Deck 26: Antacids and the Management of GERD

Question 1

An 80-year-old patient asks a primary care NP about OTC antacids for occasional heartburn.The NP notes that the patient has a normal complete blood count and normal electrolytes and a slight elevation in creatinine levels.The NP should recommend:

A) calcium carbonate (Tums).
B) aluminum hydroxide (Amphojel).
C) sodium bicarbonate (Alka-Seltzer).
D) magnesium hydroxide (Milk of Magnesia).

Answer 1

calcium carbonate (Tums).

Question 2

A patient who has gastroesophageal reflux disease (GERD)undergoes an endoscopy,which shows a hiatal hernia.The patient is mildly obese.The patient asks the primary care nurse practitioner (NP)about treatment options.The NP should tell this patient that:

A) a fundoplication will be necessary to correct the cause of GERD.
B) over-the-counter (OTC) antacids can be effective and should be tried first.
C) elevation of the head of the bed at night can relieve most symptoms.
D) a combination of lifestyle changes, medications, and surgery may be necessary.

Answer 2

a combination of lifestyle changes, medications, and surgery may be necessary.

Question 3

A patient who has GERD with erosive esophagitis has been taking a PPI for 4 weeks and reports a decrease in symptoms.The patient asks the primary care NP if the medication may be discontinued.The NP should tell the patient that:

A) the dose may be decreased for long-term therapy.
B) antireflux surgery must be done before the PPI can be discontinued.
C) the condition may eventually be cured, but therapy must continue for years.
D) once the symptoms have cleared completely, the medication may be discontinued.

Answer 3

the dose may be decreased for long-term therapy.

Question 4

A patient is taking a low-dose PPI for long-term management of GERD and reports taking sodium bicarbonate (Alka-Seltzer)to help with occasional heartburn.The primary care NP should tell the patient to:

A) change to aluminum hydroxide (Amphojel).
B) use magnesium hydroxide (Milk of Magnesia) instead.
C) continue using sodium bicarbonate (Alka-Seltzer) as needed.
D) take calcium carbonate (Tums) instead of sodium bicarbonate (Alka-Seltzer).

Question 5

A patient undergoes endoscopy,and a diagnosis of erosive esophagitis is made.The patient does not have health insurance and asks the primary care NP about using OTC antacids such as Tums.The NP should tell the patient that Tums:

A) can help to heal erosions in esophageal tissue.
B) do not help reduce symptoms of erosive esophagitis.
C) neutralize stomach acid as well as proton pump inhibitors (PPIs).
D) help reduce symptoms in conjunction with PPIs.

Question 6

A patient in the clinic reports heartburn 30 minutes after meals,a feeling of fullness,frequent belching,and a constant sour taste.The patient has a normal weight and reports having a high-stress job.The primary care NP should recommend:

A) antacid therapy as needed.
B) changes in diet to avoid acidic foods.
C) daily treatment with a PPI.
D) consultation with a gastroenterologist for endoscopy.

Question 7

A patient who has GERD has been taking a PPI for 2 months and reports a slight decrease in symptoms.The next response of the primary care NP is to:

A) add a histamine-2-receptor agonist.
B) increase the dose of the PPI.
C) change to long-term, low-dose PPI therapy.
D) refer the patient to an endocrinologist for endoscopy and further management.