Question 1

Many patients self-medicate with antacids. Which patients should be counseled to not take calcium carbonate antacids without discussing it with their provider or a pharmacist first?&#10;A)Patients with kidney stones&#10;B)Pregnant patients&#10;C)Patients with heartburn&#10;D)Postmenopausal women&#10;

Accepted Answer

Patients with kidney stones should be cautious with calcium carbonate antacids, as they can increase calcium levels and potentially worsen stone formation.

Question 2

Which of the following medications places a patient at increased risk of developing chronic kidney disease?&#10;A)Ranitidine&#10;B)Omeprazole&#10;C)Loperamide&#10;D)Ondansetron&#10;

Accepted Answer

Omeprazole, a proton pump inhibitor (PPI), can increase the risk of chronic kidney disease. Long-term use of PPIs has been associated with an increased risk of kidney damage, including chronic kidney disease, by potentially causing acute interstitial nephritis, which can progress to chronic kidney disease if not recognized and managed.

Question 3

A 15-year-old patient presents to the clinic with a 48-hour history of nausea, vomiting, and some diarrhea. She is unable to keep fluids down and her weight is four pounds less than her last recorded weight. Besides intravenous (IV) fluids, the exam warrants the use of an antinausea medication. Which of the following would be the appropriate drug to order?

A)Prochlorperazine (Compazine)
B)Meclizine (Antivert)
C)Promethazine (Phenergan)
D)Ondansetron (Zofran)

Ondansetron (Zofran)

Accepted Answer

Ondansetron (Zofran) is often the drug of choice for nausea and vomiting, especially in cases where the patient is unable to keep fluids down, due to its effectiveness and safety profile. It is commonly used in both adults and children, making it appropriate for a 15-year-old patient.

Question 4

A patient presents with complaints of heartburn that is minimally relieved with Tums (calcium carbonate) and is diagnosed as gastroesophageal reflux disease (GERD). An appropriate on-demand therapy would be:

A)Omeprazole (Prilosec) twice a day
B)Ranitidine (Zantac) twice a day
C)Famotidine (Pepcid) once a day
D)Metoclopramide (Reglan) four times a day

Accepted Answer

The answer of A patient presents with complaints of heartburn...

Question 5

Patients taking antacids should be educated regarding these drugs, including letting them know that:&#10;A)They may cause constipation or diarrhea.&#10;B)Many are high in sodium.&#10;C)They should separate antacids from other medications by one hour.&#10;D)All of the above&#10;

Accepted Answer

Antacids can cause gastrointestinal side effects such as constipation or diarrhea, many formulations are high in sodium which can be a concern for patients with hypertension or heart failure, and they can interfere with the absorption of other medications, hence the recommendation to separate their intake by at least one hour from other drugs.

Question 6

Patients who are on chronic long-term proton pump inhibitor therapy require monitoring for: A)Iron deficiency anemia, vitamin B₁₂and calcium deficiency B)Folate and magnesium deficiency C)Elevated uric acid levels leading to gout D)Hypokalemia and hypocalcemia

Accepted Answer

Chronic use of proton pump inhibitors can lead to deficiencies in vitamin B12, calcium, and iron due to reduced stomach acid, which is necessary for the absorption of these nutrients.

Question 7

A 10-year-old patient presents with uncomfortable constipation. Along with diet changes, a laxative is ordered to provide more rapid relief of constipation. An appropriate choice of medication for a 10-year-old child would be:

A)PEG 3350 (Miralax)
B)Bisacodyl (Dulcolax) suppository
C)Docusate (Colace) suppository
D)Methylnaltrexone

Accepted Answer

The answer of A 10-year-old patient presents with uncomfortable constipation....

Question 8

Bismuth subsalicylate (Pepto-Bismol) is a common over-the-counter (OTC) remedy for gastrointestinal complaints. Bismuth subsalicylate:&#10;A)May lead to toxicity if taken with ibuprofen&#10;B)Is contraindicated in children with flu-like illness&#10;C)Has no antimicrobial effects against bacterial and viral enteropathogens&#10;D)May cause stools to turn reddish color&#10;

Accepted Answer

The answer of Bismuth subsalicylate (Pepto-Bismol) is a common over-the-counter...

Question 9

A 72-year-old patient takes omeprazole for their chronic GERD. Chronic long-term omeprazole use places them at increased risk for:&#10;A)Megaloblastic anemia&#10;B)Osteoporosis&#10;C)Hypertension&#10;D)Strokes&#10;

Accepted Answer

The answer of A 72-year-old patient takes omeprazole for their...

Question 10

An elderly person has been prescribed lactulose for treatment of chronic constipation. Monitoring with long-term treatment would include:&#10;A)Electrolytes, including potassium and chloride&#10;B)Bone mineral density for osteoporosis&#10;C)Magnesium level&#10;D)Liver function&#10;

Accepted Answer

Lactulose can cause electrolyte imbalances, including hypokalemia and hypernatremia, especially with long-term use, so monitoring electrolytes is important.

Question 11

A patient has diarrhea and is wondering if they can take loperamide (Imodium). Loperamide:&#10;A)Can be given to patients of all ages, including infants and children, for viral gastroenteritis&#10;B)Slows gastric motility and reduces fluid and electrolyte loss from diarrhea&#10;C)Is the treatment of choice for the diarrhea associated with E. coli 0157&#10;D)May be used in pregnancy and by lactating women&#10;

Accepted Answer

The answer of A patient has diarrhea and is wondering...

Question 12

Methylnaltrexone is used to treat constipation in:&#10;A)Patients with functional constipation&#10;B)Patients with irritable bowel syndrome-associated constipation&#10;C)Children with encopresis&#10;D)Patients with opioid-associated constipation&#10;

Accepted Answer

The answer of Methylnaltrexone is used to treat constipation in:&#10;A)Patients...

Question 13

A young adult will be traveling to Mexico with her church group over spring break to build houses. She is concerned she may develop traveler's diarrhea. Advice includes following normal food and water precautions as well as taking:

A)Loperamide four times a day throughout the trip
B)Bismuth subsalicylate before each meal and at bedtime
C)Prescription diphenoxylate with atropine if she gets diarrhea
D)Calcium carbonate (Tums) four times a day for stomach upset

Accepted Answer

The answer of A young adult will be traveling to...

Deck 17: Drugs Affecting the Gastrointestinal System