Pharm Chapter 40 Upper GI Meds

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? 1. 1 tablet 2. 2 tablets 3. Half a tablet 4. 3 tablets

2. 2 tablets

The nurse would administer cimetidine cautiously to a client with a history of which condition? 1. Diabetes 2. Asthma 3. Hypertension 4. Hyperlipidemia

1. Diabetes

The nurse is caring for a client who is receiving antacids to relieve GI discomfort. What nursing action is most appropriate? 1. Administer this drug with other drugs or food to prolong therapeutic effects. 2. Administer the antacid 1 hour before or 2 hours after other oral medications. 3. Limit fluid intake to decrease dilution of the medication in the stomach. 4. Have the client swallow the antacid whole and do not crush or chew the tablet.

2. Administer the antacid 1 hour before or 2 hours after other oral medications.

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? 1. Headache 2. Drug-to-drug interaction 3. Diarrhea 4. Bradycardia

2. Drug-to-drug interaction

When caring for a client diagnosed with a peptic ulcer, the nurse administers omeprazole and amoxicillin. What diagnostic finding indicates therapeutic effects of this drug regimen? 1. Absence of dyspepsia 2. Absence of gastresophageal reflux 3. Increased appetite and absence of nausea 4. Absence of Helicobacter pylori

4. Absence of Helicobacter pylori

Which drugs treat heartburn by neutralizing the acidity of the stomach by combining with hydrochloric acid (HCl) and increasing the pH of the stomach acid? 1. aluminum hydroxide 2. omeprazole 3. famotidine 4. metoclopramide

1. aluminum hydroxide

An older adult client has been on long-term proton pump inhibitor (PPI) therapy. The nurse practitioner should focus on what assessment related to adverse effects? 1. bone density 2. dental health 3. joint mobility 4. integumentary system

1. bone density

Antacids are alkaline substances primarily used to directly neutralize gastric acid in the stomach to prevent/treat PUD, GERD, heartburn, and GI bleed. In the treatment of what medical diagnosis might aluminum-based antacids be used? Select all that apply. 1. chronic renal failure 2. hyperphosphatemia 3. gastresophageal reflux disease (GERD) 4. peptic ulcer disease 5. hypophosphatemia

1. chronic renal failure 2. hyperphosphatemia

A client presents to the walk-in clinic reporting vomiting and burning in the mid-epigastria. The nurse suspects peptic ulcer disease and knows that to confirm peptic ulcer disease, the provider is likely to order a diagnostic test to detect the possible presence of what? 1. Infection with Helicobacter pylori 2. Decreased stomach acid secretion. 3. Gastric irritation caused by NSAIDs. 4. Upper gastrointestinal bleeding

1. Infection with Helicobacter pylori

Which client would be most likely to benefit from treatment with ondansetron (Zofran)? 1. A woman who is receiving chemotherapy for the treatment of colon cancer 2. A woman who is recovering from a bilateral mastectomy and breast reconstruction 3. A man who has been diagnosed with chronic renal failure secondary to poorly controlled diabetes 4. A child who experienced a greenstick fracture of his humerus in a playground accident

1. A woman who is receiving chemotherapy for the treatment of colon cancer

An older adult 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? 1. Constipation 2. Urinary frequency 3. Fatty stools 4. Nausea

1. Constipation

When teaching a client about an antacid containing aluminum, what would the nurse include? 1. Decreased risk for acid rebound 2. Increased risk for hyperphosphatemia 3. Increased risk for diarrhea 4. Decreased risk for calcium imbalance

1. Decreased risk for acid rebound

What is the benefit of adding proton pump inhibitors (PPIs) to the treatment regime treating an H. pylori bacterial infection? 1. protects ulcer craters 2. decreases pepsin production 3. assists in eliminating the bacteria 4. decreases production of gastric secretions

4. decreases production of gastric secretions

How does histamine release contribute to ulcer formation? 1. stimulates gastric acid secretion 2. stimulates denaturing of gastrin 3. initiates pepsin synthesis 4. destroys parietal cells

1. stimulates gastric acid secretion

A nurse is teaching a client about his prescribed lansoprazole. The nurse instructs the client to take the drug at which time? 1. 1 hour before eating 2. 2 hours after a meal 3. first thing on arising 4. at bedtime

1. 1 hour before eating

Administering an antacid to a client taking which medications will decrease the absorption of the medication and result in a decreased drug effect? 1. Digoxin 2. Quinidine 3. Dextroamphetamine 4. Simvastatin

1. Digoxin

Which herbal products have been used as a homeopathic remedy for GI problems, including motion sickness, nausea, vomiting, and digestion? (Choose one) 1. Ginger 2. Ginseng 3. Gingko biloba 4. Ma Huang

1. Ginger

A client with ulcers has asked the nurse if it would be acceptable to take bismuth subsalicylate. Before recommending an over-the-counter (OTC) formulation of bismuth subsalicylate, the nurse should conduct which client assessment? 1. Immunization history 2. Allergy status 3. Cognition 4. Normal bowel pattern

2. Allergy status

The nurse is caring for four clients. Which client would benefit most from misoprostol, a synthetic prostaglandin E analog? 1. A 12-year-old male with obsessive-compulsive disorder 2. A 22-year-old pregnant female 3. A 46-year-old female with hypertension 4. An 83-year-old male with rheumatoid arthritis

4. 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? 1. Before the 10 a.m. medication 2. Before breakfast 3. Before the evening meal 4. At bedtime

4. At bedtime

A client is started on metoclopramide for the treatment of diabetic gastroparesis. Which adverse effect is specific to this drug therapy? 1. Anorexia 2. Nausea and vomiting 3. Increased peristalsis 4. Muscle rigidity

4. Muscle rigidity

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? 1. Esophageal cancer 2. Bowel obstruction 3. Liver cancer 4. Peptic ulcer disease

4. Peptic ulcer disease

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? 1. Increases pepsin activity 2. Decreases gastrin secretion 3. Prevents metabolic alkalosis 4. Provides antibacterial effects

4. Provides antibacterial effects

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? 1. Eats spicy food at least twice a week. 2. Has a stressful job as a air traffic controller. 3. Is 15 pounds over ideal weight 4. Self medicates with a nonsteroidal anti-inflammatory drug (NSAID) daily.

4. Self medicates with a nonsteroidal anti-inflammatory drug (NSAID) daily.

The nurse is caring for a client who has recently been prescribed misoprostol. What change in the client's health status should the nurse communicate most promptly to the care provider? 1. The client has had two nosebleeds in the past week. 2. The client's blood pressure is 146/98 mm Hg. 3. The client received the annual influenza vaccine 48 hours ago. 4. The client believes that she may be pregnant.

4. The client believes that she may be pregnant.

A client is diagnosed with peptic ulcer due to H. pylori. The nurse would anticipate administering which agent in conjunction with an antibiotic? 1. Omeprazole 2. Magaldrate 3. Sucralfate 4. Cimetidine

1. Omeprazole

The nurse administers ranitidine cautiously to clients with evidence of what condition? 1. Renal disease 2. Diabetes mellitus 3. Pulmonary disease 4. Migraine headaches

1. Renal disease

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? 1. Tremor 2. Headache 3. Visual disturbances 4. Anxiety

2. Headache

A client is prescribed a proton pump inhibitor to treat erosive gastritis. How soon will the client's symptoms be resolved? 1. 1 to 2 weeks 2. 6 weeks 3. 10 weeks 4. 12 weeks

1. 1 to 2 weeks

The nurse should warn a client taking aluminum- and calcium-containing antacids about which adverse effects? 1. Constipation 2. Diarrhea 3. Dehydration 4. Flatulence

1. Constipation

Antacids have not been effective in managing a client's gastroesophageal reflux disease, so the health care provider is prescribing a proton pump inhibitor. Why might the health care provider prescribe a proton pump inhibitor (PPI) rather than a histamine2 receptor antagonist (H2RA)? 1. PPIs suppress acid more strongly and for a longer time. 2. H2RAs do not suppress acid. 3. PPIs suppress acid more strongly and for a shorter time. 4. PPIs are less expensive.

1. PPIs suppress acid more strongly and for a longer time.

The 59-year-old client has peptic ulcer disease and is started on sucralfate. What is an appropriate nursing diagnosis related to this medication? 1. Risk for constipation related to GI effects 2. Risk for injury: bleeding 3. Imbalanced nutrition related to nausea 4. Deficient fluid volume

1. Risk for constipation related to GI effects

A client is receiving a liquid antacid. Which would the nurse instruct the client to do? 1. Shake the antacid thoroughly before using. 2. Take 1 hour before meals. 3. Drink a full glass of water after taking the drug. 4. Remove any items with strong smells or odors. 5. Take sips of fluid at frequent intervals.

1. Shake the antacid thoroughly before using.

A client diagnosed with an H. pylori-associated ulcer has been prescribed treatment that includes two antimicrobials. What does the nurse identify as the reason for using multiple antimicrobials? 1. Two antimicrobials help prevent the emergence of drug-resistant H. pylori organisms. 2. A single antimicrobial is generally not strong enough to eradicate the infection. 3. Two different microbes are involved, requiring two different antimicrobials. 4. One antimicrobial tends to alter the action of the adjunct medications.

1. Two antimicrobials help prevent the emergence of drug-resistant H. pylori organisms.

The nurse is caring for a 27-year-old female client who has just been prescribed misoprostol. What is a priority teaching point for this client? 1. You will need to use a barrier-type contraceptive 2. Do not take NSAIDs with this drug 3. Adverse effects include nausea and diarrhea 4. It protects the lining of the stomach

1. You will need to use a barrier-type contraceptive

The nurse is caring for a client who is prescribed esomeprazole. The client informs the nurse that he is also taking sucralfate. The nurse would anticipate which effect as a possibility when these two drugs are administered? 1. decreased absorption of the esomeprazole 2. increased risk of hypertensive episode 3. decreased effectiveness of sucralfate 4. increased risk of sedation

1. decreased absorption of the esomeprazole

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: 1. headache. 2. irritability. 3. dry mouth. 4. heart palpitations.

1. headache.

While reviewing the medication history of a client newly prescribed omeprazole, the nurse sees that the client is also taking warfarin. What potential interaction should the nurse account for when developing the plan of care for this client? 1. hemorrhage 2. fluid volume excess 3. venous thromboembolism 4. rebound gastroesophageal reflux disease (GERD)

1. hemorrhage

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: 1. metabolic alkalosis. 2. hypocalcemia. 3. hypercholesterolemia. 4. metabolic acidosis.

1. metabolic alkalosis.

A client, with recent abdominal pain and a 40-pack per year smoking history, is prescribed a treatment regimen for a diagnosis of duodenal ulcer. What important teaching would the nurse include in relation to treatment? 1. smoking effects on the healing of ulcers 2. the connection between smoking and chronic pain 3. the importance of taking prescribed medication until symptoms subside 4. general health dangers research has proven to be associated with smoking

1. smoking effects on the healing of ulcers

A client has presented to the emergency department with a 48-hour history of spasticity, malaise, and agitation. Arterial blood gas testing reveals that the client has metabolic alkalosis. What is the most appropriate action by the nurse? 1. Assess for any history of duodenal ulcers or gastroesophageal reflux. 2. Assess the client's use of sodium bicarbonate and other antacids. 3. Assess whether the client has a history of diverticulosis or diverticulitis. 4. Assess whether the client has been taking over-the-counter H2 antagonists.

2. Assess the client's use of sodium bicarbonate and other antacids.

The nurse is assessing a 7 year-old client with a recent history of dyspepsia. The client's parents state that their provider recommended the use of over-the-counter ranitidine. What is the nurse's best action? 1. Assess whether the parents are giving the child antacids concurrently 2. Contact the provider to question the use of this medication 3. Assess the child's nutritional status and daily eating habits 4. Educate the family about the potential adverse effects of ranitidine

2. Contact the provider to question the use of this medication

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? 1. Hypercalcemia 2. Pernicious anemia 3. Hypermagnesemia 4. Scurvy

2. Pernicious anemia

The client will receive cimetidine 800 mg PO at bedtime. Prior to administration, the nurse should inform the client that common side effects related to this medication include: 1. tremors. 2. headache. 3. visual disturbances. 4. anxiety.

2. headache.

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? 1. "I should crush the medication and mix it into apple sauce." 2. "It is important that I take the drug after each meal." 3. "I need to swallow the drug whole." 4. "I'll have to stop using antacids."

3. "I need to swallow the drug whole."

The nurse educates a client with peptic ulcer disease resulting from chronic nonsteroidal anti-inflammatory drug (NSAID) use. The client will soon begin taking misoprostol. What statement by the client indicates that the client understands the actions of this drug? 1. "Misoprostol reduces the stomach's volume of hydrochloric acid." 2. "Misoprostol increases the speed of gastric emptying." 3. "Misoprostol protects the stomach's lining." 4. "Misoprostol increases lower esophageal sphincter pressure."

3. "Misoprostol protects the stomach's lining."

A client has been prescribed chlorpromazine hydrochloride for nausea. What assessment should the nurse perform before the drug is administered to the client? 1. Keep a record of the client's bowel movements 2. Monitor continuous spitting of blood 3. Assess signs of fluid and electrolyte imbalances 4. Give the client mouthwash or frequent oral rinses

3. Assess signs of fluid and electrolyte imbalances

The client has a magnesium-based antacid prescribed for administration before meals. The nurse knows to withhold the medication if the client exhibits what? 1. Hypertension 2. Heart rate of 68 3. Renal dysfunction 4. Stress ulcer

3. Renal dysfunction

The nurse is caring for a client requiring digestive enzyme replacement therapy. What is the appropriate nursing diagnosis for this client? 1. Acute pain 2. Risk for constipation 3. Risk for imbalanced nutrition 4. Bowel incontinence

3. Risk for imbalanced nutrition

A nurse is providing education to an adult female client who has been prescribed misoprostol. What instruction should the nurse include in the teaching? 1. Supplement therapy with magnesium antacids. 2. Report postmenopausal bleeding. 3. Use effective contraceptive measures. 4. Administer the drug one time per day.

3. Use effective contraceptive measures.

A client has been prescribed omeprazole by the primary health care provider. When the nurse asks whether the medication is providing relief, the client replies, "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? 1. "That's good, but remember that you shouldn't take it on days when you're not having any symptoms." 2. "I'm glad it's working for you, but you'll probably find it works even better if you take it after eating." 3. "That's great. If you find later that it's not working as well, you might want to try taking it at bedtime." 4. "I'm glad to hear that. It sounds like you're taking it exactly like it should be taken."

4. "I'm glad to hear that. It sounds like you're taking it exactly like it should be taken."

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? 1. "Famotidine and omeprazole are both histamine-2 antagonists and could be used interchangeably." 2. "Famotidine is more expensive than omeprazole." 3. "Omeprazole is taken at bedtime making it easier to remember." 4. "Proton pump inhibitors, like omeprazole, produce fewer adverse effects among the older population."

4. "Proton pump inhibitors, like omeprazole, produce fewer adverse effects among the older population."

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? 1. Gentamicin 2. Ketoconazole 3. Vancomycin 4. Amoxicillin

4. Amoxicillin

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: 1. have diabetes. 2. are hypertensive. 3. have arthritis. 4. are pregnant.

4. are pregnant.