Upper GI prepU

The nurse admits a client who reports having taken a proton pump inhibitor for more than a decade. What assessment question will the nurse ask this client? "Do you ever experience flank pain?" "Have you noticed any blood in your urine?" "Are you experiencing diarrhea?" "When is the last time you checked your blood pressure?"

"Are you experiencing diarrhea?"

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

1 hour before eating

For treatment of a gastric ulcer, what would the recommended dosing schedule of famotidine (Pepcid) be? 10 mg bid 20 mg bid 60 mg at bedtime 40 mg q AM

20 mg bid

Why might a proton pump inhibit (PPI) be preferable to an a histamine2 receptor antagonists (H2RA) for the treatment of gastroesophageal reflux disease (GERD)? Select all that apply. PPIs have fewer adverse reactions. PPIs facilitate faster healing. PPIs act for a longer period of time. PPIs suppress acid more effectively. PPIs strengthen the cardiac sphincter. PPIs facilitate faster healing. PPIs act for a longer period of time. PPIs suppress acid more effectively.

PPIs facilitate faster healing. PPIs act for a longer period of time. PPIs suppress acid more effectively.

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? Increases pepsin activity Decreases gastrin secretion Prevents metabolic alkalosis Provides antibacterial effects

Provides antibacterial effects

A client with a history of peptic ulcer disease has responded well to treatment with a histamine-2 antagonist. What effect will this drug have? Destroy Helicobacter pylori. Coat and protect the stomach lining Increase the pH of secreted hydrochloric acid. Reduce the quantity of hydrochloric acid secreted.

Reduce the quantity of hydrochloric acid secreted.

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? Diarrhea related to adverse effects of drug therapy Acute Pain related to adverse drug effects, headache Risk for Injury related to drug-induced somnolence, dizziness, confusion, or hallucinations Potential Complication: Electrolyte Imbalance related to hypophosphatemia, secondary to drug therapy

Risk for Injury related to drug-induced somnolence, dizziness, confusion, or hallucinations

A client taking ginger for motion sickness reports heartburn. What is the nurse's best response? "Ginger should be used cautiously due to the high chance of adverse reactions." "Ginger is a new genetically engineered herb, and all the effects are not yet known." "Adverse effects are rare, but heartburn has been reported by some individuals taking ginger." "The adverse effects are less likely to occur if taken for the pain and inflammation of arthritis."

"Adverse effects are rare, but heartburn has been reported by some individuals taking ginger."

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? "That's good, but remember that you shouldn't take it on days when you're not having any symptoms." "I'm glad it's working for you, but you'll probably find it works even better if you take it after eating." "That's great. If you find later that it's not working as well, you might want to try taking it at bedtime." "I'm glad to hear that. It sounds like you're taking it exactly like it should be taken."

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

A client with peptic ulcer disease is experiencing fewer symptoms because of suppression of hydrochloric acid secretion into the lumen of the stomach. What category of medication is this client most likely receiving? Antiseptic agent Histamine-2 antagonist Proton pump inhibitor Prostaglandin

Proton pump inhibitor

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? bone density dental health joint mobility integumentary system

bone density

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

constipation

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? increased risk of hypertensive episode decreased absorption of the esomeprazole decreased effectiveness of sucralfate increased risk of sedation

decreased absorption of the esomeprazole

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

decreases production of gastric secretions

A 48-year-old woman who works as an office manager is prescribed metoclopramide (Reglan) for diabetic gastroparesis. The nurse will be sure to assess the client for: tachycardia. depression. hypotension. anemia.

depression.

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

digoxin

A nurse assesses a client for signs and symptoms of tardive dyskinesia when the client is receiving which drug? ondansetron famotidine metoclopramide lansoprazole

metoclopramide

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

stimulates gastric acid secretion

A client who is postoperative day one following a metatarsal amputation is experiencing nausea and vomiting. Consequently, the nurse has administered an intravenous dose of metoclopramide. This drug will relieve the client's nausea by: raising the pH of the client's gastric contents. blocking the effect of histamine at H2 receptors. stimulating the motility of the client's upper GI tract. eradicating H. Pylori bacteria from the client's stomach

stimulating the motility of the client's upper GI tract.

A client expresses concern about the legality of prescribed dronabinol(Marinol) for nausea. What is the nurse's best response? "I agree with your concern of taking an illegal drug." "I'll check with the primary care provider about this error." "Marinol is effective in treating cancer as well as relieving nausea." "Marijuana is legally allowed for medical use in some states."

"Marijuana is legally allowed for medical use in some states."

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? Headache Drug-to-drug interaction Diarrhea Bradycardia

Drug-to-drug interaction

A hospital client's current drug regimen includes antibiotics and proton pump inhibitors. When planning this client's care, the nurse should perform what action? Encourage the client to eat several small meals daily, rather than three larger meals. Monitor the client's calcium levels closely. Encourage the client's family to bring in a supply of antacids. Ensure the client's meals are not spicy or highly acidic.

Ensure the client's meals are not spicy or highly acidic.

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? Risk for Injury: Bleeding Imbalanced Nutrition related to abdominal discomfort Deficient Fluid Volume Impaired Bowel Elimination: Constipation

Impaired Bowel Elimination: Constipation

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. Most medications in this class have been proven to cause spontaneous abortions. These drugs do not pass into breastmilk These medications are safe for use during pregnancy and lactation

The safety of these drugs during pregnancy had not been established.

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? Two antimicrobials help prevent the emergence of drug-resistant H. pylori organisms. A single antimicrobial is generally not strong enough to eradicate the infection. Two different microbes are involved, requiring two different antimicrobials. One antimicrobial tends to alter the action of the adjunct medications.

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

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. gastresophageal reflux disease (GERD) hyperphosphatemia peptic ulcer disease chronic renal failure hypophosphatemia

chronic renal failure hyperphosphatemia

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. irritability. dry mouth. heart palpitations.

headache

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: tremors. headache. visual disturbances. anxiety.

headache

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: renal disease. diabetes mellitus. pulmonary disease. migraine headaches.

renal disease

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

renal disease

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? smoking effects on the healing of ulcers the connection between smoking and chronic pain the importance of taking prescribed medication until symptoms subside general health dangers research has proven to be associated with smoking

smoking effects on the healing of ulcers

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? Immunization history Allergy status Cognition Normal bowel pattern

Allergy status

A client with a diagnosis of peptic ulcer disease has begun taking sucralfate. The nurse should caution the client against the concurrent use of which classification of medications? NSAIDs Acetaminophen Antacids Probiotics

Antacids

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? Select all that apply. Famotidine Esomeprazole Ranitidine Lansoprazole Calcium carbonate

Famotidine Ranitidine

The clinic nurse is caring for a 78-year-old client who is taking a proton pump inhibitor. What assessment should the nurse perform when monitoring for conditions that this client risks developing? Pain level Respiratory rate and oxygen saturation Hemoglobin and hematocrit Folate levels

Hemoglobin and hematocrit

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 Ranitidine Pantoprazole Sucralfate

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 Magaldrate Sucralfate Cimetidine

Omeprazole

Which antacids would the nurse identify as being contraindicated in clients with heart failure? Calcium carbonate Magnesium hydroxide Sodium bicarbonate Aluminum hydroxide

Sodium bicarbonate

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? Do not take NSAIDs with this drug Adverse effects include nausea and diarrhea It protects the lining of the stomach You will need to use a barrier-type contraceptive

You will need to use a barrier-type contraceptive

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? aluminum hydroxide omeprazole famotidine metoclopramide

aluminum hydroxide

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

An 83-year-old male with rheumatoid arthritis

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

Assess signs of fluid and electrolyte imbalances

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

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

A critical care nurse is preparing to administer an intragastric drip of an antacid to a client through a nasogastric tube. How should the nurse most accurately titrate the dose and frequency? By assessing the pH of a 24-hour urine sample By aspirating stomach contents and measuring the pH By measuring the pH of urine after each void By swabbing the client's buccal mucosa and testing for pH daily

By aspirating stomach contents and measuring the pH

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

Ginger

A client arrives at the walk-in clinic reporting vomiting and a burning sensation in the mid-epigastric region. The nurse suspects that the client has peptic ulcer disease. Which is a potential cause of peptic ulcer disease? Decreased stomach acid secretion Infection with H. pylori Excessive worrying Overconsumption of spicy foods

Infection with H. pylori

The nurse should be aware that ranitidine achieves a therapeutic effect by which means? Raising the pH of gastric secretions Inhibiting the secretion of gastric acid Binding to proton pumps Decreasing gastric motility

Inhibiting the secretion of gastric acid

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

Use effective contraceptive measures.

What type of medication might be included in the medication therapy to treat a peptic ulcer by serving as a barrier to gastric secretions? histamine2 receptor antagonists (H2RAs) proton pump inhibitors (PPIs) sucralfate antacid

sucralfate

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)? H2RAs do not suppress acid. PPIs suppress acid more strongly and for a shorter time. PPIs are less expensive. PPIs suppress acid more strongly and for a longer time.

PPIs suppress acid more strongly and for a longer time.

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? Hypercalcemia Pernicious anemia Hypermagnesemia Scurvy

Pernicious anemia

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

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

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? Constipation Urinary frequency Fatty stools Nausea

constipation

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? hemorrhage fluid volume excess venous thromboembolism rebound gastroesophageal reflux disease (GERD)

hemorrhage

The nurse is teaching a client about lansoprazole prescribed for treatment of gastric ulcer. By what mechanism of action does lansoprazole help treat the disease? exerting an antibiotic effect healing damaged cells inhibiting acid secretion increasing mucus secretion

inhibiting acid secretion

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. hypocalcemia. hypercholesterolemia. metabolic acidosis.

metabolic alkalosis