Adams, Pharmacology for Nurse: A Pathophysiologic Approach, 4/E Chapter 40

Question 1 Type: MCSA The nursing instructor teaches the student nurses about intrinsic factor. The instructor evaluates that learning has occurred when the students make which response? 1. "Intrinsic factor is secreted b the chief cells of the stomach." 2. "Intrinsic factor is necessar for absorption of vitamin !"." 3. "Intrinsic factor aids in the secretion of mucus to protect the stomach." 4. "Intrinsic factor is necessar for absorption of vitamin !#$." Correct Answer: % ationa!e 1& Chief cells secrete pepsinogen and rennin' not intrinsic factor. ationa!e 2& Intrinsic factor is necessar for the absorption of vitamin !#$' not !". ationa!e 3& Intrinsic factor does not aid in the secretion of mucus in the stomach. ationa!e 4& (arietal cells secrete intrinsic factor' which is essential for the absorption of vitamin !#$. "!o#a! ationa!e: Co$niti%e &e%e!: Anal )ing C!ient 'eed: (h siological Integrit C!ient 'eed (u#: (h siological Adaptation 'ursin$/)nte$rated Concepts: *ursing (rocess& +valuation &earnin$ *utcome: %,-# Question 2 Type: MCMA The ph sician has ordered bismuth .(epto-!ismol/ for the client with a peptic ulcer who is coloni)ed with H. Pylori. The client asks the nurse wh he is receiving this drug. 0hat is the best response b the nurse? Note: Credit will be given only if all correct choices and no incorrect choices are selected. (tandard Te+t: Select all that appl .
Adams, Pharmacology for Nurse: A Pathophysiologic Approach, %1+ Cop right $,#% b (earson +ducation' Inc.

1. "!ismuth .(epto-!ismol/ increases stomach acid to help kill bacteria." 2. "!ismuth .(epto-!ismol/ helps prevent the side effects of antibiotics." 3. "!ismuth .(epto-!ismol/ is effective for inhibiting bacterial growth." 4. "!ismuth .(epto-!ismol/ keeps bacteria from sticking in our stomach." ,. "!ismuth .(epto-!ismol/ helps relieve ulcer-related constipation." Correct Answer: 2'% ationa!e 1& !ismuth .(epto-!ismol/ does not increase stomach acid. ationa!e 2& !ismuth .(epto-!ismol/ does not prevent the side effects of antibiotics. ationa!e 3& !ismuth compounds .(epto-!ismol/ are added to the antibiotic regimen to inhibit bacterial growth. ationa!e 4& !ismuth compounds .(epto-!ismol/ prevent H. Pylori from adhering to the gastric mucosa. ationa!e ,& !ismuth .(epto-!ismol/ is used to relieve diarrhea' not constipation. "!o#a! ationa!e: Co$niti%e &e%e!: Anal )ing C!ient 'eed: (h siological Integrit C!ient 'eed (u#: (harmacological and (arenteral Therapies 'ursin$/)nte$rated Concepts: *ursing (rocess& Implementation &earnin$ *utcome: %,-" Question 3 Type: MCSA The ph sician orders misoprostol .C totec/ for the female client with peptic ulcer disease .(34/. 0hat is a priorit 5uestion for the nurse to ask the client prior to administration of this medication? 1. "4o ou plan on becoming pregnant?" 2. "Are ou se6uall active?" 3. "Are ou pregnant?" 4. "Are our menstrual c cles irregular?" Correct Answer: 2 ationa!e 1& Misoprostol .C totec/ is safe as long as the client is not currentl pregnant.
Adams, Pharmacology for Nurse: A Pathophysiologic Approach, %1+ Cop right $,#% b (earson +ducation' Inc.

ationa!e 2& Asking if a client is se6uall active could be appropriate' but the nurse would also ask if the client is using birth control. ationa!e 3& Misoprostol .C totec/ is contraindicated during pregnanc 7 it is sometimes used to terminate pregnancies. ationa!e 4& There is no contraindication for misoprostol .C totec/ in a client with irregular menstrual c cles. "!o#a! ationa!e: Co$niti%e &e%e!: Anal )ing C!ient 'eed: (h siological Integrit C!ient 'eed (u#: (harmacological and (arenteral Therapies 'ursin$/)nte$rated Concepts: *ursing (rocess& Implementation &earnin$ *utcome: %,-8 Question 4 Type: MCSA The client receives esomepra)ole .*e6ium/. 9e asks the nurse wh that little purple pill is better than his cimetidine .Tagamet/. 0hat is the best response b the nurse? 1. "It is about the same' but a lot cheaper than our cimetidine .Tagamet/." 2. "It decreases acid in our stomach' better than cimetidine .Tagamet/." 3. "It is about the same' but has fewer side effects than our cimetidine .Tagamet/." 4. "It is not as effective as cimetidine .Tagamet/' but kills bacteria better." Correct Answer: $ ationa!e 1& +somepra)ole .*e6ium/ is not cheaper than cimetidine .Tagamet/. ationa!e 2& (roton-pump inhibitors reduce acid secretion to a greater e6tent than 9$-receptor antagonists' and have a longer duration of action. ationa!e 3& +somepra)ole .*e6ium/ does not have fewer side effects than cimetidine .Tagamet/. ationa!e 4& +somepra)ole .*e6ium/ is more effective than cimetidine .Tagamet/' but will not kill bacteria. "!o#a! ationa!e: Co$niti%e &e%e!: Anal )ing C!ient 'eed: (h siological Integrit C!ient 'eed (u#: (harmacological and (arenteral Therapies 'ursin$/)nte$rated Concepts: *ursing (rocess& Implementation
Adams, Pharmacology for Nurse: A Pathophysiologic Approach, %1+ Cop right $,#% b (earson +ducation' Inc.

&earnin$ *utcome: %,-8 Question , Type: MCSA A client is admitted for treatment of a duodenal ulcer. 0hat will the nurse:s admission assessment likel reveal? 1. *ausea and lower right 5uadrant abdominal pain 2. !urning pain several hours after eating a meal 3. Anore6ia and weight loss 4. ;ow back pain radiating down the left leg Correct Answer: $ ationa!e 1& *ausea and lower right 5uadrant abdominal pain are more likel associated with appendicitis. ationa!e 2& 4uodenal ulcers are associated with burning upper abdominal pain after a meal. ationa!e 3& Anore6ia and weight loss are more common with gastric' not duodenal' ulcers. ationa!e 4& 4uodenal ulcers do not cause low back pain radiating down the left leg. "!o#a! ationa!e: Co$niti%e &e%e!: Appl ing C!ient 'eed: (h siological Integrit C!ient 'eed (u#: (h siological Adaptation 'ursin$/)nte$rated Concepts: *ursing (rocess& Assessment &earnin$ *utcome: %,-2 Question Type: MCSA The nurse has completed education about peptic ulcer disease .(34/ with the client. The nurse evaluates that learning has occurred when the client makes which statement? 1. "I will limit m intake of caffeine products." 2. "I will take ibuprofen .Motrin/ for m headaches." 3. "I will drink more milk and limit spic foods." 4. "I will <oin a g m and increase m e6ercise."
Adams, Pharmacology for Nurse: A Pathophysiologic Approach, %1+ Cop right $,#% b (earson +ducation' Inc.

Correct Answer: # ationa!e 1& Caffeine is a risk factor for peptic ulcer disease .(34/' so limiting caffeine will be beneficial in the treatment of peptic ulcer disease .(34/. ationa!e 2& *onsteroidal anti-inflammator drugs .*SAI4S/ are a primar cause of peptic ulcer disease .(34/. ationa!e 3& Milk can increase acid production and spic foods are not an issue with peptic ulcer disease .(34/. ationa!e 4& There is no correlation between e6ercise and the management of peptic ulcer disease .(34/. "!o#a! ationa!e: Co$niti%e &e%e!: Anal )ing C!ient 'eed: (h siological Integrit C!ient 'eed (u#: (h siological Adaptation 'ursin$/)nte$rated Concepts: *ursing (rocess& +valuation &earnin$ *utcome: %,-$ Question . Type: MCSA An elderl client comes to the emergenc department with his wife. 9e has a histor of peptic ulcer disease .(34/' and is currentl e6periencing confusion and severe headaches. 0hat does the best plan b the nurse include? 1. Ask the client if he has e6perienced an head in<uries recentl . 2. =btain a complete blood count .C!C/' chemistr profile' and urine drug screen. 3. Ask the client>s wife for a list of medications that the client has taken. 4. =btain a magnetic resonance imaging .M?I/ e6am to assess if the client has e6perienced a stroke. Correct Answer: 2 ationa!e 1& Since the client has (34' it would be logical to ask about medication prior to asking about in<ur . ationa!e 2& A complete blood count .C!C/' chemistr profile' and urine drug screen are worthwhile tests' but the first priorit for a client with a histor of peptic ulcer disease .(34/ should be to find out what medications he has been taking. ationa!e 3& There is a known correlation between 9$-receptor antagonists and confusion and headaches in the elderl population7 the nurse should ascertain what medications the client is taking. ationa!e 4& It is premature to obtain a magnetic resonance imaging .M?I/ e6am until other causes have been ruled out.
Adams, Pharmacology for Nurse: A Pathophysiologic Approach, %1+ Cop right $,#% b (earson +ducation' Inc.

"!o#a! ationa!e: Co$niti%e &e%e!: Anal )ing C!ient 'eed: (h siological Integrit C!ient 'eed (u#: (harmacological and (arenteral Therapies 'ursin$/)nte$rated Concepts: *ursing (rocess& Assessment &earnin$ *utcome: %,-@ Question / Type: MCSA The client has gastroesophageal reflu6 disease .A+?4/ and has been receiving medication treatment for man ears. 0hat priorit assessment findings associated with the medication must the nurse report to the ph sician? 1. Bomiting and mild upper mid-epigastric pain 2. Anemia' fatigue' and weakness 3. 9 potension and tach cardia 4. 4iarrhea and soft stools Correct Answer: $ ationa!e 1& Bomiting and mild upper mid-epigastric pain are not signs of pernicious anemia or vitamin !#$ deficienc that ma result from chronic suppression of stomach acid from medications. ationa!e 2& Anemia' fatigue' and weakness are common signs of pernicious anemia or vitamin !#$ deficienc . 0ith chronic suppression of stomach acid b medications used for gastroesophageal reflu6 disease .A+?4/' the stomach ma not be able to absorb vitamin !#$' and there is the possibilit of pernicious anemia. ationa!e 3& 9 potension and tach cardia are not signs of pernicious anemia or vitamin !#$ deficienc that ma result from chronic suppression of stomach acid from medications. ationa!e 4& 4iarrhea and soft stools are not signs of pernicious anemia or vitamin !#$ deficienc that ma result from chronic suppression of stomach acid from medications. "!o#a! ationa!e: Co$niti%e &e%e!: Anal )ing C!ient 'eed: (h siological Integrit C!ient 'eed (u#: (harmacological and (arenteral Therapies 'ursin$/)nte$rated Concepts: *ursing (rocess& Assessment &earnin$ *utcome: %,-$ Question 0 Type: MCSA
Adams, Pharmacology for Nurse: A Pathophysiologic Approach, %1+ Cop right $,#% b (earson +ducation' Inc.

The ph sician has ordered combination therap for the client with peptic ulcer disease .(34/. The nurse plans to do medication education. 0hat will the best plan b the nurse include? 1. Combination therap has the best outcomes when antibiotics are used with antacids. 2. Combination therap has the best outcomes when antibiotics are used with proton-pump inhibitors. 3. The use of sucralfate .Carafate/ along with antibiotics is the best combination therap for peptic ulcer disease .(34/. 4. Barious antibiotics are used to eradicate the bacteria that are responsible for the development of peptic ulcer disease .(34/. Correct Answer: $ ationa!e 1& Combination therap has the best outcomes when antibiotics are used with proton-pump inhibitors' not with antacids. ationa!e 2& Combination therap has the best outcomes when antibiotics are used with proton-pump inhibitors. ationa!e 3& Combination therap has the best outcomes when antibiotics are used with proton-pump inhibitors' not with sucralfate .Carafate/. ationa!e 4& Combination therap has the best outcomes when antibiotics are combined with proton-pump inhibitors' rather than when used alone. "!o#a! ationa!e: Co$niti%e &e%e!: Anal )ing C!ient 'eed: (h siological Integrit C!ient 'eed (u#: (harmacological and (arenteral Therapies 'ursin$/)nte$rated Concepts: *ursing (rocess& (lanning &earnin$ *utcome: %,-8 Question 10 Type: MCMA The nurse designs a plan of care for the client with peptic ulcer disease .(34/ who is taking omepra)ole .(rilosec/ for the management of his illness. 0hat will the best plan b the nurse include? Note: Credit will be given only if all correct choices and no incorrect choices are selected. (tandard Te+t: Select all that appl . 1. =mepra)ole .(rilosec/ should not be crushed or chewed. 2. =mepra)ole .(rilosec/ is best taken with ogurt.
Adams, Pharmacology for Nurse: A Pathophysiologic Approach, %1+ Cop right $,#% b (earson +ducation' Inc.

3. =mepra)ole .(rilosec/ is recommended for long-term treatment of peptic ulcer disease .(34/. 4. =mepra)ole .(rilosec/ should be administered before meals. ,. =mepra)ole .(rilosec/ should be administered after meals. Correct Answer: #'% ationa!e 1& =mepra)ole .(rilosec/ is enteric-coated and needs to dissolve in the intestine7 it should not be crushed or chewed. ationa!e 2& Cogurt ma help replace beneficial bacteria' but should not be taken at the same time. ationa!e 3& =mepra)ole .(rilosec/ is recommended for short-term' not long-term' use. ationa!e 4& =mepra)ole .(rilosec/ should be administered before meals. ationa!e ,& =mepra)ole .(rilosec/ should be administered before' not after' meals in order to be most effective. "!o#a! ationa!e: Co$niti%e &e%e!: Appl ing C!ient 'eed: (h siological Integrit C!ient 'eed (u#: (harmacological and (arenteral Therapies 'ursin$/)nte$rated Concepts: *ursing (rocess& (lanning &earnin$ *utcome: %,-D Question 11 Type: MCSA The nurse planning medication administration instruction for a client receiving antacids should consider including which information? 1. Antacids can be safel administered with 9$-receptor medications. 2. Antacids can be safel administered with antibiotics. 3. Administer antacids at least $ hours before other oral medications. 4. ;a down for 2, minutes after taking antacids. Correct Answer: 2 ationa!e 1& Administering antacids with 9$-receptor antagonists will decrease their absorption. ationa!e 2& Administering antacids with antibiotics will decrease their absorption.
Adams, Pharmacology for Nurse: A Pathophysiologic Approach, %1+ Cop right $,#% b (earson +ducation' Inc.

ationa!e 3& Administering antacids with other oral medications can affect the absorption of the other medications7 the should be taken $ hours before other oral medications. ationa!e 4& There is no need for the client to la down after taking antacids. "!o#a! ationa!e: Co$niti%e &e%e!: Appl ing C!ient 'eed: (h siological Integrit C!ient 'eed (u#: (harmacological and (arenteral Therapies 'ursin$/)nte$rated Concepts: *ursing (rocess& (lanning &earnin$ *utcome: %,-@ Question 12 Type: MCSA The client receives 9$-receptor antagonists for treatment of peptic ulcer disease .(34/. 0hich assessment finding should be reported immediatel to the ph sician? 1. The client reports he is constipated. 2. The client reports pain after $% hours of treatment. 3. The client reports episodes of melana. 4. The client reports he took the antacid Tums with his 9$-receptor antagonist. Correct Answer: 2 ationa!e 1& Constipation is a common side effect that does not need to be immediatel reported to the ph sician. ationa!e 2& The client ma still e6perience pain for several da s with this t pe of medication. ationa!e 3& Melana could indicate AI bleeding and should be reported to the ph sician immediatel . ationa!e 4& Taking Tums with an 9$-receptor antagonist will cause deceased absorption of the 9$-receptor antagonist' but this does not need to be reported to the ph sician7 the nurse should educate the client. "!o#a! ationa!e: Co$niti%e &e%e!: Anal )ing C!ient 'eed: (h siological Integrit C!ient 'eed (u#: (harmacological and (arenteral Therapies 'ursin$/)nte$rated Concepts: *ursing (rocess& Implementation &earnin$ *utcome: %,-8 Question 13
Adams, Pharmacology for Nurse: A Pathophysiologic Approach, %1+ Cop right $,#% b (earson +ducation' Inc.

Type: MCSA The nurse completes medication education for the client receiving sucralfate .Carafate/. The nurse evaluates that learning has occurred when the client makes which statement? 1. "This works b inhibiting bacterial growth in m stomach." 2. "This works b dissolving into a <ell and sticking to m ulcer." 3. "This works b decreasing the amount of acid in m stomach." 4. "This works b neutrali)ing the acid in m stomach." Correct Answer: $ ationa!e 1& Sucralfate .Carafate/ does not inhibit bacterial growth. ationa!e 2& Sucralfate .Carafate/ works b dissolving into a gel and adhering to the site of the ulcer. ationa!e 3& Sucralfate .Carafate/ does not decrease the amount of acid in the stomach. ationa!e 4& Sucralfate .Carafate/ does not neutrali)e stomach acid. "!o#a! ationa!e: Co$niti%e &e%e!: Anal )ing C!ient 'eed: (h siological Integrit C!ient 'eed (u#: (harmacological and (arenteral Therapies 'ursin$/)nte$rated Concepts: *ursing (rocess& +valuation &earnin$ *utcome: %,-8 Question 14 Type: MCSA 0hat is the correct administration techni5ue for sucralfate .Carafate/? 1. Administer it after meals. 2. Administer it prior to meals. 3. Administer the drug once dail . 4. Administer it with milk. Correct Answer: $ ationa!e 1& Administering sucralfate .Carafate/ after meals will inhibit its abilit to adhere to the ulcer.
Adams, Pharmacology for Nurse: A Pathophysiologic Approach, %1+ Cop right $,#% b (earson +ducation' Inc.

ationa!e 2& Sucralfate .Carafate/ provides a protective coating and should be administered before meals in order to be effective. ationa!e 3& Sucralfate .Carafate/ must be taken % times a da . ationa!e 4& Administering sucralfate .Carafate/ with milk will inhibit its action. "!o#a! ationa!e: Co$niti%e &e%e!: Appl ing C!ient 'eed: (h siological Integrit C!ient 'eed (u#: (harmacological and (arenteral Therapies 'ursin$/)nte$rated Concepts: *ursing (rocess& Implementation &earnin$ *utcome: %,-8 Question 1, Type: MCSA The client receives misoprostol .C totec/ for treatment of peptic ulcer disease .(34/. The client asks the nurse wh he is receiving this medication. 0hat is the best response b the nurse? 1. "It dissolves into a gel and sticks to our ulcer." 2. "It increases mucus production in our stomach." 3. "It inhibits bacterial growth." 4. "It neutrali)es stomach acid." Correct Answer: $ ationa!e 1& Sucralfate .Carafate/' not misoprostol .C totec/' dissolves into a gel and adheres to the ulcer site. ationa!e 2& Misoprostol .C totec/ inhibits gastric secretion and stimulates the production of protective mucus. ationa!e 3& !ismuth .(epto-!ismol/' not misoprostol .C totec/' inhibits bacterial growth. ationa!e 4& Antacids' not misoprostol .C totec/' neutrali)e stomach acid. "!o#a! ationa!e: Co$niti%e &e%e!: Anal )ing C!ient 'eed: (h siological Integrit C!ient 'eed (u#: (harmacological and (arenteral Therapies 'ursin$/)nte$rated Concepts: *ursing (rocess& Implementation &earnin$ *utcome: %,-@
Adams, Pharmacology for Nurse: A Pathophysiologic Approach, %1+ Cop right $,#% b (earson +ducation' Inc.

Question 1Type: MCSA The p loric sphincter regulates flow of food into the 1. small intestine. 2. stomach. 3. esophagus. 4. rectum. Correct Answer: # ationa!e 1& The p loric sphincter regulates food out of the stomach into the small intestine. ationa!e 2& The p loric sphincter moves food out of the stomach. ationa!e 3& The cardiac sphincter keeps food from moving back into the esophagus. ationa!e 4& The p loric sphincter regulates food out of the stomach' not the rectum. "!o#a! ationa!e: Co$niti%e &e%e!: ?emembering C!ient 'eed: (h siological Integrit C!ient 'eed (u#: (h siological Adaptation 'ursin$/)nte$rated Concepts: *ursing (rocess& Assessment &earnin$ *utcome: %,-# Question 1. Type: MCSA An erosion of the mucosal la er of the stomach or duodenum describes a 1. diverticulum. 2. Crohn>s lesion. 3. hiatal hernia. 4. (eptic ulcer. Correct Answer: % ationa!e 1& 4iverticulum occurs in the large intestine.
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ationa!e 2& Crohn>s lesion can occur an wa in the gastrointestinal tract. ationa!e 3& 9iatal hernias are an outpouching in the esophagus. ationa!e 4& A peptic ulcer is erosion of the mucosal la er of the stomach or duodenum. "!o#a! ationa!e: Co$niti%e &e%e!: ?emembering C!ient 'eed: (h siological Integrit C!ient 'eed (u#: (h siological Adaptation 'ursin$/)nte$rated Concepts: *ursing (rocess& Assessment &earnin$ *utcome: %,-2 Question 1/ Type: MCSA The primar goal in treatment of gastroesophageal reflu6 disease is to 1. promote ulcer healing. 2. prevent infection. 3. reduce gastric acid secretions. 4. decrease stomach pain. Correct Answer: 2 ationa!e 1& (romoting ulcer healing is not the goal. ationa!e 2& (reventing infection is not the goal. ationa!e 3& The primar goal is to reduce gastric secretions' which produce the reflu6. ationa!e 4& 9eartburn occurs' but not pain in the stomach. "!o#a! ationa!e: Co$niti%e &e%e!: ?emembering C!ient 'eed: (h siological Integrit C!ient 'eed (u#: (harmacological and (arenteral Therapies 'ursin$/)nte$rated Concepts: *ursing (rocess& Implementation &earnin$ *utcome: %,-% Question 10 Type: MCSA
Adams, Pharmacology for Nurse: A Pathophysiologic Approach, %1+ Cop right $,#% b (earson +ducation' Inc.

(eptic ulcer disease is treated primaril with 1. pharmacotherap . 2. e6ercise. 3. a combination of lifest le changes and pharmacotherap . 4. diet. Correct Answer: 2 ationa!e 1& A combination of lifest le changes and pharmacotherap is the best and most effective wa to treat peptic ulcer disease. ationa!e 2& A combination of lifest le changes and pharmacotherap is the best and most effective wa to treat peptic ulcer disease. ationa!e 3& A combination of lifest le changes and pharmacotherap is the best and most effective wa to treat peptic ulcer disease. ationa!e 4& A combination of lifest le changes and pharmacotherap is the best and most effective wa to treat peptic ulcer disease. "!o#a! ationa!e: Co$niti%e &e%e!: ?emembering C!ient 'eed: (h siological Integrit C!ient 'eed (u#: (harmacological and (arenteral Therapies 'ursin$/)nte$rated Concepts: *ursing (rocess& Implementation &earnin$ *utcome: %,-@ Question 20 Type: MCSA The nurse is aware that antacids containing magnesium and aluminum can cause 1. diarrhea. 2. abdominal pain. 3. constipation. 4. indigestion. Correct Answer: #
Adams, Pharmacology for Nurse: A Pathophysiologic Approach, %1+ Cop right $,#% b (earson +ducation' Inc.

ationa!e 1& Magnesium and aluminum' such as in Maalo6' can cause diarrhea. ationa!e 2& Antacids do not cause abdominal pain. ationa!e 3& Calcium-based products' such as Tums' cause constipation. ationa!e 4& Antacid would help the indigestion. "!o#a! ationa!e: Co$niti%e &e%e!: 3nderstanding C!ient 'eed: (h siological Integrit C!ient 'eed (u#: (harmacological and (arenteral Therapies 'ursin$/)nte$rated Concepts: *ursing (rocess& (lanning &earnin$ *utcome: %,-@ Question 21 Type: MCSA The mechanism of action of proton pump inhibitors is to 1. neutrali)e acid. 2. reduce acid secretion in the stomach. 3. block 9$ receptors in the stomach. 4. decrease infection. Correct Answer: $ ationa!e 1& The mechanism of action of proton pump inhibitors is to reduce acid secretion in the stomach. ationa!e 2& The mechanism of action of proton pump inhibitors is to reduce acid secretion in the stomach. ationa!e 3& The mechanism of action of proton pump inhibitors is to reduce acid secretion in the stomach. ationa!e 4& The mechanism of action of proton pump inhibitors is to reduce acid secretion in the stomach. "!o#a! ationa!e: Co$niti%e &e%e!: ?emembering C!ient 'eed: (h siological Integrit C!ient 'eed (u#: (harmacological and (arenteral Therapies 'ursin$/)nte$rated Concepts: *ursing (rocess& (lanning &earnin$ *utcome: %,-E
Adams, Pharmacology for Nurse: A Pathophysiologic Approach, %1+ Cop right $,#% b (earson +ducation' Inc.

Question 22 Type: MCMA A client comes to the clinic with report of intermittent epigastric pain that is associated with meals. The nurse would review the client:s medical record and assess for the presence of which risk factors for peptic ulcer disease .(34/? Note: Credit will be given only if all correct choices and no incorrect choices are selected. (tandard Te+t: Select all that appl . 1. The client reports that his mother and grandfather both had ulcers. 2. The client has t pe A! blood. 3. The client reports drinking several cups of coffee ever morning. 4. The client reports mild to moderate <ob and famil stress. ,. The client tested positive for influen)a A. Correct Answer: #'2 ationa!e 1& A close famil histor of (34 increases the client:s risk for developing the disease. ationa!e 2& The risk for developing (34 is higher in those with t pe =. ationa!e 3& Consumption of beverages that contain caffeine increases the risk for (34. ationa!e 4& The presence of e6cessive ps chological stress increases the risk for (34. ationa!e ,& Infection with h licobacter p lori increases the risk for (34. Influen)a A is not associated with increased risk. "!o#a! ationa!e: Co$niti%e &e%e!: Anal )ing C!ient 'eed: (h siological Integrit C!ient 'eed (u#: (h siological Adaptation 'ursin$/)nte$rated Concepts: *ursing (rocess& Assessment &earnin$ *utcome: ;= F$ Question 23 Type: MCMA It is suspected that a client has developed peptic ulcer disease .(34/. 0hich information should the nurse provide this client regarding pro<ected course of treatment?
Adams, Pharmacology for Nurse: A Pathophysiologic Approach, %1+ Cop right $,#% b (earson +ducation' Inc.

Note: Credit will be given only if all correct choices and no incorrect choices are selected. (tandard Te+t: Select all that appl . 1. Cou will be started on an antibiotic. 2. Cou will be tested for the presence of 9. p lori. 3. Cou ma be directed to take (epto-!ismol along with our other medications. 4. Cou should plan on taking medication for % to D weeks. ,. There are some lifest le changes ou can take to make therap more successful. Correct Answer: $'2'%'E ationa!e 1& The client ma or ma not be started on an antibiotic. ationa!e 2& The client should be tested for the presence of 9. p lori before antibiotic therap is started. ationa!e 3& If the client is positive for 9. p lori' bismuth-containing medications are sometimes prescribed for concurrent use. ationa!e 4& It takes time to heal a peptic ulcer' so therap ma continue for several weeks. ationa!e ,& Some lifest le changes such as changing dietar habits and smoking cessation can help therap be more successful. "!o#a! ationa!e: Co$niti%e &e%e!: Anal )ing C!ient 'eed: (h siological Integrit C!ient 'eed (u#: (harmacological and (arenteral Therapies 'ursin$/)nte$rated Concepts: *ursing (rocess& Implementation &earnin$ *utcome: %,." Question 24 Type: MCMA A client has been prescribed ranitidine .Gantac/. The nurse plans to include which information in the teaching plan for this client? Note: Credit will be given only if all correct choices and no incorrect choices are selected. (tandard Te+t: Select all that appl . 1. Cou should e6perience s mptom relief in #, to #E minutes after taking this drug.
Adams, Pharmacology for Nurse: A Pathophysiologic Approach, %1+ Cop right $,#% b (earson +ducation' Inc.

2. Take this medication after our meal. 3. Take this medication first thing in the morning' before breakfast. 4. This drug will not work as well if ou continue smoking. ,. If ou e6perience confusion' discontinue the drug and call for an appointment. Correct Answer: $'% ationa!e 1& =nset of action is 2, to ", minutes. ationa!e 2& This medication should be administered after a meal. ationa!e 3& This medication should be taken with food at bedtime. ationa!e 4& Smoking decreases the effectiveness of ranitidine. ationa!e ,& ?anitidine does not cause the confusion and C*S depression observed with cimetidine. "!o#a! ationa!e: Co$niti%e &e%e!: Appl ing C!ient 'eed: (h siological Integrit C!ient 'eed (u#: (harmacological and (arenteral Therapies 'ursin$/)nte$rated Concepts: *ursing (rocess& (lanning &earnin$ *utcome: %,.D Question 2, Type: MCMA A client has been prescribed aluminum h dro6ide .AlternaA+;/ for the treatment of heartburn. 0hich information should the nurse plan to teach this client? Note: Credit will be given only if all correct choices and no incorrect choices are selected. (tandard Te+t: Select all that appl . 1. Cou should e6pect this medication to take up to two da s to start taking effect. 2. Take this medication with a glass of milk. 3. Cou ma notice constipation as an effect of this drug. 4. Take this medication at least $ hours before or after an other medication ou are taking. ,. This medication will reduce the acid our stomach produces.
Adams, Pharmacology for Nurse: A Pathophysiologic Approach, %1+ Cop right $,#% b (earson +ducation' Inc.

Correct Answer: 2'% ationa!e 1& This medication:s onset of action is within $,H%, minutes. ationa!e 2& There is no reason for the client to drink milk with this medication. ationa!e 3& Constipation ma be a side effect of this antacid. ationa!e 4& Absorption ma be affected if taken within $ hours of an other drug. ationa!e ,& This medication acts to neutrali)e acid' not to reduce its production. "!o#a! ationa!e: Co$niti%e &e%e!: Appl ing C!ient 'eed: (h siological Integrit C!ient 'eed (u#: (harmacological and (arenteral Therapies 'ursin$/)nte$rated Concepts: *ursing (rocess& (lanning &earnin$ *utcome: ;= FD

Adams, Pharmacology for Nurse: A Pathophysiologic Approach, %1+ Cop right $,#% b (earson +ducation' Inc.