Question 1

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

Accepted Answer

Older adults are more likely to experience drowsiness and acute confusion when taking these drugs.They should avoid driving or operating dangerous equipment until they know how the drug affects them.Although the drug should be taken with a meal or before bedtime,the safety issue with the confusion and drowsiness has the highest priority.Avoiding caffeine and elevating the head of the bed are helpful for GERD but are not related to drug therapy.

Question 2

Which protective mechanism by the stomach protects it from stomach acids and the formation of gastric ulcers?&#10;A) Buffers such as bicarbonate neutralize stomach acids.&#10;B) The stomach secretes a thick gel-like mucus to coat itself.&#10;C) Acid secretion is decreased when food is not present in the stomach.&#10;D) Stomach secretions such as lipase digest foods and protect the stomach.

Accepted Answer

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.

Question 3

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?&#10;A) &#34;Take this drug 30 minutes before each meal.&#34;&#10;B) &#34;Do not drink fluids for at least 30 minutes after taking this drug.&#34;&#10;C) &#34;Be sure to consume a diet with lots of vegetables and other foods with fiber.&#34;&#10;D) &#34;Report any episodes of diarrhea immediately to your prescriber.&#34;

Accepted Answer

Aluminum hydroxide is an aluminum-based antacid.The most common side effect of these drugs is constipation.Patients should be taught to consume a diet rich in fiber-containing foods to prevent this side effect.

Question 4

A patient who has been prescribed rabeprazole (Aciphex)develops black,tarry stools.What is the nurse's best first action?&#10;A) Check the patient's medication list for prescribed iron supplements.&#10;B) Teach the patient that this is an expected side effect of proton pump inhibitors.&#10;C) Send a stool sample to the lab for analysis.&#10;D) Notify the prescriber immediately.

Accepted Answer

Black and tarry stools are never normal; they indicate bleeding and should be reported to the prescriber at once.Sending a stool sample to the laboratory to test for blood helps to confirm the presence of blood in the stool,but an order from the prescriber is needed to perform this action.

Question 5

A patient with a history of GI ulcers reports feeling new onset burning,gnawing stomach pain.What is the nurse's best action?&#10;A) Assess the patient's abdomen for the presence of active bowel sounds.&#10;B) Administer the already ordered as-needed dose of liquid antacid.&#10;C) Offer the patient food to buffer excess stomach acid.&#10;D) Notify the prescriber immediately.

Accepted Answer

The most common symptom of peptic ulcer is burning,gnawing pain caused by stomach acid coming into contact with an open wound (ulcer).The pain usually occurs somewhere between the navel and breastbone and may last from a few minutes to many hours.Even though foods and antacids may relieve the pain,the fact that this is new onset pain indicates that the nurse should notify the prescriber immediately.

Question 6

To prevent a common risk among older adults who are prescribed proton pump inhibitors,which safety precaution does the nurse recommend?&#10;A) &#34;Be sure to take a daily multivitamin.&#34;&#10;B) &#34;Use handrails when going up or down stairs.&#34;&#10;C) &#34;Take this drug with food or a full glass of fluid.&#34;&#10;D) &#34;Notify your prescriber if you develop belching or gas.&#34;

Accepted Answer

Proton pump inhibitors have been associated with increased hip fracture in older adults because of decreased calcium absorption.Teach patients to use side rails when going up or down stairs.

Question 7

A patient who is prescribed omeprazole (Prilosec)asks the nurse why the drug should be taken before breakfast.What is the nurse's best response?&#10;A) &#34;The intended action of this drug is best achieved when given before meals, preferably in the morning.&#34;&#10;B) &#34;It is best to take this drug in the morning so that antacids taken later in the day do not interfere with absorption.&#34;&#10;C) &#34;This drug should always be taken on an empty stomach for maximal action and for better absorption.&#34;&#10;D) &#34;Taking this drug early in the morning helps to minimize the occurrence of side effects or adverse effects.&#34;

Accepted Answer

Omeprazole is a proton pump inhibitor.These drugs work best when given before meals,preferably in the morning.Proton pump inhibitors can be given with antacids,with food,or without food.

Question 8

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?&#10;A) Darkened urine and white stool&#10;B) Altered food taste and dry mouth&#10;C) Weekly constipation with bloating&#10;D) Reduced interest in sexual activity

Accepted Answer

Cimetidine can cause drug-induced hepatitis.Dark urine and white stool are symptoms of liver problems and should be investigated immediately before any damage becomes permanent.It is likely the drug will need to be discontinued.

Question 9

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 patient's family to watch for?&#10;A) Confusion&#10;B) Anxiety&#10;C) Depression&#10;D) Psychosis

Accepted Answer

Famotidine is a histamine H₂ blocker.The most common side effect of these drugs is confusion.The nurse must teach the patient's family to monitor for changes in level of consciousness and confusion and to notify the prescriber if this occurs.

Question 10

A patient who has been prescribed ranitidine (Zantac)reports darkened stools.What is the nurse's best action?&#10;A) Hold the dose and notify the prescriber.&#10;B) Document the report as the only action.&#10;C) Reassure the patient that this is a common and harmless side effect.&#10;D) Ask the patient if he or she has been using aspirin or any other nonsteroidal anti-inflammatory drug (NSAID).

Accepted Answer

Ranitidine contains a substance that darkens the tongue and the stools.This is a harmless side effect and does not indicate a health problem.It is not a reason to stop the drug.

Question 11

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

Accepted Answer

The answer of The nurse is instructing a pregnant patient...

Question 12

Why does the backward flow of stomach contents into the esophagus cause tissue damage?&#10;A) No digestive processes occur in the esophagus.&#10;B) The esophagus does not have the thick gel-like mucus to protect it from acid.&#10;C) The esophagus secretes only bicarbonate, which is not strong enough to neutralize stomach acids.&#10;D) The esophagus cannot expand with extra volume, and the excessive stretching damages the muscle layer.

Accepted Answer

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Question 13

A patient with gastroesophageal reflux disease is prescribed ranitidine (Zantac).Which statement by the patient indicates to the nurse a need for additional teaching?&#10;A) &#34;If I need to use ranitidine for more than 2 weeks, I will notify my prescriber.&#34;&#10;B) &#34;I will look into a smoking cessation program when I go home.&#34;&#10;C) &#34;I will take the ranitidine first thing in the morning so that its effect will last all day and night.&#34;&#10;D) &#34;I will not drive until I know how the ranitidine affects me.&#34;

Accepted Answer

The answer of A patient with gastroesophageal reflux disease is...

Question 14

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

Accepted Answer

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Question 15

A patient who is prescribed sucralfate asks the nurse how this drug will help treat his gastric ulcer.What is the nurse's best response?&#10;A) &#34;Sucralfate decreases secretion of gastric acids to help your ulcer heal.&#34;&#10;B) &#34;Sucralfate completely blocks the secretion of gastric acids so your ulcer can heal.&#34;&#10;C) &#34;Sucralfate treats the infection with H. pylori that is the major cause of gastric ulcers.&#34;&#10;D) &#34;Sucralfate forms a thick coating to cover the ulcer, protect from further damage, and allow healing.&#34;

Accepted Answer

The answer of A patient who is prescribed sucralfate asks...

Question 16

Which symptoms are associated with gastric ulcers?&#10;A) Constant bloating and diarrhea&#10;B) Shortness of breath in any position&#10;C) Burning pain that is relieved by eating&#10;D) Burning pain that is relieved by abstaining from food

Accepted Answer

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Question 17

Which precaution is most important for the nurse to teach a patient who is prescribed raberprazole (Aciphex)?&#10;A) &#34;Wear a hat and sunscreen outdoors to prevent sunburn.&#34;&#10;B) &#34;Take this drug one hour before or two hours after a meal.&#34;&#10;C) &#34;Drink at least 3 liters of fluid daily to prevent constipation.&#34;&#10;D) &#34;Avoid eating raw fruits and vegetables while taking this drug.&#34;

Accepted Answer

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Question 18

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? 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

Accepted Answer

The answer of A patient who has been taking nizatidine...

Question 19

Which factor is the cause of most peptic ulcers?&#10;A) Excessive production of stomach acids&#10;B) Lifestyle factors such as stress and spicy foods&#10;C) Infection with Helicobacter pylori bacteria&#10;D) Excessive use of drugs such as nonsteroidal anti-inflammatory drugs (NSAIDs)

Accepted Answer

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Question 20

Why are older patients who are prescribed proton pump inhibitors more at risk for drug-induced hip fracture?&#10;A) Induced drowsiness increases the risk for falling.&#10;B) Inhibited calcium absorption makes bones more fragile.&#10;C) Excessive potassium loss reduces muscle strength and balance.&#10;D) Anemia and fatigue prevent participation in exercise and reduce mobility.

Accepted Answer

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Question 21

Why should parents be taught not to give bismuth subsalicylate (Pepto-Bismol)to a child?&#10;A) It contains aspirin that can cause Reye's syndrome.&#10;B) It changes stool color making the identification of GI bleeding more difficult.&#10;C) It has such powerful antidiarrheal effects that toxic megacolon can occur.&#10;D) It produces a paradoxical reaction in children that results in worsening of the symptoms.

Accepted Answer

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Question 22

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?&#10;A) &#34;This drug coats my ulcer and protects it so that healing can occur.&#34;&#10;B) &#34;I should eat foods with lots of fiber while I'm taking this drug.&#34;&#10;C) &#34;If I feel dizzy, I will be sure to get up from bed slowly.&#34;&#10;D) &#34;Once I am feeling better I can stop taking the drug.&#34;

Accepted Answer

The answer of The nurse is instructing a patient who...

Question 23

The spouse of an older adult with Alzheimer's disease tells the nurse that he has been giving the patient Amphogel (aluminum hydroxide)for heartburn.What is the nurse's best action?&#10;A) Ask the spouse how often the patient is taking the Amphogel.&#10;B) Suggest that the patient be given AlternaGEL instead.&#10;C) Teach the spouse that taking this drug can worsen the patient's condition.&#10;D) Remind the spouse that giving this drug often can interfere with bowel function.

Accepted Answer

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Question 24

What should the nurse plan to teach a patient about smoking and peptic ulcer disease?&#10;A) Smoking increases acid secretion.&#10;B) Smoking is not a cause of ulcer formation.&#10;C) Smoking slows ulcer healing.&#10;D) Smoking is related to the reoccurrence of ulcers.&#10;E) Smoking decreases stomach mucus production.

Accepted Answer

The answer of What should the nurse plan to teach...

Question 25

Which precaution is most important for the nurse to teach a patient who is prescribed an antacid?&#10;A) &#34;Avoid using extra pepper on your food while taking this drug.&#34;&#10;B) &#34;If you become constipated, stop taking the antacid completely.&#34;&#10;C) &#34;Take this drug at least 2 hours before or after taking any other drug.&#34;&#10;D) &#34;Notify your prescriber if heartburn continues after you have taken the drug for 3 days.&#34;

Accepted Answer

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Question 26

A patient with gastroesophageal reflux disease (GERD)asks the nurse why metoclopramide (Reglan)has been prescribed.What is the nurse's best response?&#10;A) &#34;This purpose of this drug for GERD is to prevent nausea.&#34;&#10;B) &#34;This drug has been prescribed to help move food along through your GI tract.&#34;&#10;C) &#34;Metoclopramide will prevent vomiting and the risk for aspiration.&#34;&#10;D) &#34;This drug causes growth of new cells to heal your esophagus.&#34;

Accepted Answer

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Question 27

Which foods,activities,and drugs does the nurse teach the patient with peptic ulcer disease to avoid?&#10;A) Alcohol&#10;B) Caffeine&#10;C) Dairy products&#10;D) Exercising&#10;E) Smoking&#10;F) Spicy food&#10;G) Nonsteroidal anti-inflammatory drugs (NSAIDs)

Accepted Answer

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Deck 20: Drugs for Gastric Ulcers and Reflux