Pharm Chapter 57 - Drugs Affecting Gastrointestinal Secretions

a, b, c, e, f

Patients who use antacids frequently can be expected to experience which adverse effects? a. Systemic alkalosis b. Electrolyte imbalances c. Hypokalemia d. Metabolic acidosis e. Constipation or diarrhea f. Muscular weakness

a, b, d

Saliva substitute (Moi-Stir) may be useful in which circumstances? Select all that apply: a. Cancer radiation therapy b. Stroke c. Parkinson disease d. Brain injury e. Situational anxiety f. Hypertension

d

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? a. Some clients have taken omeprazole therapy as long as 5 years. b. Recommended time for therapy is usually between 2 and 8 weeks. c. Heartburn pain subsides within a few minutes of the first dose. d. Acid-inhibiting effects occur within 2 hours.

c

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 increase the risk for which problem for this client? a. Liver cancer b. Peptic ulcer disease c. Hip fractures d. Hypercalcemia

a

A client is prescribed a proton pump inhibitor to treat erosive gastritis. How soon will the client's symptoms be resolved? a. 1 to 2 weeks b. 6 weeks c. 10 weeks d. 12 weeks

a

A client is prescribed cimetidine for the treatment of a peptic ulcer disease and gastric reflux. The dosage of this drug should be reduced if the client has: a. renal disease. b. diabetes mellitus. c. pulmonary disease. d. migraine headaches.

oral

A client is prescribed misoprostol. The nurse would expect to administer this drug by which route? a. Oral b. Subcutaneous c. Transdermal d. Intravenous

d

A nurse caring for a patient receiving pancreatic enzymes as replacement therapy should be assessing the patient for a. hypertension. b. cardiac arrhythmias. c. excessive weight gain. d. signs of GI irritation.

D

An adult patient is prescribed cimetidine (Tagamet). A nurse will instruct the patient that an appropriate dosage and frequency of cimetidine is what? A) 20 mg PO b.i.d B) 150 mg PO b.i.d C) 300 mg PO at bedtime D) 800 mg PO at bedtime

a, b, d, e, f

Acid production in the stomach is stimulated by which factors? Select all that apply: a. Protein in the stomach b. Calcium products in the stomach c. High levels of acid in the stomach d. Alcohol in the stomach e. Low levels of acid in the stomach f. H2 stimulation

a

Acid rebound is a condition that occurs when: a. lowering gastric acid to an alkaline level stimulates the release of gastric acid. b. raising gastric acid levels causes heartburn. c. combining protein, calcium, and smoking greatly elevates gastric acid levels. d. eating citrus fruit neutralizes gastric acid.

A

After providing teaching to a patient prescribed lansoprazole (Prevacid), the nurse evaluates the patient understands the action of this medication when the patient makes what statement? A) The medication inhibits acid secretions. B) The medication is an antibiotic. C) The medication is an analgesic. D) The medication will promote healing of my ulcer.

d

After teaching a group of students about GI activity and constipation, the instructor determines that the teaching was successful when the students state which information about constipation? a. It results from increased peristaltic activity in the intestinal tract. b. It occurs primarily when one does not have a daily bowel movement. c. It leads to decreased salt and water absorption from the large intestine. d. It can be artificially induced by increasing the volume of the large intestine.

d

An older client has been prescribed omeprazole for the treatment of gastresophageal reflux disease (GERD). What explanation should the nurse provide when asked by the client why they are not being treated with famotidine? a. "Famotidine and omeprazole are both histamine-2 antagonists and could be used interchangeably." b. "Famotidine is more expensive than omeprazole." c. "Omeprazole is taken at bedtime making it easier to remember." d. "Proton pump inhibitors, like omeprazole, produce fewer adverse effects among the older population."

B

For treatment of a gastric ulcer, what would the recommended dosing schedule of famotidine (Pepcid) be? A) 10 mg b.i.d B) 20 mg b.i.d C) 60 mg at bedtime D) 40 mg q am

a

Gastrin a. stimulates acid secretion in the stomach b. secretion is blocked by the products of protein digestion in the stomach. c. secretion is stimulated by acid in the duodenum. d. is responsible for the chemical or gastric phase of intestinal secretion.

d

H2 receptors are found throughout the body, including a. in the nasal passages, upper airways, and stomach. b. in the CNS and upper airways. c. in the respiratory tract and the heart. d. in the heart, CNS, and stomach.

c

In explaining the importance of the pancreas to a student nurse, the instructor would explain that the pancreas a. is primarily an endocrine gland. b. secretes enzymes in response to an increased plasma glucose concentration. c. neutralizes the hydrochloric acid secreted by the stomach. d. produces bile.

b

Misoprostol (Cytotec) is a prostaglandin that is used to: a. prevent uterine contractions b. prevent NSAID-related gastric ulcers in patients at high risk. c. decrease hyperacidity with meals and at bedtime. d. relieve the burning associated with hiatal hernia at night.

B

What nursing interventions are included in the plan of care for a patient receiving antacids to relieve GI discomfort? A) Administer this drug with other drugs or food. B) Administer the antacid 1 hour before or 2 hours after other oral medications. C) Limit fluid intake to decrease dilution of the medication in the stomach. D) Have the patient swallow the antacid whole and do not crush or chew the tablet.

C

What priority teaching point does the nurse include when instructing patients about the use of antacids? A) Reduce calorie intake to reduce acid production. B) Take before each meal and before bed. C) Be aware of risk of acid rebound with long-term use. D) Consider liquid diet if diarrhea occurs.

A

What symptoms would the nurse find to be consistent with a diagnosis of a peptic ulcer? A) Pain a few hours after eating B) Pain described as sharp and stabbing C) Explosive diarrhea within 1 hour of eating D) Unable to stand comfortably due to abdominal pain

A, B, C, D

What would the nurse consider an indication for the use of antacids? (Select all that apply.) A) Gastric hyperacidity B) Gastritis C) Peptic esophagitis D) Hiatal hernia E) Duodenal ulcer

D

When caring for a patient diagnosed with a peptic ulcer, the nurse administers omeprazole (Prilosec) along with what antibiotic to eradicate Helicobacter pylori? A) Gentamicin B) Ketoconazole C) Tetracycline D) Amoxicillin

C

When comparing the histamine-2 antagonists to each other the nurse recognizes that cimetidine (Tagamet) is more likely to cause which adverse effect? A) Dizziness B) Headache C) Gynecomastia D) Somnolence

c

A nurse is providing education to an adult female client who has been prescribed misoprostol. What instruction should the nurse include in the teaching? a. Supplement therapy with magnesium antacids. b. Report postmenopausal bleeding. c. Use effective contraceptive measures. d. Administer the drug one time per day

a

A nurse is teaching a client about prescribed lansoprazole. The nurse instructs the client to take the drug at which time? a. 1 hour before eating b. 2 hours after a meal c. first thing on arising d. at bedtime

c

A nurse taking care of a patient who is receiving a proton pump inhibitor should teach the patient to: a. take the drug after every meal. b. chew or crush tablets to increase their absorption. c. swallow tablets or capsules whole. d. stop taking the drug after 3 weeks of therapy.

A

A patient comes to the clinic complaining of acid indigestion and tells the nurse he is tired of buying over-the-counter (OTC) antacids and wants a prescription drug to cure the problem. What would the nurse specifically assess for? A) Alkalosis B) Hypocalcemia C) Hypercholesterolemia D) Rebound

C

A patient has been prescribed esomeprazole (Nexium). What statement by the patient does the nurse evaluate as indicating that he or she has a good understanding of his newly prescribed drug? A) I should open the capsules and crush the drug into applesauce. B) It is important that I take the drug after each meal. C) I need to swallow the drug whole and not chew the capsules. D) I should always take the drug with an antacid.

A

A patient presents to the walk-in clinic complaining of vomiting and burning in his or her mide-pigastria. The nurse suspects peptic ulcer disease and knows that to confirm peptic ulcer disease, the physician is likely to order a diagnostic test to detect the possible presence of what?' A) Infection with Helicobacter pylori B) Decreased stomach acid secretion C) Gastric irritation caused by nonsteroidal anti-inflammatory drugs (NSAIDs) D) Overconsumption of spicy foods

C

A patient with a duodenal ulcer is receiving sucralfate for short-term treatment. What will the nurse advise the patient to avoid? A) Milk of Magnesia B) Tums C) Aluminum salts D) Proton pump inhibitors

a

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? a. Omeprazole b. Esomeprazole c. Lansoprazole d. Pantoprazole

c

Most of the nutrients absorbed from the GI tract pass immediately into the portal venous system and are processed by the liver. This is possible because almost all absorption occurs through a. the lower section of the stomach. b. the top section of the large intestine. c. the small intestine. d. the ileum.

A

The 59-year-old patient has peptic ulcer disease and is started on sucralfate (Carafate). What is an appropriate nursing diagnosis related to this medication? A) Risk for constipation related to GI effects B) Risk for injury: bleeding C) Imbalanced nutrition related to nausea D) Deficient fluid volume

a, b, c, e, f

The CTZ in the brain is activated by which processes? Select all that apply: a. Stretch of the uterus b. Stretch of the bladder c. Decreased GI activity d. Radiation e. Cell death f. Extreme pain

d

The basic type of movement that occurs in the small intestine is a. peristalsis. b. mass movement. c. churning. d. segmentation.

C

The clinic nurse is caring for a 78-year-old male patient who is taking a proton pump inhibitor. What condition is this patient at increased risk for developing? A) Sickle cell anemia B) Megaloblastic anemia C) Pernicious anemia D) Iron deficiency anemia

A

The nurse administers ranitidine (Zantac) cautiously to patients with evidence of what conditions? A) Renal disease B) Diabetes mellitus C) Pulmonary disease D) Migraine headaches

A

The nurse admits a patient who reports having taken a proton pump inhibitor for more than a decade. What assessment question will the nurse ask this patient? A) Are you experiencing diarrhea? B) Do you experience much abdominal pain? C) Have you noticed any blood in your urine? D) When is the last time you checked your blood pressure?

C

The nurse develops a discharge teaching plan for a patient who was prescribed pancreatic enzyme replacement and includes what important teaching point? A) Take the enzymes on an empty stomach. B) Crush the capsules and take with food. C) Avoid spilling the powder on the skin because it may be irritating. D) Pancreatin and pancrelipase are interchangeable

A

The nurse is caring for a 27-year-old female patient who has just been prescribed misoprostol. What is a priority teaching point for this patient? A) You will need to use a barrier-type contraceptive B) Do not take NSAIDs with this drug C) Adverse effects include nausea and diarrhea D) It protects the lining of the stomach

C

The nurse is caring for a patient requiring digestive enzyme replacement therapy and establishes what appropriate nursing diagnosis for this patient? A) Acute pain B) Risk for constipation C) Risk for imbalanced nutrition D) Bowel incontinence

C

The nurse is caring for a patient with cystic fibrosis who has recently not been taking her pancreatic enzymes recently. What is the primary assessment finding the nurse will see as a result of this noncompliance? A) Constipation B) Diarrhea C) Malnutrition D) Abdominal pain

C

The nurse is preparing a patient for discharge with a prescription for sucralfate (Carafate) and teaches the patient to take the medication when? A) With meals B) With an antacid before breakfast C) 1 hour before or 2 hours after meals and at bedtime D) After each meal

C

The nurse is providing education for a patient with peptic ulcer disease resulting from chronic nonsteroidal anti-inflammatory drug (NSAID) use who will begin a prescription of misoprostol (Cytotec). The nurse evaluates that the patient understands the actions of this drug when he or she says it does what? A) Reduces the stomach's volume of hydrochloric acid B) Increases the speed of gastric emptying C) Protects the stomach's lining D) Increases lower esophageal sphincter pressure

A

The nurse questions an order for a proton pump inhibitor when the patient is known to take what other medication? A) Theophylline B) Penicillin C) Digoxin D) Heparin

B, C, E

The nurse would assess patients with what condition to determine whether there is a need for a saliva substitute? (Select all that apply.) A) Cystic fibrosis B) Stroke C) Cancer receiving chemotherapy or radiation therapy D) Myocardial infarction E) Chronic dry mouth

D

The nurse would question an order for misoprostol if the patient was diagnosed with what condition? A) Diabetes B) Hypertension C) Arthritis D) Pregnancy

B

The nurse, caring for a patient with cystic fibrosis, administers pancreatic enzymes on what schedule? A) 1 hour after meals and snacks B) With meals and snacks C) 2 hours before meals and snacks D) In the morning and before bed

A

The patient prescribed nizatidine (Axid) chooses to take the medication once a day at bedtime. What dosage will the nurse administer? A) 150 to 300 mg B) 100 to 125 mg C) 20 to 40 mg D) 5 to 7.5 mg

B

The patient will receive ranitidine (Zantac) 150 mg PO at bedtime. Prior to administration, the nurse will inform the patient that common adverse effects related to this medication include what? A) Tremors B) Headache C) Visual disturbances D) Anxiety

d

The presence of fat in the duodenum causes a. acid indigestion b. decreased acid production. c. increased gastrin release. d. contraction of the gallbladder.

B

What H2 antagonist would the nurse consider the drug of choice for a patient with advanced liver failure? A) Cimetidine B) Nizatidine C) Ranitidine D) Famotidine

D

What action does the histamine-2 antagonist administered by the nurse have on the human body that will help to prevent peptic ulcer disease? A) Destroys Helicobacter pylori B) Coats and protects the stomach lining C) Increases the pH of the secreted hydrochloric acid D) Reduces the amount of hydrochloric acid secreted

C

What classification of drugs does the nurse administer to treat peptic ulcers by suppressing the secretion of hydrochloric acid into the lumen of the stomach? A) Antipeptic agents B) Histamine-2 antagonists C) Proton pump inhibitors D) Prostaglandins

D

What drug combination will the nurse normally administer most often to treat a gastric ulcer? A) Antibiotics and histamine-2 antagonists B) H2 antagonists, antibiotics, and bicarbonate salts C) Bicarbonate salts, antibiotics, and ZES D) Antibiotics and proton pump inhibitors

B

What histamine-2 antagonist might the nurse administer to a child? A) Cimetidine B) Famotidine C) Nizatidine D) Ranitidine

b, c, d, f

When describing the action of pancreatic digestive enzymes in breaking down substances, which substances would the instructor include? Select all that apply: a. Gastric acid b. Fats c. Proteins d. Sugars e. Bile f. Lipids

a, b, c, e

When educating a client prescribed a histamine antagonists, which of the following should be avoided? Select all that apply. a. cigarettes b. alcohol c. caffeine d. fibrous foods e. acid stimulating foods

c

When explaining the control of the activities of the GI tract—movement and secretion—the nurse would be most accurate to state that the GI is basically controlled by a. the sympathetic nervous system .b. the parasympathetic nervous system. c. local nerve reflexes of the GI nerve plexus. d. the medulla in the brainstem.

c

Which H2 antagonist would the nurse expect to be ordered for a patient with known liver dysfunction? a. Cimetidine b. Famotidine c. Nizatidine d. Ranitidine

c

Which condition would the nurse need to monitor more closely if a patient was receiving IV cimetidine (generic) versus the oral form of the medication? a. GI upset b. Gynecomastia c. Cardiac arrhythmias d. Constipation

c

Which of the following would a nurse expect as most likely to be used in combination with antibiotics for treatment of Helicobacter pylori infection? a. Famotidine b. Calcium carbonate c. Omeprazole d. Sucralfate

D

Which of these patients would the nurse expect to be the best candidate for misoprostol (Cytotec)? A) A 12-year-old with obsessive-compulsive disorder B) A 22-year-old pregnant patient C) A 46-year-old trial lawyer with hypertension D) An 83-year-old man with rheumatoid arthritis

c

Which would a nurse include when describing the action of H2 antagonists to a patient? a. They block the release of gastrin and pepsin, leading to a decrease in protein digestion. b. They selectively block histamine receptors, reducing swelling and inflammation at numerous sites. c. They selectively block specific histamine receptor sites, leading to a reduction in gastric acid secretion. d. They are effective primarily for long-term use because of their slow onset of action