Deck 59: Pharmacotherapy of Peptic Ulcer Disease

Question 1

A client with a diagnosis of peptic ulcer disease is prescribed omeprazole (Prilosec)and asks the nurse where in the body this medication will work.The nurse correctly answers:

A)"On the gastric mucus layer."
B)"On the mucosa of the trachea."
C)"On the surface of parietal cells."
D)"On the H₂ receptors."

Answer 1

"On the surface of parietal cells."

Question 2

The nurse is caring for an adult male diagnosed with a peptic ulcer.The nurse states that the most likely causative agent is:

A)Cryptococcus.
B)Pneumocystis carinii.
C)Helicobacter pylori.
D)Mycobacterium avium.

Answer 2

Helicobacter pylori.

Question 3

A client complains of gastroesophageal symptoms every evening.The nurse would include what in the teaching to decrease the client's symptoms?

A)Moderating alcohol use
B)Avoiding acidic foods
C)Sleeping with the legs elevated on pillows
D)Eating smaller meals at least 1 hour before sleep

Answer 3

Avoiding acidic foods

Question 4

The nurse is caring for a client being treated for duodenal ulcer.The nurse anticipates the client will begin to experience symptoms of discomfort associated with this condition in ___ to 3 hours after eating a meal.

Question 5

A nurse is performing discharge teaching for a client being discharged with a diagnosis of gastroesophageal reflux disease.The nurse should teach the client to eliminate what foods from the diet?

A)Mashed potatoes
B)Tomato sauce
C)Bananas
D)Toast

Question 6

The nurse is planning care for a client with PUD.What treatment goal should be included in the plan of care for this client?

A)Prevent recurrence of the disease.
B)Patient reports tolerating symptoms.
C)Reduce the level of H.pylori by one-third.
D)Promote stasis of the ulcer.

Question 7

The health care team is attempting to determine cause for a client's duodenal ulcer.Which factors are not associated with peptic ulcer disease?

A)Smoking cigarettes
B)Having a parent diagnosed with a peptic ulcer
C)Excessive stress at home
D)Having type A blood

Question 8

During a pain assessment,a client reports stomach pain that feels like gnawing in the upper abdomen that occurs about 1-1/2 hours after eating meals.The nurse identifies these symptoms to be most consistent with:

A)a duodenal ulcer.
B)acute appendicitis.
C)an exacerbation of diverticulitis.
D)cholelithiasis.

Question 9

A client with a chronic cough,wheezing,and a sore throat states these symptoms have been present for 3 months,and asthma is not the cause.What does the nurse suspect to be causing this client's respiratory issues and sore throat?

A)Zollinger-Ellison syndrome
B)Gastroesophageal reflex disease
C)Crohn disease
D)A gastric ulcer

Question 10

A 48-year-old male is returned from endoscopy with a diagnosis of a duodenal ulcer.The nurse is aware that the most likely causative agent for this ulcer is:

A)H.pylori.
B)prolonged NSAID use.
C)intermittent use of glucocorticoids.
D)chronic stress.

Question 11

A client new to the clinic reports having peptic ulcer disease and a weight loss of 14 pounds in 2 months.The symptom of weight loss would be most consistent with:

A)a duodenal ulcer.
B)a gastric ulcer.
C)frequent exercise.
D)anorexia nervosa.

Question 12

The nurse is teaching the family of a client recently diagnosed with PUD.The nurse knows the family understands the teaching when they state that the risk factors for the development of PUD include: Note: Credit will be given only if all correct choices and no incorrect choices are selected Standard Text: Select all that apply.

A)infection with the bacterium Helicobacter pylori.
B)daily use of aspirin.
C)blood type AB.
D)consumption of caffeine-free soda.
E)smoking.

Question 13

The nurse is caring for a client with PUD.What signs and symptoms does the nurse expect the client to exhibit? Note: Credit will be given only if all correct choices and no incorrect choices are selected.Standard Text: Select all that apply.

A)Anorexia
B)Weight loss
C)Vomiting
D)Heartburn
E)Belching

Question 14

A client who was taking large doses of ibuprofen (Motrin)for over a year developed a peptic ulcer.The client asks the nurse why this occurred.The nurse best answers the client by stating:

A)"Motrin works against your own body's ulcer defenses."
B)"It sounds like your stress might have caused your ulcer."
C)"Taking Motrin cannot cause a peptic ulcer."
D)"The natural defenses of your large intestine were overwhelmed."

Question 15

A client diagnosed with GERD asks the nurse what his treatment will be.The nurse correctly states:

A)"You likely will be instructed to change your lifestyle to see if that helps relieve your symptoms."
B)"We will start you on an over-the-counter agent because you have easy access to them and a small chance of overdosing on them."
C)"We need to attack this early,and will start with combination therapy."
D)"GERD will require a surgical treatment for symptom relief."

Question 16

What are the principal physiological stimuli that regulate acid secretion from the proton pump? Note: Credit will be given only if all correct choices and no incorrect choices are selected.Standard Text: Select all that apply.

A)Gastrin
B)Histamine (H₂)
C)Acetylcholine
D)Intrinsic factor
E)Dopamine

Question 17

The nurse caring for a client with PUD explains that the treatment goals include: Note: Credit will be given only if all correct choices and no incorrect choices are selected.Standard Text: Select all that apply.

A)immediate relief from symptoms.
B)promoting healing of the ulcer.
C)preventing complications of the disease.
D)preventing future recurrence of the disease.
E)reduction of the level of H.pylori by one-third.

Question 18

What client has the greatest risk of having a peptic ulcer?

A)A 24-year-old who complains of being stressed mentally
B)A 52-year-old who smokes
C)A 56-year-old who is taking prednisone and ibuprofen for chronic low-back pain
D)A 48-year-old who is taking acetaminophen and aspirin to reduce fever

Question 19

A client with peptic ulcer disease is undergoing pharmacologic therapy.After reviewing the medication administration record,the nurse suggests changing a prn pain order of ibuprofen to:

A)acetaminophen.
B)aspirin.
C)ketorolac.
D)naprosyn.

Question 20

The nurse correctly states that which function is not characteristic of the parietal cells?

A)Secretion of intrinsic factor
B)Microbial control
C)Secretion of hydrochloric acid
D)Secretion of pepsinogen

Question 21

A client is diagnosed with a gastric ulcer secondary to NSAID overuse.The nurse would health care provider order?

A)Clarithromycin
B)Omeprazole
C)Famotidine
D)Ranitidine

Question 22

A client with GERD must be cautioned against the overuse of antacids to avoid which syndrome?

A)Metabolic alkalosis
B)Metabolic acidosis
C)Respiratory alkalosis
D)Respiratory acidosis

Question 23

The nurse is reviewing the medication administration record for a client who is receiving an initial regimen for the eradication of H.pylori.The nurse anticipates the inclusion of which medications for this client? Note: Credit will be given only if all correct choices and no incorrect choices are selected.Standard Text: Select all that apply.

A)Omeprazole
B)Metronidazole
C)Bismuth subsalicylate
D)Amoxicillin
E)Clarithromycin

Question 24

The nurse is performing a head-to-toe assessment on a client taking aluminum hydroxide (AlternaGel).Why must the nurse closely assess for bowel changes?

A)Hyperactive bowel sounds indicate imminent vomiting; suction should be made available.
B)Hypoactive bowel sounds indicate duodenal ulcerations.
C)Hematochezia is a sign that the medication is working.
D)A distended abdomen could indicate constipation,a side effect of this medication.

Question 25

A client diagnosed with Barrett esophagus might require the most efficient pharmacologic therapy of GERD.This would include the use of which class of drug?

A)Proton pump inhibitor
B)Antacid
C)Magnesium citrate
D)H₂-receptor antagonist

Question 26

A nurse is ordered to administer lansoprazole to a client on a mechanical soft diet.How should the nurse administer this medication?

A)Sprinkle granules into applesauce,then administer.
B)Crush the tablet and stir it into pudding,then administer.
C)Ask the client to chew the medication.
D)First ask the client to drink an entire glass of water,then give the medication.

Question 27

A client is prescribed omeprazole (Prilosec).The nurse prepares to perform client teaching based on the knowledge that omeprazole is a:

A)nicotinic receptor blocker.
B)proton pump inhibitor.
C)muscarinic receptor blocker.
D)histamine-2 receptor agonist.

Question 28

A client with known peptic ulcer disease is placed on a clear-liquid diet pending an endoscopy.What proton pump inhibitor can be given in a liquid form to this client?

A)Famotidine (Pepcid)
B)Ranitidine (Zantac)
C)Lansoprazole (Prevacid)
D)Esomeprazole (Nexium)

Question 29

A client is prescribed an H₂-receptor antagonist.The nurse teaches this client that the purpose of the drug is to:

A)reduce gastric acid secretion in the stomach.
B)prevent the vasodilating effects of histamine.
C)alleviate nasal allergy symptoms.
D)prevent the release of histamine from MAST cells.

Question 30

A client brings her mother to the office and states,"I'm worried about Mom; she takes aluminum hydroxide up to three times a day for this pain in her abdomen." Which statement about aluminum hydroxide is true?

A)Aluminum hydroxide can cause acute appendicitis and should be stopped immediately.
B)A transient abdominal discomfort occurs with the use of aluminum hydroxide and there is no need for concern.
C)It is safe to take aluminum hydroxide up to three times daily,due to its safety profile.
D)Antacids are for occasional use only; further investigation is warranted.

Question 31

A client is prescribed ranitidine (Zantac).The nurse checks the client's BUN and serum creatinine levels prior to administering the drug for the first time.The rationale for checking these labs is:

A)serum BUN and creatinine should be checked on all clients.
B)that the drug is primarily biometabolized by the liver.
C)to identify a hidden drug allergy.
D)that the drug is primarily excreted by the kidneys.

Question 32

A client in a long-term care facility is ordered to receive ranitidine (Zantac).When should the nurse administer this medication?

A)At bedtime with water
B)After the evening meal
C)Before eating in the morning
D)One hour before meals

Question 33

A client is prescribed omeprazole,bismuth subsalicylate,and metronidazole for the treatment of H.pylori.The nurse explains that combination therapy will accomplish which outcome?

A)Increase the number of ulcerations
B)Eliminate the population of H.pylori
C)Allow H.pylori to adhere to the gastric mucosa
D)Immediately relieve symptoms of gastric ulceration

Question 34

Effective client teaching regarding the treatment of H.pylori has been done for a client when the client states:

A)"I will stop taking this medication when my symptoms subside."
B)"I will be sure to take all of the medication exactly as prescribed."
C)"I will stop taking this medication if I get an upset stomach."
D)"I will take this medication when I experience pain or heartburn."

Question 35

The nurse who is planning care for a client with GERD anticipates that the health care provider will order medications from which drug class? Note: Credit will be given only if all correct choices and no incorrect choices are selected.Standard Text: Select all that apply.

A)Proton pump inhibitors
B)H₂-receptor antagonists
C)Antacids
D)Diuretics
E)Antianginals