Chapter 23-agents used to treat hyperacidity

Question 1

The reason the client’s abdominal pain is most severe just prior to mealtime is because:

Answer 1

stomach acid and pepsin are not being consumed by food.

Question 2

The client asks the office nurse if his smoking can cause the development of peptic ulcer disease. The nurse’s best response is:

Answer 2

“Smoking increases the secretion of stomach acid, as well as decreases the acid-neutralizing capacity within the first part of the small intestines

Question 3

The client asks the nurse what the difference is between antacids and proton pump inhibitors. The nurse’s best response is:

Answer 3

“Antacids neutralize gastric acid, and proton pump inhibitors prevent the secretion of gastric acid.”

Question 4

When teaching a client about antacids, which comment by the client indicates further teaching is needed:

Answer 4

“Taking antacids will not affect my heart medication (digoxin).”

Antacids decrease the absorption of digoxin, thus alter its effectiveness.

Question 5

Antacids decrease the absorption of digoxin, thus alter its effectiveness.

Answer 5

the antacid has a much longer duration of action.

When administered 1 hour after meals, antacids have a duration of 3 to 4 hours.

Question 6

Which of the following statements is TRUE about antacid therapy?

Answer 6

Gas released by effervescent antacid solutions may lead to distention and secretion of additional hydrochloric acid
. For this reason, effervescent antacids should not be ingested until the fizzing has stopped.

Question 7

The client asks the nurse how his ranitidine works to treat his heartburn. The nurse’s best response is:

Answer 7

“Ranitidine block the histamine-2 receptors in the stomach to decrease gastric acid.”

This is the action of ranitidine, a histamine-2 receptor antagonist.

Question 8

An example of an antacid that releases carbon dioxide when it neutralizes acid in the stomach is:

Answer 8

calcium carbonate.

Calcium carbonate releases carbon dioxide in the stomach.

Question 9

The client says to the nurse that since he started taking an antacid “that distended feeling in my stomach is better.” In explaining this effect, the nurse understands that the antacid probably contained:

Answer 9

simethicone.- is an antiflatulent.

Question 10

For the client taking enteric-coated aspirin for a heart condition, the nurse should instruct the client to:

Answer 10

not to take his antacid within 1 to 2 hours of his EC (enteric-coated) aspirin.
Antacids will alter the absorption of EC aspirin in the duodenum.

Question 11

Prior to preparing to administer a liquid antacid, the nurse must:

Answer 11

shake well to mix the liquid prior to pouring.

Question 12

The nurse understands that antacids absorbed systemically:

Answer 12

have a rapid onset and a short duration of action.

Question 13

The ideal antacid does not cause acid rebound. Acid rebound is best described as:

Answer 13

overproduction of acid when the stomach pH is above the 4 to 5 range.
This describes acid rebound

Question 14

Clients sometimes prefer chewable forms of antacids because of their convenience. When this form of antacid is used, the nurse instructs the client to:

Answer 14

chew the tablet completely before swallowing and follow it with a glass of water.

Question 15

The client is prescribed cimetidine for treatment of hyperacidity. The nurse should tell the client:

Answer 15

“Your cigarette smoking may decrease the effectiveness of this drug.”

This is information that the client taking cimetidine should be given.

Question 16

Acid-neutralizing capacity (ANC) is an important consideration in choice of antacid. The nurse realizes that further client education is necessary when the client expresses which of the following ideas?

Answer 16

“Antacids with a high ANC can only be obtained by prescription.”

Question 17

Cimetidine is not as commonly used as often in adults as other drugs in its class. The nurse understands that this is because cimetidine:

Answer 17

has more drug-to-drug interactions.

Question 18

Which of the following statements by the client indicates that further teaching about proton pump inhibitor therapy is warranted?

Answer 18

“These are just more expensive versions of the histamine-2 antagonists.”

Proton pump inhibitors action differs from that of the histamine-2 antagonists.

Question 19

In addition to treating duodenal ulcer disease, lansoprazole and omeprazole also are approved in the treatment of:

Answer 19

H. pylori infections-In combination with amoxicillin or clarithromycin, these drugs are approved to treat H. pylori infections in clients with duodenal ulcer disease.

Question 20

The client asks the nurse why her health care provider prescribed esomeprazole for her. The nurse’s best response is:

Answer 20

“This drug is used to treat the inflammation in your esophagus caused by GERD.”

Question 21

A hospitalized client has been prescribed sucralfate. The nurse recruit exhibits understanding about this medication when he states, “Sucralfate is used because it:

Answer 21

forms a protective complex over duodenal ulcers.”

Question 22

What is the nurse recruit’s best response when asked, “Which of the following clients is most likely to experience pancreatic enzyme deficiency?”

Answer 22

a client with cystic fibrosis

Clients with cystic fibrosis require pancreatic enzyme replacement.

Question 23

The nurse recognizes that which of the following is NOT a histamine H2-receptor antagonist?

Answer 23

quinidine- is an antiarrhythmic.

Question 24

A client taking ranitidine tells the nurse that he frequently experiences headaches. The best response by the nurse is:

Answer 24

“Though headaches can occur, can you describe these headaches for me?”

Question 25

A client taking nonsteroidal anti-inflammatory agents (NSAIDs) for arthritis is experiencing gastric irritation. The nurse anticipates the health care provider will prescribe:

Answer 25

misoprostol-This is the agent used to treat gastric irritation caused by NSAIDs.

Question 26

A client is prescribed esomeprazole and metoclopramide for GERD. The client approaches the nurse saying, “I understand why he prescribed Nexium, but why the laxative?” The nurse’s best response is:

Answer 26

“Metoclopramide is a gastric stimulant, not a laxative.”

Question 27

The nurse admitting a client with GERD is planning the client’s care and determines that the priority nursing diagnosis for this client is:

Answer 27

risk for injury related to development of complications of GERD.
Complications of GERD include esophagitis, esophageal erosions, and esophageal cancer. This is the highest priority for this client.

Question 28

The nurse would question a prescription for metoclopramide for which of the following clients?

Answer 28

client with a seizure disorde-may increase the risk of seizures.

Question 29

A client is experiencing constipation secondary to the use of calcium carbonate. The nurse’s most appropriate response to this client is:

Answer 29

“Alternating the calcium carbonate with magnesium hydroxide will help prevent this.”

By alternating calcium carbonate with a magnesium-based antacid (adverse side effect is diarrhea), the client should be able to avoid both adverse effects.

Question 30

A client asks the nurse if drinking coffee might make her peptic ulcer disease worse. The nurse’s best response is:

Answer 30

“Both caffeinated and decaffeinated coffees are ulcerogenic and must be avoided.”

Question 31

The instructor asks the nurse recruit, “Which of these clients is the most appropriate candidate for metoclopramide therapy?” Considering the action of this agent, the nurse recruit would be correct when responding:

Answer 31

a client debilitated by a stroke.
Because this client is at high risk for Curling’s ulcer from prolonged contact between the gastric mucosa and gastric acid from immobility, this client is the most appropriate.

Question 32

A young child being treated with metoclopramide for gastroesophageal reflux develops an acute dystonic reaction. The nurse anticipates administering:

Answer 32

parenteral diphenhydramine.

Acute dystonic reaction in children receiving metoclopramide is reversed by parenteral diphenhydramine.

Question 33

The client receiving Prevacid would be monitored for which of the following?

Answer 33

a. diarrhea
b. constipation
c. nausea and vomiting
d. vertigo
e. skin rash
f. headache

Question 34

Which of the following statements are true of Aciphex?

Answer 34

a. Headache is an adverse effect.
b. The client should avoid OTC products.
c. The client’s CBC should be monitored.
e. Nervousness is an adverse effect.
f. The medication increases digoxin levels.

Question 35

The client has a prescription for the PPI Kapidex. Which of the following would be included in client teaching?

Answer 35

b. DVT may occur.
c. The medication can be taken without regard to food.
d. If unable to swallow the capsules, the client may mix the contents in the capsule with 1 tablespoon of applesauce or pudding.
e. Altered taste may occur.