeprazole magnesium for erosive gastroesophageal reflux disease. Which should the nurse include in teaching the patient? A. take the medication daily with breakfast B. Healing should occur in 1 week C. This medication decreases stomach acid secretion D. A blood test to check kidney function should be done

C. This medication decreases stomach acid secretion

When a patient complains of pain accompanying a peptic ulcer, why should the nurse give an antacid? A. Antacids decrease gastrointestinal motility B. Antacids decrease gastric acid secretion C. Antacids strengthen the lower esophageal sphincter's action D. Antacids neutralize hydrochloric acid and reduce pepsin activity

D. Antacids neutralize hydrochloric acid and reduce pepsin activity

The patient has been diagnosed with peptic ulcer disease and has been on propanthelin bromide (Pro-banthine) 15 mg t.i.d. 30 minutes before meals and 30 mg at bedtime. How does propantheline bromide work? A. It blocks H2 receptors B. It coats the lining of the stomach C. It increases gastric motiility D. It inhibits gastric secretions

D. It inhibits gastric secretions

A student nurse is preparing to administer sucralfate to a patient. Which statement made by the student nurse demonstrates understanding of sucralfate's mode of action? A. Sucralfate neutralizes gastric acid B. Gastric acid secretion is decreased by inhibiting histamine at histamine2 receptors in parietal cells C. Gastric acid secretion is suppressed by inhibiting the hydrogen/potassium ATP eenzyme. D. Sucralfate combines with protein to form a viscous substance that forms a protective covering over the ulcer.

D. Sucralfate combines with protein to form a viscous substance that forms a protective covering over the ulcer.

With how many ounces of water should a patient take a liquid antacid for best results? a. 2-4 b. 4-6 c. 6-8 d. 8 or more

a. 2-4

The nurse is caring for a patient who has Zollinger-Ellison syndrome. Which medication order would the nurse question for this patient? a. Cimetadine (Tagamet) b. Pantoprazole (Protonix) c. Rabeprazole (Aciphex) d. Ranitidine (Zantac)

a. Cimetadine (Tagamet)

A patient who takes propantheline bromine (Pro-Banthine) and omeprazole (Prilosec) for an ulcer will begin taking an antacid. The nurse will give which instruction to the patient regarding how to take the antacid? a. Take the antacid 2 hours after taking the propantheline. b. Take the antacid along with a meal. c. Take the antacid with milk. d. Take the antacid with the propantheline bromine.

a. Take the antacid 2 hours after taking the propantheline.

A patient is taking esomeprazole (Nexium) 15 mg per day to treat a duodenal ulcer. After 10 days of treatment, the patient reports that the pain has subsided. The nurse will counsel the patient to a. continue the medication for 4 more weeks. b. reduce the medication dose by half. c. stop taking the medication. d. take the medication every other day.

a. continue the medication for 4 more weeks.

Which antacid is likely to cause acid rebound? a. Aluminum hydroxide b. Calcium carbonate c. Magnesium hydroxide d. Magnesium trisilicate

b. Calcium carbonate

A male patient who has been taking a histamine2 blocker for several months reports decreased libido and breast swelling. What will the nurse do? a. Contact the provider to report possible drug toxicity. b. Reassure the patient that these symptoms will stop when the drug is discontinued. c. Request an order for serum hormone levels. d. Suggest that the patient see an endocrinologist.

b. Reassure the patient that these symptoms will stop when the drug is discontinued.

A patient who has been instructed to use a liquid antacid medication to treat gastrointestinal upset asks the nurse about how to take this medication. What information will the nurse include when teaching this patient? a. Take a laxative if constipation occurs. b. Take 60 minutes after meals and at bedtime. c. Take with at least 8 ounces of water to improve absorption. d. Take with milk to improve effectiveness.

b. Take 60 minutes after meals and at bedtime.

A patient with a peptic ulcer has been diagnosed with H. pylori. The provider has ordered lansoprazole (Prevacid), clarithromycin (Biaxin), and metronidazole (Flagyl). The patient asks the nurse why two antibiotics are needed. The nurse will explain that two antibiotics a. allow for less toxic dosing. b. combat bacterial resistance. c. have synergistic effects. d. improve acid suppression.

b. combat bacterial resistance.

A patient reports experiencing flatulence and abdominal distension to the nurse. Which over-the-counter medication will the nurse recommend? a. Alka-Seltzer b. Maalox c. Mylicon d. Tums

c. Mylicon

A patient who is diagnosed with peptic ulcer disease has been started on a regimen that includes ranitidine (Zantac) 300 mg daily at bedtime. The patient calls the clinic 1 week later to report no relief from discomfort. What action will the nurse take? a. Contact the provider to discuss changing to cimetidine (Tagamet). b. Notify the provider to discuss increasing the dose. c. Reassure the patient that the drug may take 1 to 2 weeks to be effective. d. Suggest that the patient split the medication into twice daily dosing.

c. Reassure the patient that the drug may take 1 to 2 weeks to be effective

A patient who has been taking ranitidine (Zantac) continues to have pain associated with peptic ulcer. A noninvasive breath test is negative. Which treatment does the nurse expect the provider to order for this patient? a. Adding an over-the-counter antacid to the patient's drug regimen b. A dual drug therapy regimen c. Amoxicillin (Amoxil), clarithromycin (Biaxin), and omeprazole (Prilosec) d. Lansoprazole (Prevacid) instead of ranitidine

d. Lansoprazole (Prevacid) instead of ranitidine

An elderly patient reports using Maalox frequently to treat acid reflux. The nurse should notify the patient's provider to request an order for which laboratory tests? a. Liver enzymes and serum calcium b. Liver enzymes and serum magnesium c. Renal function tests and serum calcium d. Renal function tests and serum magnesium

d. Renal function tests and serum magnesium

A patient has been taking famotidine (Pepcid) 20 mg bid to treat an ulcer but continues to have pain. The provider has ordered lansoprazole (Prevacid) 15 mg per day. The patient asks why the new drug is necessary, since it is more expensive. The nurse will explain that lansoprazole a. can be used for long-term therapy. b. does not interact with other drugs. c. has fewer medication side effects. d. is more potent than famotidine.

d. is more potent than famotidine.

The nurse is caring for a patient who will begin taking omeprazole (Prevacid) 20 mg per day for 4 to 8 weeks to treat gastroesophageal reflux disease esophagitis. The nurse learns that the patient takes digoxin. The nurse will contact the provider for orders to a. decrease the dose of omeprazole. b. increase the dose of digoxin. c. increase the omeprazole to 60 mg per day. d. monitor for digoxin toxicity.

d. monitor for digoxin toxicity.

A patient who has symptoms of peptic ulcer disease will undergo a test that requires drinking a liquid containing 13C urea and breathing into a container. The nurse will explain to the patient that this test is performed to a. assess the level of hydrochloric acid. b. detect H. pylori antibodies. c. measure the pH of gastric secretions. d. test for the presence of 13CO2.

d. test for the presence of 13CO2.