Chapter 23 Review Qs & Evolve Flashcards
- Which drug is a cytoprotective drug?
A. Ranitidine B. Omeprazole C. Calcium carbonate D. Sucralfate
D
- A patient prescribed a proton pump inhibitor tells you that he or she is experiencing black tarry stools. What side effect does this indicate?
A. Water brash B. Reflux C. Bleeding D. Diarrhea
C
- A patient prescribed omeprazole tells you that he had persistent abdominal pain. What should you do? A. Administer an antacid B. Notify the prescriber C. Order a bland diet for the patient D. Instruct the patient to drink milk
B
- When should you teach a patient prescribed lanzoprazole to take the drug?
A. Immediately on waking in the morning B. One hour after each meal C. Before meals in the morning D. Only at bedtime
C
- An older adult patient is prescribed famotidine for reflux. Which information and precautions would you teach his family? (Select all that apply.)
A. The patient may experience dizziness. B. Be sure to report every episodes of dyspepsia to the prescriber. C. Tell the prescriber if you notice LOC changes such as confusion. D. Take this drug with an antacid to increase its absorption. E. Be aware that the patient is at increased risk for falls. F. This drug will form a protective coating in his stomach.
A C E
- A patient asks you how cytoprotective drugs will help prevent gastric ulcers. What is your best response?
A. “It will increase movement of digested food through your bowel.” B. “It will decrease secretion of acids in your stomach.” C. “It will coat and protect the stomach lining.” D. “It will neutralize stomach acids.”
C
- For which common side effect of proton pump inhibitors must you monitor a patient?
A. Constipation B. Confusion C. Reflux D. Bleeding
A
- What must you be sure to do before administering a histamine H2 blocker? (Select all that apply.)
A. Check patient’s level of consciousness. B. Ask the patient about usual bowel habits. C. Give a drug to prevent diarrhea. D. Give once a day histamine H2 blockers with a meal. E. Ask about bleeding and reflux.
A B E
- A patient has been taking over-the-counter histamine H2 blockers for more than 2 weeks and his GERD symptoms have not improved. What must you instruct the patient to do?
A. Continue taking the histamine H2 blockers. B. Take the histamine H2 blockers more often. C. Try taking a different histamine H2 blocker. D. Inform his or her health care provider.
D
- Which of the following drugs may pass into breast milk and are not recommended when a woman is breastfeeding? (Select all that apply.)
A. ranitidine (Zantac) B. pantoprazole (Protonix) C. magnesium hydroxide (Maalox) D. aluminum hydroxide (Amphojel) E. omeprazole (Prilosec)
A B E
The nurse is admitting a patient diagnosed with peptic ulcer disease (PUD). What condition is a complication of this disease?
Reye’s syndrome
Esophageal stricture
Barrett’s esophagus
Perforation
Perforation
Complications of peptic ulcers include bleeding, perforation, and gastric obstruction.
A patient asks the nurse what drug types are used to treat peptic ulcer disease (PUD)? What medications does the nurse tell the patient? (select all that apply)
Histamine H2 blockers Proton pump inhibitors Antacids Promotility drugs Cytoprotective drugs Antibiotics
Histamine H2 blockers Proton pump inhibitors Antacids (teacher says so, not Evolve) Cytoprotective drugs Antibiotics
A patient is diagnosed with gastroesophageal reflux disease (GERD). What common symptom do you expect to see in this patient?
Nausea
Vomiting of bright red or black blood
Burning, gnawing pain occurring between the umbilicus and sternum
Heartburn
Heartburn
The most common symptom of GERD is dyspepsia (heartburn). Other common symptoms include sour or bitter taste; bitter stomach fluid going into the mouth, especially during sleep; hoarseness; water brash (regurgitation of watery acid from the stomach); a repeated need to clear the throat; difficulty swallowing food or liquid; wheezing or coughing at night; and worsening of symptoms after eating or when bending over or lying down. Nausea is not a symptom of GERD. Vomiting of bright red or black blood can be a symptom of peptic ulcer disease (PUD) and indicates GI bleeding. Pain between the umbilicus and the sternum is a symptom of PUD
A patient with peptic ulcer disease (PUD) asks why sucralfate (Carafate) has been prescribed. What is your best response?
“It coats your stomach and protects it from gastric acids.”
“It coats your ulcer and protects it from gastric acids.”
“It blocks the secretions of gastric acids.”
“It decreases the secretion of gastric acids.”
“It coats your ulcer and protects it from gastric acids.”
A nurse is discharging a patient who has been diagnosed with gastroesophageal reflux disease (GERD). In addition to medication, what recommended treatments can the nurse tell the patient? (select all that apply)
Avoid chocolate Lie flat after eating Avoid tobacco use Avoid eating within 1 hour of bedtime Eat smaller, more frequent meals Chew gum after meals
Avoid chocolate
Avoid tobacco use
Eat smaller, more frequent meals
Chew gum after meals
GERD is a chronic condition; treatment is lifelong. Treatment of GERD is divided into five stages and involves not only drugs but also lifestyle changes such as avoiding foods that cause increased reflux such as chocolate, peppermint, alcohol, and caffeinated drinks; smoking cessation; avoidance of large meals and foods that cause regurgitation; and chewing gum after meals because it increases the production of saliva, which contains bicarbonate, and increases the rate of swallowing. Other treatments include decreased dietary fat intake and weight reduction. After meals the patient with GERD should remain upright for 3 hours and not lie flat and should not eat within 3 hours of bedtime.REF: p. 376
