Chapter 57: Drugs Affecting Gastrointestinal Secretions

A nurse is caring for an elderly patient who has been administered cimetidine. Which intervention should the nurse perform? a)Closely monitor the patient for confusion and dizziness. b)Monitor the patient for reports of pain or sour taste. c)Monitor the patient for concentrated urine and restlessness. d)Inform the PHCP if the patient exhibits tardive dyskinesia symptoms.

a)Closely monitor the patient for confusion and dizziness.

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

a)Constipation

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

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

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? a)The safety of these drugs during pregnancy had not been established. b)These drugs do not pass into breastmilk c)Most medications in this class have been proven to cause spontaneous abortions. d)These medications are safe for use during pregnancy and lactation

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

Pancrelipase would most likely be used to treat a patient with cystic fibrosis. a)True b)False

a)True

How should the critical care nurse most accurately titrate the dose and frequency of administration of an intragastric drip of an antacid through a nasogastric tube? a)by aspirating stomach contents and measuring the pH b)by assessing the pH of a 24-hour urine sample c)by swabbing the client's buccal mucosa and testing for pH daily d)by measuring the pH of urine after each void

a)by aspirating stomach contents and measuring the pH

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? a)"I should crush the medication and mix it into apple sauce." b)"I need to swallow the drug whole." c)"I'll have to stop using antacids." d)"It is important that I take the drug after each meal."

b)"I need to swallow the drug whole."

A client is diagnosed with peptic ulcer due to H. pylori. The nurse would anticipate administering which agent in conjunction with an antibiotic? a)Sucralfate b)Omeprazole c)Cimetidine d)Magaldrate

b)Omeprazole

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? a)Bowel obstruction b)Peptic ulcer disease c)Liver cancer d)Esophageal cancer

b)Peptic ulcer disease

The nursing instructor is teaching students about proper administration of sucralfate. According to the instructor, sucralfate should be administered: a)immediately after each meal. b)an hour before meals. c)with an antacid. d)with meals.

b)an hour before meals.

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

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

When describing the possible adverse effects associated with omeprazole therapy, which of the following would the nurse identify as least common? a)Headache b)Cough c)Alopecia d)Dizziness

c)Alopecia

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? a)Tremor b)Visual disturbances c)Headache d)Anxiety

c)Headache

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? a)Lansoprazole b)Esomeprazole c)Omeprazole d)Rabeprazole

c)Omeprazole

Ranitidine (Zantac) is preferred over cimetidine (Tagamet) therapy in critically ill clients due to decreased risk of which adverse effect? a)Diarrhea b)Hypotension c)Macular rash and cough d)Drug-drug interactions

d)Drug-drug interactions

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? a)Overconsumption of spicy foods b)Decreased stomach acid secretion c)Excessive worrying d)Infection with H. pylori

d)Infection with H. pylori

A nurse is teaching a client about his 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)at bedtime d)first thing on arising

a)1 hour before eating

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: a)interfere with the metabolism of other drugs. b)cause diarrhea. c)result in hypotension. d)cause macular rash and cough.

a)interfere with the metabolism of other drugs.

A client has a magnesium-based antacid prescribed for administration as needed. Which condition contraindicates the administration of this classification of medications? a)renal dysfunction b)hypertension c)stress ulcer d)heart rate of 68

a)renal dysfunction

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? a)Hyperactive gastric mucosa b)Rebound acidity c)Gastric reflux d)Hypocalcemia

b)Rebound acidity

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? a)acetaminophen b)antacids c)NSAIDs d)probiotics

b)antacids

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: a)are hypertensive. b)are pregnant. c)have diabetes. d)have arthritis.

b)are pregnant.

A female client is self-administering cimetidine. What is the home care nurse's most important assessment of this client? a)Adverse reactions b)Toxicity c)Potential drug-drug interactions d)Allergic reactions

c)Potential drug-drug interactions

The client has Maalox ordered for administration before meals. Which condition is contraindicated with the administration of Maalox? a)Heart rate of 68 b)Hypertension c)Renal dysfunction d)Stress ulcer

c)Renal dysfunction

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? a)Do not chew, open, or crush the tablet. b)Administer the drug one hour before travel. c)Use a reliable contraceptive. d)Swallow the tablet one hour before eating.

c)Use a reliable contraceptive.

An older adult's 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? a)urinary frequency b)fatty stools c)constipation d)nausea

c)constipation

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)Sucralfate d)Omeprazole

d)Omeprazole

A client is diagnosed with Helicobacter pylori infection. The health care provider will order amoxicillin and what other type of medication? a)Sucralfate b)H2RAs c)Antacids d)Proton pump inhibitors

d)Proton pump inhibitors

A client is taking cimetidine for increased gastric pain and hypersecretion. Nurses should use extreme caution when administering cimetidine to clients with which condition? a)hepatic disease b)cancer c)diabetes mellitus d)hypertension

a)hepatic disease

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? a)1 tablet b)2 tablets c)Half a tablet d)3 tablets

b)2 tablets

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: a)diabetes mellitus. b)renal disease. c)pulmonary disease. d)migraine headaches.

b)renal disease.

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 a)shellfish. b)ragweed. c)pork. d)pollen.

c)pork.

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? a)Risk for injury related to the side effects of the drug therapy b)Alteration in comfort related to the drug therapy and the adverse effect of a headache c)Imbalanced nutrition: less than body requirements, related to impaired digestion secondary to insufficient pancreatic enzymes d)Alterations in elimination related to the disease process

c)Imbalanced nutrition: less than body requirements, related to impaired digestion secondary to insufficient pancreatic enzymes

What is an effect of histamine release that is related to ulcer formation? a)initiates pepsin synthesis b)destroys parietal cells c)stimulates gastric acid secretion d)stimulates denaturing of gastrin

c)stimulates gastric acid secretion

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)Lansoprazole b)PantoprazoleA client is diagnosed with peptic ulcer due to H. pylori. The nurse would anticipate administering which agent in conjunction with an antibiotic? c)Esomeprazole d)Omeprazole

d)Omeprazole

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? a)PPI toxicity b)Decreased absorption of the PPIs c)Subtherapeutic levels of PPIs in the bloodstream d)Transient elevations in liver function tests

d)Transient elevations in liver function tests

Which teaching intervention is most important to share with the client prescribed misoprostol? a)Report postmenopausal bleeding. b)Administer the drug one time per day. c)Supplement therapy with magnesium antacids. d)Use effective contraceptive measures.

d)Use effective contraceptive measures.

Because of the possible adverse effects of long-term proton pump inhibitor (PPI) use, the nurse practitioner should focus on what assessment in a 72-year-old client? a)dental health b)joint mobility c)integumentary system d)bone density

d)bone density

A male client is taking misoprostol. Which adverse effect is more likely to occur with cimetidine than with other histamine2 receptor antagonists? a)hypertension b)seizures c)hypoxia d)gynecomastia

d)gynecomastia

The nurse should be aware that ranitidine achieves a therapeutic effect by which means? a)decreasing gastric motility b)raising the pH of gastric secretions c)binding to proton pumps d)inhibiting the secretion of gastric acid

d)inhibiting the secretion of gastric acid