Pharm 154 Prep U Practice Quiz 5
A patient is in the intensive care unit and being administered ranitidine (Zantac) parenterally. How long will it take for ranitidine (Zantac) to reach peak blood levels?
15 minutes
A nurse is teaching a client about omeprazole, which has been prescribed as part of a regimen to treat an H. pylori infection. What statement, made by the client, suggests that the client understands proper use of the drug?
"I need to swallow the drug whole."
After teaching a client who is receiving sucralfate about the drug, which statement indicates that the teaching has been successful?
"I should eat a high-fiber diet."
A female client is prescribed ranitidine in addition to the antacid that she already takes for gastric reflux. Which statement made by the client indicates that she understood the teaching provided about taking these medications?
"I should take ranitidine 2 hours before or after my antacid dosage."
Which statement by a patient receiving pancrelipase indicates that the patient has understood his instructions?
"I should take the drug with meals and snacks."
A 60-year-old man has scheduled a follow-up appointment with his primary care provider stating that the omeprazole (Prilosec) which he was recently prescribed is ineffective. The client states, "I take it as soon as I feel heartburn coming on, but it doesn't seem to help at all." How should the nurse best respond to this client's statement?
"Prilosec will help your heartburn but it's not designed to provide immediate relief of specific episodes of heartburn."
A woman with numerous chronic health problems has been diagnosed with a benign gastric ulcer has begun treatment with ranitidine (Zantac). Which of the following teaching points should the nurse provide to this patient?
"Quitting smoking will significantly increase the chance that this drug will heal your ulcer."
A female client has GERD and is taking ranitidine (Zantac). She continues to have gastric discomfort and asks whether she can take an antacid. Which is an appropriate response by the nurse?
"Yes, but be sure to wait at least 2 hours to take the antacid after you take the ranitidine."
A patient is prescribed a proton pump inhibitor to treat erosive gastritis. How soon will the patient's symptoms be abolished?
1-2 weeks
When describing proton pump inhibitors, which would be appropriate to include?
Acid labile
A client has been prescribed 200 micrograms of misoprostol to be taken 4 times a day orally for the prevention of gastric ulcers. The drug is available in 100 microgram tablets. How many tablets should the nurse administer to the client each time?
2 tablets
The nursing instructor is discussing the use of histamine2 receptor antagonists in the treatment of peptic ulcer disease. According to the instructor, which is a typical dosing schedule of famotidine during the first few weeks of treatment for gastric ulcer in patients with normal renal function?
20 mg bid
A client is receiving sucralfate. The nurse understands that this drug would begin to act within which time frame?
30 minutes
Which client is at risk for the development of an acute ulcer?
A client on a mechanical ventilator for 5 days A client with 2nd degree burns over 50% of the body A client who experienced a stroke A client who is diagnosed with jaundice
An 86-year-old client has been prescribed ranitidine (Zantac). The nurse knows that an older adult who takes H2RAs may experience what adverse effect?
Agitation
When describing the possible adverse effects associated with omeprazole therapy, which of the following would the nurse identify as least common?
Alopecia
Following an endoscopy, a 66-year-old man has been diagnosed with a duodenal ulcer resulting from Helicobacter pylori infection. Which medication will likely be used in an attempt to eradicate the patient's H. pylori infection?
Antibiotics A PPI
When educating a client prescribed a histamine-2 antagonists, which of the following should be avoided?
Caffeine Alcohol Cigarettes
Which agent is associated with antiandrogenic effects?
Cimetidine
Which agent would a nurse identify as the prototype histamine-2 receptor antagonist?
Cimetidine
Which would a nurse anticipate as having antiandrogenic effects?
Cimetidine
A nurse is caring for an elderly patient who has been administered cimetidine. Which intervention should the nurse perform?
Closely monitor the patient for confusion and dizziness.
A client is receiving sodium bicarbonate orally. Which of the following would lead the nurse to suspect that the client is developing systemic alkalosis?
Confusion Headache Tetany Irritability
A group of students are reviewing the signs and symptoms of systemic alkalosis that can occur as a result of using sodium bicarbonate. The students demonstrate a need for additional teaching when they identify which as a possible manifestation?
Constipation
The nurse should warn a client taking aluminum- and calcium-containing antacids about which adverse effects?
Constipation
A clinic nurse is planning care for a 68-year-old man who has been on omeprazole (Prilosec) therapy for heartburn for some time. Regarding the patient's safety, which of the following would be a priority nursing action?
Coordinate bone density testing for the patient.
The nurse is caring for a client diagnosed with cancer. The nurse should perform which assessment(s) for safe administration of the ondansetron?
Determine if the client takes any antidepressants or antipsychotic drugs for possible interactions. Assess if the client has any nausea or vomiting, and if so the number of episodes and amount of vomitus. Obtain baseline vital signs and renal profile with electrolytes at baseline to compare with later labs.
A female client self-administers magnesium antacids. She presents to the office with symptoms of dizziness and weakness. The nurse knows that these symptoms are secondary to what common adverse effect of magnesium antacids?
Diarrhea
The nurse instructs the patient to use over-the-counter ranitidine (Zantac) instead of cimetidine (Tagamet). What risk is decreased when using ranitidine over cimetidine?
Drug-to-drug interaction
In preparing a teaching plan for a patient who is to receive misoprostol, which would the nurse include as possible adverse effects?
Dysmenorrhea Excessive vaginal bleeding Dyspepsia Flatulence
The nurse is preparing a teaching plan for a patient who is receiving sucralfate. Which would the nurse need to address?
Ensuring safety precautions Eating a high fiber diet Taking the drug on an empty stomach Encouraging frequent mouth care
Which H-2 antagonist would the nurse identify as most potent?
Famotidine
A female client comes to the clinic with reports of burning pain in the stomach. She states that she thinks she had a virus 48 hours ago and she vomited many times. She hasn't vomited in 24 hours. She asks the health care provider to give her a prescription for omeprazole because she saw an ad on TV that said it would heal stomach pain. The nurse assists the client in understanding that PPIs are considered drugs of choice for treatment of what conditions?
Gastric ulcers Zollinger-Ellison syndrome Duodenal ulcers
Which adverse effect is more likely to be caused by cimetidine than by other H2RAs?
Gynecomastia
The health care provider has prescribed ranitidine for a hospitalized client on a unit. Prior to administering the drug for the first time, which adverse effects should the nurse mention to the client?
Headache
Carter, age 2, is diagnosed with cystic fibrosis; the physician places him on pancrelipase. What would be the most appropriate diagnosis for Carter related to his medication regimen?
Imbalanced nutrition: less than body requirements, related to impaired digestion secondary to insufficient pancreatic enzymes
The nurse is caring for a client who has been prescribed sucralfate for treatment of peptic ulcer disease. Which nursing diagnosis may relate specifically to administration of this medication?
Impaired Bowel Elimination: Constipation
A client arrives at the walk-in clinic reporting vomiting and a burning sensation in the midepigastric region. The nurse suspects that the client has peptic ulcer disease. Which is a potential cause of peptic ulcer disease?
Infection with H. pylori
The nurse should explain that metoclopramide (Reglan) decreases nausea and vomiting by which of the following actions?
Inhibiting stimulation of the vomiting center in the brain
Mr. Palmer is scheduled to receive ranitidine at 9:00 am this morning. What is a correct explanation of the pharmacodynamics of ranitidine?
It inhibits both daytime and nocturnal basal gastric acid secretions as well as gastric acid secretion.
A nurse is preparing to administer a prostaglandin drug used to reduce the risk of NSAID-induced gastric ulcers in high-risk clients, such as the elderly or the critically ill. Which medication will the client administer?
Misoprostol
A client is diagnosed with peptic ulcer due to H. pylori. The nurse would anticipate administering which agent in conjunction with an antibiotic?
Omeprazole
A nurse is reviewing information about proton pump inhibitors. The nurse recognizes that which of the following is available as an over-the-counter agent?
Omeprazole
After teaching a group of students about proton pump inhibitors, the instructor determines that the students have understood the information when they identify which agent as the prototype proton pump inhibitor?
Omeprazole
Which of the following would a nurse expect as most likely to be used in combination with antibiotics for treatment of Helicobacter pylori infection?
Omeprazole
Which of the following drugs are commonly used in combination with certain antibiotics in the treatment of H. pylori? Select all that apply:
Omeprazole (Prilosec) Lansoprazole (Prevacid)
A client is prescribed misoprostol. The nurse would expect to administer this drug by which route?
Oral
A 35-year-old man is at his follow-up visit for GERD. Antacids have not been effective for his reflux, and the health care provider is prescribing a proton pump inhibitor. Why might the provider prescribe a PPI rather than an H2RA?
PPIs suppress acid more strongly and for a longer time.
A client is taking nonsteroidal anti-inflammatory agents for arthritis of the knees and hips. Which disease is a result of cellular destruction of the gastrointestinal tract from this medication?
Peptic ulcer disease
An older client has been prescribed a proton pump inhibitor. When addressing the medication's effect on nutrient absorption and the resulting risks, which medical condition should the nurse discuss with the client?
Pernicious anemia
A female client is self-administering cimetidine. What is the home care nurse's most important assessment of this client?
Potential drug-drug interactions
Which agent would a nurse identify as inhibiting the secretion of gastrin?
Prostaglandin
Which of the following best reflects the rationale for using histamine-2 receptor antagonists for stress ulcer prophylaxis?
Protects the stomach lining via acid blockage
A client is diagnosed with Helicobacter pylori infection. The health care provider will order amoxicillin and what other type of medication?
Proton pump inhibitors
A nurse educating a client on the antacid calcium carbonate (Mylanta) should warn the client of which of the following adverse reactions?
Rebound hyperacidity headache confusion
A 32-year-old female executive comes to the clinic with severe heartburn. The health care provider prescribes omeprazole (Prilosec). The client asks the nurse when the pain will go away. What is an appropriate response by the nurse?
Recommended time for therapy is usually between 2 and 8 weeks.
The client has Maalox ordered for administration before meals. Which condition is contraindicated with the administration of Maalox?
Renal dysfunction
A nurse in a health care facility is caring for a patient who is administered milk of magnesia to control constipation. Which nursing diagnosis should the care plan for this patient include?
Risk for imbalanced fluid volume
A nurse is caring for a patient who is prescribed omeprazole for a duodenal ulcer. The patient is also taking benzodiazepines for the management of a seizure disorder. Which of the following should be the effect of the interaction between these two drugs?
Risk for toxic level of benzodiazepines
The following data identified during a nursing assessment and interview. When considering risks for the development of a peptic ulcer, which situation should the nurse discuss with the client?
Self medicates with a nonsteroidal anti-inflammatory drug (NSAID) daily.
A 75-year-old client is treating an ulcer with antacids. Based on the client's age, the nurse expects the health care provider to prescribe a dose of antacid that compares with the average prescribed dose in what way?
Smaller than the average prescribed dose
Which antacids would the nurse identify as being contraindicated in clients with heart failure?
Sodium bicarbonate
A woman is prescribed a Histamine-2 (H2) antagonists. What information should the nurse provide the client concerning the use of this class of medication if a pregnancy should occur?
The safety of these drugs during pregnancy had not been established.
A male client has liver disease and is diagnosed with esophageal reflux. He asks the health care provider to prescribe PPIs. The nurse is aware that PPIs given in conjunction with liver disease may result in what issue for this client?
Transient elevations in liver function tests
Pancrelipase would most likely be used to treat a patient with cystic fibrosis.
True
What is the rationale for using two antimicrobials when treating a Helicobacter pylori infection?
Two antimicrobials are needed to prevent the emergence of drug-resistant H. pylori organisms.
A 30-year-old nonpregnant patient is prescribed misoprostol. Which of the following should the nurse instruct the patient as part of the teaching plan?
Use a reliable contraceptive.
A client is receiving pancrelipase. The nurse would expect to administer this drug at which time?
With meals and snacks
The nursing instructor is teaching students about proper administration of sucralfate. According to the instructor, sucralfate should be administered:
an hour before meals.
Misoprostol is a synthetic form of prostaglandin E prescribed to protect the gastric mucosa from erosion and ulceration. The drug is contraindicated in clients who:
are pregnant.
A 42-year-old man is being treated for a peptic ulcer with ranitidine (Zantac) taken PO at bedtime. Even though few adverse effects are associated with this drug, one common adverse effect that can be severe is:
headache
A 52-year-old man is suffering from a deficiency of exocrine pancreatic secretions and is prescribed pancrelipase (Pancrease MT). Before the medication therapy begins, the nurse will assess for allergies related to
pork.
The nurse is administering an H-2 receptor antagonist to a client with multiple burn trauma to prevent the development of stress ulcers based on the understanding that the drug:
provides protection of the stomach lining via acid blockage.
A client is prescribed ranitidine for the treatment of a peptic ulcer disease and gastric reflux. The dosage of this drug should be reduced if the client has:
renal disease
A client who takes aluminum hydroxide with magnesium hydroxide (Mylanta) frequently for upset stomach, heartburn, and sour stomach is seen regularly in the clinic. The nurse should assess:
serum phosphate level.
What is an effect of histamine release that is related to ulcer formation?
stimulates gastric acid secretion
A nurse is caring for a client experiencing stomach hyperacidity. The health care provider has prescribed aluminum carbonate gel. The nurse would administer this drug cautiously to the client with which condition?
upper GI bleeding
An older client has been prescribed omeprazole for the treatment of gastroesophageal reflux disease (GERD). What explanation should the nurse provide when asked by the client why they are not being treated with famotidine?
"Proton pump inhibitors, like omeprazole, produce fewer adverse effects among the older population."
Which instruction would be most important to give to a client who is receiving omeprazole?
"Swallow the tablet stole with a large glass of water."
A common drug regimen for eradication of H. pylori includes a proton pump inhibitor (PPI) and two antibiotics. What is one of the preferred antibiotics?
Amoxicillin
The nurse is caring for four clients. Which client would benefit most from misoprostol, a synthetic prostaglandin E analog?
An 83-year-old male with rheumatoid arthritis
An antacid has been added to the treatment regimen for a client on multiple medications. When is the best time for the nurse to administer the antacid?
At bedtime
The nurse should warn a client taking magnesium- and sodium-containing antacids about which adverse effects?
Diarrhea
Which of the following would a nurse expect to administer if the goal of therapy is to block the release of hydrochloric acid in the stomach?
Histamine-2 receptor antagonist
Which statement made by a client currently being treated for several medical conditions requires additional medication education by the nurse concerning the use of calcium salts?
I take an antacid with my morning medications to minimize their effect on my stomach
Which adverse reaction of proton pump inhibitors is specific to menopausal women with osteoporosis?
Increased fracture risk An increase in fractures of the hip, wrist, and spine have been seen in clients taking high doses of PPIs and undergoing treatment of osteoporosis with bisphosphonates.
A 75-year-old client is diagnosed with type 2 diabetes mellitus, hypertension, osteoporosis, and gastric ulcer disease. She is prescribed PPIs. The nurse is aware that long-term (greater than 1 year) administration of PPIs may lead to what problem for this client?
Increased risk for hip fractures
Ms. Law has been taking omeprazole for the last 10 years. What is the risk to the patient from long-term use of omeprazole?
Increased risk of gastric cancer
A nurse is preparing to administer a drug that reduces the secretion of gastric acid by inhibiting the action of histamine at H2 receptors in the stomach. Which medication might the nurse be preparing to administer?
Ranitidine (Zantac) Famotidine (Pepcid)
A female client presents to the health care provider's office with increasing stomach acidity. She self-administers calcium antacids. She notes that she seems to be having more issues with stomach acid, so she has been taking the calcium antacids more frequently. The nurse suspects that this may have caused what to occur in this client?
Rebound acidity
The nurse is scheduled to administer sucralfate 1 gram po four times daily to a pregnant client admitted with gastroesophageal reflux disease (GERD). What is the priority teaching that would be provided regarding this medication?
Take it an hour before the meal or bedtime
A nurse is planning care for a 59-year-old woman who is on ranitidine therapy. The nurse is concerned for the client's safety. What would be an appropriate nursing diagnosis?
Risk for Injury related to drug-induced somnolence, dizziness, confusion, or hallucinations
Ranitidine and cimetidine are both H2RAs used in the treatment of peptic ulcer disease. Of the two, ranitidine is preferred in critically ill clients because it is less likely to:
interfere with the metabolism of other drugs. Unlike cimetidine, ranitidine does not affect the cytochrome P450 drug-metabolizing system in the liver and therefore does not interfere with the metabolism of other drugs by that system.
A male client tells the nurse that he takes antacid tablets several times each day. Knowing that the brand of antacid he uses contains calcium carbonate, the nurse cautions the client that overuse could place him at risk for:
metabolic alkalosis.
A client is taking cimetidine (Tagamet) for increased gastric pain and hypersecretion. Nurses should use caution when administering cimetidine to those with which condition?
Hepatic disease