Deck 60: Pharmacotherapy of Peptic Ulcer Disease

Question 1

Which of the following patients has the greatest risk of having a peptic ulcer?
1)A 52-year-old who smokes
2)A 56-year-old who is taking prednisone and ibuprofen for chronic low back pain
3)A 48-year-old who is taking acetaminophen and aspirin to reduce fever
4)A 24-year-old who complains of being stressed mentally

Answer 1

2

Question 2

A patient, new to the clinic, reports having peptic ulcer disease and a weight loss of 14 pounds in two months.The symptom of weight loss would be most consistent with:
1)A duodenal ulcer.
2)Frequent exercise.
3)Anorexia nervosa.
4)A gastric ulcer.

Answer 2

1

Question 3

A patient is prescribed an H2-receptor antagonist.The nurse teaches this patient that the purpose of the drug is to:
1)Alleviate nasal allergy symptoms.
2)Prevent the vasodilating effects of histamine.
3)Prevent the release of histamine from MAST cells.
4)Reduce gastric acid secretion in the stomach.

Answer 3

4

Question 4

Which of the following is a treatment goal for a patient with PUD?
1)Promote stasis of the ulcer.
2)Provide minor relief of symptoms.
3)Prevent recurrence of the disease.
4)Reduce the level of H.pylori by one-third.

Question 5

A patient complains of gastroesophageal symptoms every evening.The nurse teaches the patient to do all of the following except:
1)Avoid acidic foods.
2)Eat smaller meals at least three hours before sleep.
3)Eliminate alcohol use.
4)Sleep with the legs elevated on pillows.

Question 6

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:
1)Prolonged NSAID use.
2)Chronic stress.
3)Intermittent use of glucocorticoids.
4)H.pylori.

Question 7

A patient with GERD must be cautioned against the overuse of antacids to avoid which syndrome?
1)Respiratory acidosis
2)Metabolic acidosis
3)Respiratory alkalosis
4)Metabolic alkalosis

Question 8

A patient diagnosed with Barrett's esophagus might require the most efficient pharmacologic therapy of GERD.This would include the use of which class of drug?
1)Proton pump inhibitor
2)Antacid
3)H2-receptor antagonist
4)Magnesium citrate

Question 9

Which of the following is not a function of the parietal cells?
1)Secretion of hydrochloric acid
2)Secretion of intrinsic factor
3)Microbial control
4)Secretion of pepsinogen

Question 10

A patient is diagnosed with a gastric ulcer secondary to NSAID overuse.The nurse would question which physician order?
1)Omeprazole
2)Ranitidine
3)Clarithromycin
4)Famotidine

Question 11

Effective patient teaching regarding the treatment of H.pylori has been done for a patient when the patient states:
1)"I will take this medication when I experience pain or heartburn."
2)"I will be sure to take all of the medication exactly as prescribed."
3)"I will stop taking this medication when my symptoms subside."
4)"I will stop taking this medication if I get an upset stomach."

Question 12

A patient 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:
1)"On the histamine-2 receptors."
2)"On the surface of parietal cells."
3)"On the gastric mucus layer."
4)"On the mucosa of the trachea."

Question 13

A nurse is performing discharge teaching for a patient being discharged with a diagnosis of gastroesophageal reflux disease.The nurse should teach the patient that which of the following foods should be eliminated from the patient's diet?
1)Tomato sauce
2)Mashed potatoes
3)Bananas
4)Toast

Question 14

A patient is prescribed omeprazole, bismuth subsalicylate, and metronidazole for the treatment of H.pylori.The nurse explains that the combination therapy will do all of the following except:
1)Prevent H.pylori from adhering to the gastric mucosa.
2)Reduce stomach acid.
3)Reduce the population of H.pylori.
4)Immediately relieve symptoms of gastric ulceration.

Question 15

A patient presents with a chronic cough, wheezing, and a sore throat.He states he's had these symptoms for three months, and asthma is not the cause.The nurse suspects that which of the following might be causing this patient's respiratory issues and sore throat?
1)Zollinger-Ellison syndrome
2)A gastric ulcer
3)Gastroesophageal reflex disease
4)Crohn's disease

Question 16

A patient diagnosed with GERD asks the nurse what his treatment will be.The nurse correctly states:
1)"You likely will be instructed to change your lifestyle to see if that helps relieve your symptoms."
2)"We need to attack this early, and will start with combination therapy."
3)"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."
4)"GERD will require a surgical treatment for symptom relief."

Question 17

The health care team is attempting to determine cause for a patient's duodenal ulcer.Which of the following is not associated with peptic ulcer disease?
1)Having a parent diagnosed with a peptic ulcer
2)Having type A blood
3)Smoking cigarettes
4)Excessive stress at home

Question 18

A patient with peptic ulcer disease is undergoing pharmacologic therapy.After reviewing the medication administration record, the nurse suggests changing a p.r.n.pain order of ibuprofen to:
1)Naprosyn.
2)Ketorolac.
3)Acetaminophen.
4)Aspirin.

Question 19

An adult male has been diagnosed with a peptic ulcer.The most likely causative agent is:
1)Cryptococcus.
2)Pneumocystis carinii.
3)Mycobacterium avium.
4)Helicobacter pylori.

Question 20

A patient who was taking large doses of ibuprofen (Motrin)for over a year developed a peptic ulcer.The patient asks the nurse why this occurred.The nurse best answers the patient by stating:
1)"The natural defenses of your large intestine were overwhelmed."
2)"Taking Motrin cannot cause a peptic ulcer."
3)"Motrin works against your own body's ulcer defenses."
4)"It sounds like your stress might have caused your ulcer."

Question 21

A patient is prescribed ranitidine (Zantac).The nurse checks the patient's BUN and serum creatinine levels prior to administering the drug for the first time.The rationale for checking these labs is:
1)The drug is primarily biometabolized by the liver.
2)Serum BUN and creatinine should be checked on all patients.
3)To identify a hidden drug allergy.
4)The drug is primarily excreted by the kidneys.

Question 22

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

Question 23

A patient who is prescribed omeprazole (Prilosec)for GERD repeatedly takes the agent before bedtime.The most appropriate nursing diagnosis for this patient is:
1)Fluid Volume Imbalance, risk for.
2)Acute Pain.
3)Acute Confusion.
4)Deficient Knowledge.

Question 24

A patient with known peptic ulcer disease is placed on a clear-liquid diet pending an endoscopy.Which of the following proton pump inhibitors can be given in a liquid form to this patient?
1)Esomeprazole (Nexium)
2)Lansoprazole (Prevacid)
3)Ranitidine (Zantac)
4)Famotidine (Pepcid)

Question 25

The nurse is performing a head-to-toe assessment on a patient taking aluminum hydroxide (AlternaGel).Why must the nurse closely assess for bowel changes?
1)A distended abdomen could indicate constipation, a side effect of this medication.
2)Hyperactive bowel sounds indicate imminent vomiting; suction should be made available.
3)Hypoactive bowel sounds indicate duodenal ulcerations.
4)Hematochezia is a sign that the medication is working.

Question 26

A 29-year-old female is prescribed ranitidine (Zantac)for symptoms of GERD.Which of the following patient teaching components is essential for this patient?
1)Notify your health care provider if you become pregnant.
2)Limit your alcohol intake to no more than one drink per day.
3)If this medication doesn't help your symptoms, you may take an over-the-counter antacid.
4)Black stools are common with this medication, and not a cause for concern.

Question 27

A patient in a long-term care facility is ordered to receive ranitidine (Zantac).When should the nurse administer this medication?
1)One hour before meals
2)Two hours after a meal
3)With meals
4)At bedtime with water

Question 28

A patient is prescribed omeprazole (Prilosec).The nurse prepares to perform patient teaching based on the knowledge that omeprazole is a(:
1)Histamine-2 receptor agonist.
2)Proton pump inhibitor.
3)Muscarinic receptor blocker.
4)Nicotinic receptor blocker.

Question 29

A nurse is ordered to administer lansoprazole to a patient on a mechanical soft diet.How should the nurse administer this medication?
1)Crush the tablet and sprinkle it into pudding, then administer.
2)Ask the patient to chew the medication.
3)First ask the patient to drink an entire glass of water, then give the medication.
4)Sprinkle granules into applesauce, then administer.