Course Point- Chapter 57

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

True

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

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

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

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

The nurse is caring for an adult client presenting with recent heartburn, which the client treated with over-the-counter omeprazole 20 mg PO daily. After reviewing the client's current list of medications, the nurse should report which medication because concurrent use may increase blood levels of omeprazole? a. atorvastatin b. Enteric-coated aspirin c. Clarithromycin d. Phenytoin

c. Clarithromycin d. Phenytoin

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

c. Constipation

Which adverse effect is more likely to be caused by cimetidine than by other H2RAs? a. Seizures b. Hypertension c. Gynecomastia d. Hypoxia

c. Gynecomastia

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

c. Infection with H. pylori -peptic ulcers can result from H. pylori, gastric acid, pepsin, or NSAIDs

What should the nurse monitor for in older patients when antiemetics are given?

the nurse should frequently monitor for reports of pain, sour tase, spitting blood, or coffee-ground emesis

What should the nurse observe in older patients when antacids are given?

the nurse should observe for concentrated urine & restlessness

What should the nurse report when prolonged doses of metoclopramide are given to older patients?

the nurse should report signs of tardive dyskinesia or extrapyramidal symptoms

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. 12 weeks d. 10 weeks

a. 1 to 2 weeks

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

a. Alopecia -occurs with PPI therapy -b, c, d are common adverse effects

A male client is taking cimetidine. Which adverse effect is more likely to occur with cimetidine than with other histamine2 receptor antagonists? a. Hypertension b. Gynecomastia c. Hypoxia d. Seizures

b. Gynecomastia

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. Pantoprazole b. Lansoprazole c. Omeprazole d. Esomeprazole

c. Omeprazole -Omeprazole is the prototype

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. have diabetes. b. have arthritis. c. are pregnant. d. are hypertensive.

c. are pregnant.

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

c. decreases production of gastric secretions

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.

a. renal disease. -H2RAs must be used cautiously with renal disease.

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? a. inhibiting acid secretion b. healing damaged cells c. exerting an antibiotic effect d. increasing mucus secretion

a. inhibiting acid secretion -PPIs suppress gastric acid secretion

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. Antacids b. Acetaminophen c. Probiotics d. NSAIDs

a. Antacids -antacids decrease the effects of sucralfate & should not be taken within 30 minutes of each other

Following an endoscopy, a 66-year-old man has been diagnosed with a duodenal ulcer resulting from Helicobacter pylori infection. Which medication will likely be used in an attempt to eradicate the patient's H. pylori infection? (Select all that apply.) a. Antibiotics b. Aluminum hydroxide c. Cisapride (Propulsid) d. A PPI e. Ondansetron (Zofran)

a. Antibiotics d. A PPI

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 concentrated urine and restlessness. c. Inform the PHCP if the patient exhibits tardive dyskinesia symptoms. d. Monitor the patient for reports of pain or sour taste.

a. Closely monitor the patient for confusion and dizziness.

Which adverse reaction of proton pump inhibitors is specific to menopausal women with osteoporosis? a. Increased fracture risk b. Abdominal pain c. Diarrhea d. Headache

a. Increased fracture risk

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

a. Inhibiting the secretion of gastric acid

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. Hypocalcemia b. Rebound acidity c. Hyperactive gastric mucosa d. Gastric reflux

b. Rebound acidity

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

d. Renal dysfunction -Mg based antacids are contraindicated in renal failure

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. Has a stressful job as a air traffic controller. c. Eats spicy food at least twice a week. d. Is 15 pounds over ideal weight

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

Client teaching should include what instruction about antacids? a. Take antacid 1 hour before other medications. b. Take antacid only at bedtime. c. Take antacid with other medications. d. Take antacid 1/2 hour after other medications.

a. Take antacid 1 hour before other medications.

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

a. an hour before meals.

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 an older adult or a client who is critically ill. Which medication will the client administer? a. Sucralfate b. Ranitidine c. Misoprostol d. Pantoprazole

c. Misoprostol -reduces the risk of NSAID-induced gastric ulcers in high-risk patients

After teaching a client who is receiving sucralfate about the drug, which statement indicates that the teaching has been successful? a. "I may need something to control diarrhea." b. "I need to limit my fluid intake." c. "I need to avoid sugarless lozenges." d. "I should eat a high-fiber diet."

d. "I should eat a high-fiber diet." -constipation is the most common adverse effect, increasing fiber prevents constipation

A female client has GERD and is taking cimetidine. She continues to have gastric discomfort and asks whether she can take an antacid. Which is an appropriate response by the nurse? a. "No, the two drugs will work against each other." b. "I wouldn't advise it. You may experience severe constipation." c. "Sure, you may take an antacid with cimetidine." d. "Yes, but be sure to wait at least 2 hours to take the antacid after you take the cimetidine."

d. "Yes, but be sure to wait at least 2 hours to take the antacid after you take the cimetidine."

The nurse is caring for an 8-year-old client with cystic fibrosis. The provider has prescribed pancreatic enzyme replacement. Replacement therapy is required for which function? a. Absorption of proteins b. Absorption of fats c. Absorption of carbohydrates d. All the above

d. All the above

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. Alterations in elimination related to the disease process c. Alteration in comfort related to the drug therapy and the adverse effect of a headache d. Imbalanced nutrition: less than body requirements, related to impaired digestion secondary to insufficient pancreatic enzymes

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

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? a. hemorrhage b. venous thromboembolism c. fluid volume excess d. rebound gastroesophageal reflux disease (GERD)

a. hemorrhage

A client is taking cimetidine for increased gastric pain and hypersecretion. Nurses should use caution when administering cimetidine to those with which condition? a. Cancer b. Hepatic disease c. Asthma d. Hypertension

b. Hepatic disease

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. Peptic ulcer disease b. Hip fractures c. Liver cancer d. Hypercalcemia

b. Hip fractures -PPIs decrease calcium absorption which affects the bones, leading to osteoporosis -Pts 50+ yrs are at risk for fx on long-term PPI

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. Calcium carbonate b. Omeprazole c. Famotidine d. Sucralfate

b. Omeprazole

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

b. Renal dysfunction -Mg based antacids are contraindicated in renal failure

A nurse is providing education to a 23-year-old female client who has been prescribed misoprostol. What instruction should the nurse include in the teaching? a. Supplement therapy with magnesium antacids. b. Use effective contraceptive measures. c. Administer the drug one time per day. d. Report postmenopausal bleeding.

b. Use effective contraceptive measures.

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: a. anxiety. b. headache. c. visual disturbances. d. tremors.

b. headache. -HA, dizziness, somnolence, mental confusion occur with H2 antagonists

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

b. interfere with the metabolism of other drugs.

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

b. pork. -pancrelipase is derived from pork