Ch 41 Peptic Ulcer Disease Questions

-Decreased belching -Decreased nausea -Decreased dysphasia

A 35 year old male patient has been prescribed Omeprazole for treatment of gastroesophageal reflux disease. Which of the following assessment findings would assist the nurse to determine whether the drug therapy has been effective? -Decreased "gnawing" upper abdominal pain on an empty stomach -Decreased belching -Decreased appetite -Decreased nausea -Decreased dysphagia

-The client reports that his mother and grandfather both had ulcers -The client reports drinking several cups of coffee every morning

A client comes to the clinic with report of intermittent epigastric pain that is associated with meals. The nurse would review the client's medical record and assess for the presence of which risk factors for peptic ulcer disease (PUD)? Select all that apply. -The client reports that his mother and grandfather both had ulcers. -The client has type AB blood. -The client reports drinking several cups of coffee every morning. -The client reports mild to moderate job and family stress. -The client tested positive for influenza A.

-You may notice constipation as an effect of this drug -Take this medication at least 2 hours before or after any other medication you are taking

A client has been prescribed aluminum hydroxide (AlternaGEL) for the treatment of heartburn. Which information should the nurse plan to teach this client? Select all that apply. -You should expect this medication to take up to 2 days to start taking effect. -Take this medication with a glass of milk. -You may notice constipation as an effect of this drug. -Take this medication at least 2 hours before or after any other medication you are taking. -This medication will reduce the acid your stomach produces.

-Take this medication after your meal -This drug will not work as well if you continue smoking

A client has been prescribed ranitidine (Zantac). The nurse plans to include which information in the teaching plan for this client? Select all that apply. -You should experience symptom relief in 10 to 15 minutes after taking this drug. -Take this medication after your meal. -Take this medication first thing in the morning, before breakfast. -This drug will not work as well if you continue smoking. -If you experience confusion, discontinue the drug and call for an appointment.

-Burning pain several hours after eating a meal

A client is admitted for treatment of a duodenal ulcer. What will the nurse's admission assessment likely reveal? -Nausea and lower right quadrant abdominal pain -Burning pain several hours after eating a meal -Anorexia and weight loss -Low back pain radiating down the left leg

-Increased risk of osteopenia

A client who has gastroesophageal reflux disease (GERD) has been taking proton pump inhibitors (PPIs) for many years. The nurse discusses which potential complication of this long-term therapy? -Increased risk of anemia -Increased risk of osteopenia -Increased risk of hypertension -Increased risk of intestinal irritation

-Consult with the healthcare provider about the appropriate amount and type of antacid

A female patient reports using OTC aluminum hydroxide for relief of gastric upset. She is on renal dialysis three times a week. What should the nurse teach the patient? -Continue using the antacids but if she needs to continue them beyond a few months, she should consult the health care provider about different therapies. -Take the antacid no longer than for two weeks; if it has not worked by then, it will not be effective. -Consult with the health care provider about the appropriate amount and type of antacid. -Continue to take the antacid; it is OTC and safe.

-Treat diarrhea with over-the-counter antidiarrheal drugs -Increase intake of active culture yogurt

A patient being treated for GERD has increased risk for development of infection with Clostridium difficile. The nurse would include which information in this patient's teaching? Select all that apply. -Report any episode of diarrhea. -Treat diarrhea with over-the-counter antidiarrheal drugs. -Increase intake of active culture yogurt. -Avoid fatty foods. -Increase fluid intake.

-"The damage to your esophagus may result in esophagitis." -"Long-term exposure to acid increases risk for esophageal cancer."

A patient who has been diagnosed with GERD is reluctant to make suggested lifestyle changes. What information about GERD should the nurse provide?Note: Credit will be given only if all correct choices and no incorrect choices are selected.Standard Text: Select all that apply. -"The damage to your esophagus may result in esophagitis." -"Long-term exposure to acid increases risk for esophageal cancer." -"Without lifestyle changes, the medications will be totally ineffective." -"The lifestyle changes are not so bad if you adopt them one at a time and institute them gradually." -"You will have trouble swallowing if you do not treat this condition."

-Peptic ulcer

An erosion of the mucosal layer of the stomach or duodenum describes a -diverticulum -Chron's lesion -hiatal hernia -peptic ulcer

-Ask the client's wife for a list of medications that the client has taken

An older adult client comes to the emergency department with his wife. He has a history of peptic ulcer disease (PUD) and is currently experiencing confusion and severe headaches. What does the best plan by the nurse include? -Ask the client if he has experienced any head injuries recently. -Obtain a complete blood count (CBC), chemistry profile, and urine drug screen. -Ask the client's wife for a list of medications that the client has taken. -Obtain a magnetic resonance imaging (MRI) exam to assess if the client has experienced a stroke.

-Check with his healthcare provider about his continued discomfort

In taking a new patients history, the nurse notices that he has been taking Omeprazole consistently over the past 6 months for treatment of epigastric pain. Which recommendation would be the best for the nurse to give this patient? -Try switching to a different form of the drug -Try a drug like cimetidine (Tagamet) or famotidine (Pepcid) -Try taking the drug after meals instead of before meals -Check with his healthcare provider about his continued discomfort

If there is a decrease in acid reflux and/or abdominal pain. Same as Ranitidine

How would you assess if therapy with a PPI, such as Omeprazole is effective?

If there is a decrease in acid reflux and/or abdominal pain. Same as Omeprazole

How would you assess if therapy with an H2RA, such as Ranitidine, is effective?

-You will be tested for the presence of H. pylori -You may be directed to take Pepto-Bismol along with your other medications -You should plan on taking medication for 4 to 8 weeks -There are some lifestyle changes you can take to make therapy more successful

It is suspected that a client has developed peptic ulcer disease (PUD). Which information should the nurse provide this client regarding projected course of treatment? Select all that apply. -You will be started on an antibiotic. -You will be tested for the presence of H. pylori. -You may be directed to take Pepto-Bismol along with your other medications. -You should plan on taking medication for 4 to 8 weeks. -There are some lifestyle changes you can take to make therapy more successful.

-A combination of lifestyle changes and pharmacotherapy

Peptic ulcer disease is treated primarily with -pharmacotherapy -exercise -a combination of lifestyle changes and pharmacotherapy -diet

-Decrease the amount of gas associated with GI disorders

Simethicone (Gas-X, Mylicon) may be added to some medications or given plain for what therapeutic effect? -Decrease the amount of gas associated with GI disorders. -Increase the acid-fghting ability of some medications. -Prevent constipation associated with gastrointestinal drugs. -Prevent diarrhea associated with gastrointestinal drugs

-The client reports episodes of melena

The client receives H2-receptor antagonists for treatment of peptic ulcer disease (PUD). Which assessment finding should be reported immediately to the physician? -The client reports he is constipated. -The client reports pain after 24 hours of treatment. -The client reports episodes of melena. -The client reports he took the antacid Tums with his H2-receptor antagonist.

-"It decreases acid in your stomach better than cimetidine (Tagamet)."

The client receives esomeprazole (Nexium). He asks the nurse why that medication is better than his cimetidine (Tagamet). What is the best response by the nurse? -"It is about the same but a lot cheaper than your cimetidine (Tagamet)." -"It decreases acid in your stomach better than cimetidine (Tagamet)." -"It is about the same but has fewer side effects than your cimetidine (Tagamet)." -"It is not as effective as cimetidine (Tagamet) but kills bacteria better."

-"It increases mucus production in your stomach."

The client receives misoprostol (Cytotec) for treatment of peptic ulcer disease (PUD). The client asks the nurse why he is receiving this medication. What is the best response by the nurse? -"It dissolves into a gel and sticks to your ulcer." -"It increases mucus production in your stomach." -"It inhibits bacterial growth." -"It neutralizes stomach acid."

-Those with diminished renal function -People who are on sodium-restricted diets

The nurse is presenting community education regarding self-treatment of heartburn with antacids. As part of this discussion, the nurse advises people with which conditions to avoid antacids? Select all that apply. -People with low calcium levels. -Those with diminished renal function. -Women who are peri menopausal. -People who are on sodium-restricted diets. -People with coronary artery disease.

A

The nurse is using this diagram to teach a patient about GERD. Which spot would the nurse identify as the cardiac sphincter?

-Reduce acid secretion in the stomach

The mechanism of the action of proton pump inhibitors is to -neutralize acid -reduce acid secretion in the stomach -block H2 receptors in the stomach -decrease infection

-"This works by dissolving into a jelly and sticking to my ulcer."

The nurse completes medication education for the client receiving sucralfate (Carafate). The nurse evaluates that learning has occurred when the client makes which statement? -"This works by inhibiting bacterial growth in my stomach." -"This works by dissolving into a jelly and sticking to my ulcer." -"This works by decreasing the amount of acid in my stomach." -"This works by neutralizing the acid in my stomach."

-Omeprazole (Prilosec) should not be crushed or chewed. -Omeprazole (Prilosec) should be administered before meals.

The nurse designs a plan of care for the client with peptic ulcer disease (PUD) who is taking omeprazole (Prilosec) for the management of his illness. What will the best plan by the nurse include? Select all that apply. -Omeprazole (Prilosec) should not be crushed or chewed. -Omeprazole (Prilosec) is best taken with yogurt. -Omeprazole (Prilosec) is recommended for long-term treatment of peptic ulcer disease (PUD). -Omeprazole (Prilosec) should be administered before meals. -Omeprazole (Prilosec) should be administered after meals.

-"I will limit my intake of caffeine products."

The nurse has completed education about peptic ulcer disease (PUD) with the client. The nurse evaluates that learning has occurred when the client makes which statement? -"I will limit my intake of caffeine products." -"I will take ibuprofen (Motrin) for my headaches." -"I will drink more milk and limit spicy foods." -"I will join a gym and increase my exercise."

-About 30 minutes before her morning meal

The nurse is assisting the older adult diagnosed with a gastric ulcer to schedule her medication administration. What would be the most appropriate time for this patient to take her lansoprazole? -About 30 minutes before her morning meal. -At night before bed. -After fasting at least 2 hours. -30 minutes after each meal.

-Low iron levels

The nurse is aware that antacids containing aluminum can cause -low iron levels -abdominal pain -constipation -indigestion

-Amoxicillin

The nurse is caring for a patient with gastroesophageal reflux disease and would question an order for which of the following? -Amoxicillin (Amoxil) -Ranitidine (Zantac) -Pantoprazole (Protonix) -Calcium carbonate (Tums)

-"I was surprised at how quickly my symptoms went away after I started taking the medications and following the lifestyle changes." -"My previous doctor said my ulcer was completely healed."

The nurse is collecting information from a patient who has history of peptic ulcer disease (PUD). The nurse will evaluate that the goals of therapy for PUD have been met when the patient makes which statements? Select all that apply. -"I was surprised at how quickly my symptoms went away after I started taking the medications and following the lifestyle changes." -"My PUD comes back once in a while if I am under a lot of stress." -"My previous doctor said my ulcer was completely healed." -"I still have to be very careful about what I eat." -"As long as I do not lay down for a couple of hours after I eat, I have no problems."

-Administer antacids at least 2 hours before other oral medications

The nurse planning medication administration instruction for a client receiving antacids should consider including which information? -Antacids can be safely administered with H2-receptor medications. -Antacids can be safely administered with antibiotics. -Administer antacids at least 2 hours before other oral medications. -Lie down for 30 minutes after taking antacids.

-"Intrinsic factor is necessary for absorption of vitamin B12

The nursing instructor teaches the student nurses about intrinsic factor. The instructor evaluates that learning has occurred when the students make which response? -"Intrinsic factor is secreted by the chief cells of the stomach." -"Intrinsic factor is necessary for absorption of vitamin B6." -"Intrinsic factor aids in the secretion of mucus to protect the stomach." -"Intrinsic factor is necessary for absorption of vitamin B12

-"The medicine you are on for GERD changes you gastric pH." -"You may be more susceptible to respiratory infection while taking this medication."

The patient being treated for GERD says, "I seem to have so many colds and coughs now." How should the nurse respond to this statement? Select all that apply.1. "Be sure to get your flu shot."2. "The medicine you are on for GERD changes your gastric pH."3. "You need to avoid crowds until your GERD is under control."4. "You may be more susceptible to respiratory infection while taking this medication."5. "You may be having an allergic reaction to your medicine."

-"Bismuth (Pepto-Bismol) is effective for inhibiting bacterial growth." -"Bismuth (Pepto-Bismol) keeps bacteria from sticking in your stomach."

The physician has ordered bismuth (Pepto-Bismol) for the client with a peptic ulcer who is colonized with H. pylori. The client asks the nurse why he is receiving this drug. What is the best response by the nurse? Select all that apply. -"Bismuth (Pepto-Bismol) increases stomach acid to help kill bacteria." -"Bismuth (Pepto-Bismol) helps prevent the side effects of antibiotics." -"Bismuth (Pepto-Bismol) is effective for inhibiting bacterial growth." -"Bismuth (Pepto-Bismol) keeps bacteria from sticking in your stomach." -"Bismuth (Pepto-Bismol) helps relieve ulcer-related constipation."

-Combination therapy has the best outcomes when antibiotics are used with proton-pump inhibitors

The physician has ordered combination therapy for the client with peptic ulcer disease (PUD) who tested positive for H. pylori. The nurse plans to do medication education. What will the best plan by the nurse include? -Combination therapy has the best outcomes when antibiotics are used with antacids. -Combination therapy has the best outcomes when antibiotics are used with proton-pump inhibitors. -The use of sucralfate (Carafate) along with antibiotics is the best combination therapy for peptic ulcer disease (PUD). -Various antibiotics are used to eradicate the bacteria that are responsible for the development of peptic ulcer disease (PUD).

-"Are you pregnant?"

The physician orders misoprostol (Cytotec) for the female client with peptic ulcer disease (PUD). What is a priority question for the nurse to ask the client prior to administration of this medication? -"Do you plan on becoming pregnant?" -"Are you sexually active?" -"Are you pregnant?" -"Are your menstrual cycles irregular?"

-Reduce gastric acid secretions

The primary goal in treatment of gastroesophageal reflux disease is to -promote ulcer healing -prevent infection -reduce gastric acid secretions -decrease stomach pain

-Small intestine

The pyloric sphincter regulates flow of food into the -small intestine -stomach -esophagus -rectum

constipation with regular or high high doses; phosphate depletion with long-term doses

What adverse effects should you teach your patients about when prescribed frequent, high, or long term doses of Aluminum based antacids?

Zollinger-Ellison Syndrome

What syndrome is Omeprazole the best treatment for?

20-30 minutes before first major meal of the day

When is the best time to take PPIs?