Drugs for Gastric Ulcers and Reflux

Understanding Pharmacology Essentials for Medication Safety

Nursing
27
Questions
0
True/False
25
Choices
2
Essay
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Questions

Q1
Free

Which protective mechanism by the stomach protects it from stomach acids and the formation of gastric ulcers?

Multiple Choice
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A) Buffers such as bicarbonate neutralize stomach acids.
B) The stomach secretes a thick gel-like mucus to coat itself.
C) Acid secretion is decreased when food is not present in the stomach.
D) Stomach secretions such as lipase digest foods and protect the stomach.
Answer:
B) The stomach secretes a thick gel-like mucus to coat itself.

Explanation:
The stomach secretes a thick gel-like mucus that coats and protects it from contact with stomach acids. Acid production is usually balanced by mucous secretion. When acid production exceeds mucous production, the risk for tissue damage and ulcer formation increases.
Q2
Free

Why does the backward flow of stomach contents into the esophagus cause tissue damage?

Multiple Choice
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A) No digestive processes occur in the esophagus.
B) The esophagus does not have the thick gel-like mucus to protect it from acid.
C) The esophagus secretes only bicarbonate, which is not strong enough to neutralize stomach acids.
D) The esophagus cannot expand with extra volume, and the excessive stretching damages the muscle layer.
Answer:
B) The esophagus does not have the thick gel-like mucus to protect it from acid.

Explanation:
The stomach is the site where protein digestion begins. Acid is secreted in the stomach to enhance this process. Because the acids can damage the stomach lining, the stomach secretes a thick, gel-like mucus to protect it. Neither the esophagus nor the duodenum has this protection. Stomach contents that reflux up into the esophagus are highly acidic and cause inflammatory damage with ulcer formation to the lining.
Q3
Free

Which factor is the cause of most peptic ulcers?

Multiple Choice
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A) Excessive production of stomach acids
B) Lifestyle factors such as stress and spicy foods
C) Infection with Helicobacter pylori bacteria
D) Excessive use of drugs such as nonsteroidal anti-inflammatory drugs (NSAIDs)
Answer:
C) Infection with Helicobacter pylori bacteria

Explanation:
Historically the cause of peptic ulcers was thought to be excessive acid formation. Research has shown that 80% to 90% of gastric ulcers are caused by H. pylori infections. Lifestyle changes including stress and diet as well as acid secretion are causes, but H. pylori is the major cause of peptic ulcers.
Q4

Which symptoms are associated with gastric ulcers?

Multiple Choice
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A) Constant bloating and diarrhea
B) Shortness of breath in any position
C) Burning pain that is relieved by eating
D) Burning pain that is relieved by abstaining from food
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Q5

A patient with a history of GI ulcers reports feeling new onset burning, gnawing stomach pain. What is the nurses best action?

Multiple Choice
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A) Assess the patients abdomen for the presence of active bowel sounds.
B) Administer the already ordered as-needed dose of liquid antacid.
C) Offer the patient food to buffer excess stomach acid.
D) Notify the prescriber immediately.
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Q6

A patient who is prescribed sucralfate asks the nurse how this drug will help treat his gastric ulcer. What is the nurses best response?

Multiple Choice
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A) Sucralfate decreases secretion of gastric acids to help your ulcer heal.
B) Sucralfate completely blocks the secretion of gastric acids so your ulcer can heal.
C) Sucralfate treats the infection with H. pylori that is the major cause of gastric ulcers.
D) Sucralfate forms a thick coating to cover the ulcer, protect from further damage, and allow healing.
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Q7

How do histamine (H2) blockers help heal gastric ulcers?

Multiple Choice
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A) They promote cell division.
B) They neutralize acids that are present in the stomach.
C) They decrease the amount of acid secreted by stomach cells.
D) They increase the rate that stomach contents move into the intestinal tract.
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Q8

The nurse is preparing an older adult patient who has been prescribed famotidine (Pepcid) for discharge. Which common side effect should the nurse instruct the patients family to watch for?

Multiple Choice
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A) Confusion
B) Anxiety
C) Depression
D) Psychosis
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Q9

A patient who has been taking nizatidine (Axid) for the last month has all of the following blood laboratory results. Which result does the nurse report to the prescriber as soon as possible?

Multiple Choice
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A) International normalized ratio (INR) of 0.9
B) Red blood cell count of 2 million/mm3
C) White blood cell count of 8000/mm3
D) Platelet count of 150,000/mm3
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Q10

A patient with gastroesophageal reflux disease is prescribed ranitidine (Zantac). Which statement by the patient indicates to the nurse a need for additional teaching?

Multiple Choice
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A) If I need to use ranitidine for more than 2 weeks, I will notify my prescriber.
B) I will look into a smoking cessation program when I go home.
C) I will take the ranitidine first thing in the morning so that its effect will last all day and night.
D) I will not drive until I know how the ranitidine affects me.
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Q11

A patient who has been prescribed ranitidine (Zantac) reports darkened stools. What is the nurses best action?

Multiple Choice
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A) Hold the dose and notify the prescriber.
B) Document the report as the only action.
C) Reassure the patient that this is a common and harmless side effect.
D) Ask the patient if he or she has been using aspirin or any other nonsteroidal anti-inflammatory drug (NSAID).
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Q12

A patient who has been taking cimetidine (Tagamet) for a year has all of the following symptoms. Which symptom does the nurse report immediately to the prescriber?

Multiple Choice
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A) Darkened urine and white stool
B) Altered food taste and dry mouth
C) Weekly constipation with bloating
D) Reduced interest in sexual activity
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Q13

The nurse is instructing a pregnant patient about how to manage reflux. Which point about histamine H2 blockers does the nurse include in the teaching plan?

Multiple Choice
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A) They are safe for use during pregnancy.
B) They may be used while breastfeeding.
C) They should only be taken with a prescribers approval.
D) They can be prescribed instead of lifestyle changes to control reflux.
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Q14

Which precaution is most important for the nurse to teach an older patient who is starting histamine H2 blockers for gastroesophageal reflux disease (GERD)?

Multiple Choice
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A) Do not drink caffeine while taking this drug.
B) Elevate the head of your bed by 6 to 10 inches.
C) Take this drug with meals and before going to bed.
D) Avoid driving until you know how this drug affects you.
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Q15

A patient who is prescribed omeprazole (Prilosec) asks the nurse why the drug should be taken before breakfast. What is the nurses best response?

Multiple Choice
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A) The intended action of this drug is best achieved when given before meals, preferably in the morning.
B) It is best to take this drug in the morning so that antacids taken later in the day do not interfere with absorption.
C) This drug should always be taken on an empty stomach for maximal action and for better absorption.
D) Taking this drug early in the morning helps to minimize the occurrence of side effects or adverse effects.
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Q16

Which precaution is most important for the nurse to teach a patient who is prescribed raberprazole (Aciphex)?

Multiple Choice
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A) Wear a hat and sunscreen outdoors to prevent sunburn.
B) Take this drug one hour before or two hours after a meal.
C) Drink at least 3 liters of fluid daily to prevent constipation.
D) Avoid eating raw fruits and vegetables while taking this drug.
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Q17

A patient who has been prescribed rabeprazole (Aciphex) develops black, tarry stools. What is the nurses best first action?

Multiple Choice
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A) Check the patients medication list for prescribed iron supplements.
B) Teach the patient that this is an expected side effect of proton pump inhibitors.
C) Send a stool sample to the lab for analysis.
D) Notify the prescriber immediately.
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Q18

To prevent a common risk among older adults who are prescribed proton pump inhibitors, which safety precaution does the nurse recommend?

Multiple Choice
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A) Be sure to take a daily multivitamin.
B) Use handrails when going up or down stairs.
C) Take this drug with food or a full glass of fluid.
D) Notify your prescriber if you develop belching or gas.
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Q19

Why are older patients who are prescribed proton pump inhibitors more at risk for drug-induced hip fracture?

Multiple Choice
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A) Induced drowsiness increases the risk for falling.
B) Inhibited calcium absorption makes bones more fragile.
C) Excessive potassium loss reduces muscle strength and balance.
D) Anemia and fatigue prevent participation in exercise and reduce mobility.
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Q20

A patient with indigestion is prescribed aluminum hydroxide (Amphogel). To prevent the most common side effect of this drug, what does the nurse teach the patient?

Multiple Choice
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A) Take this drug 30 minutes before each meal.
B) Do not drink fluids for at least 30 minutes after taking this drug.
C) Be sure to consume a diet with lots of vegetables and other foods with fiber.
D) Report any episodes of diarrhea immediately to your prescriber.
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Q21

Which precaution is most important for the nurse to teach a patient who is prescribed an antacid?

Multiple Choice
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A) Avoid using extra pepper on your food while taking this drug.
B) If you become constipated, stop taking the antacid completely.
C) Take this drug at least 2 hours before or after taking any other drug.
D) Notify your prescriber if heartburn continues after you have taken the drug for 3 days.
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Q22

Why should parents be taught not to give bismuth subsalicylate (Pepto-Bismol) to a child?

Multiple Choice
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A) It contains aspirin that can cause Reyes syndrome.
B) It changes stool color making the identification of GI bleeding more difficult.
C) It has such powerful antidiarrheal effects that toxic megacolon can occur.
D) It produces a paradoxical reaction in children that results in worsening of the symptoms.
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Q23

The spouse of an older adult with Alzheimers disease tells the nurse that he has been giving the patient Amphogel (aluminum hydroxide) for heartburn. What is the nurses best action?

Multiple Choice
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A) Ask the spouse how often the patient is taking the Amphogel.
B) Suggest that the patient be given AlternaGEL instead.
C) Teach the spouse that taking this drug can worsen the patients condition.
D) Remind the spouse that giving this drug often can interfere with bowel function.
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Q24

The nurse is instructing a patient who has been prescribed sucralfate (Carafate) for peptic ulcer disease. Which statement by the patient indicates the need for additional teaching?

Multiple Choice
expand_more
A) This drug coats my ulcer and protects it so that healing can occur.
B) I should eat foods with lots of fiber while Im taking this drug.
C) If I feel dizzy, I will be sure to get up from bed slowly.
D) Once I am feeling better I can stop taking the drug.
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Q25

A patient with gastroesophageal reflux disease (GERD) asks the nurse why metoclopramide (Reglan) has been prescribed. What is the nurses best response?

Multiple Choice
expand_more
A) This purpose of this drug for GERD is to prevent nausea.
B) This drug has been prescribed to help move food along through your GI tract.
C) Metoclopramide will prevent vomiting and the risk for aspiration.
D) This drug causes growth of new cells to heal your esophagus.
Answer:

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Q26

[Multiple Response] Which foods, activities, and drugs does the nurse teach the patient with peptic ulcer disease to avoid? (Select all that apply.)
a. Alcohol
b. Caffeine
c. Dairy products
d. Exercising
e. Smoking
f. Spicy food g. Nonsteroidal anti-inflammatory drugs (NSAIDs)

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Q27

[Multiple Response] What should the nurse plan to teach a patient about smoking and peptic ulcer disease? (Select all that apply.)
a. Smoking increases acid secretion.
b. Smoking is not a cause of ulcer formation.
c. Smoking slows ulcer healing.
d. Smoking is related to the reoccurrence of ulcers.
e. Smoking decreases stomach mucus production.

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