McCuistion: Pharmacology: A Patient-Centered Nursing Process Approach,
11th Edition
MULTIPLE CHOICE
1. A patient who has been instructed to use a liquid antacid medication to treat
gastrointestinal upset asks the nurse about how to take this medication. What information
will the nurse include when teaching this patient?
a. All antacids can be taken safely with renal insufficiency.
b. Take 60 minutes after meals and at bedtime.
c. Take with at least 8 ounces of water to improve absorption.
d. Take with milk to improve effectiveness.
ANS: B
Since maximum acid secretion occurs after eating and at bedtime, antacids should be
taken 1 to 3 hours after eating and at bedtime. Taking antacids with meals slows
gastric emptying time and causes increased gastrointestinal (GI) secretions.
Aluminium salt antacids can accumulate in renal insufficiency and lead to toxicity.
Patients should use 2 to 4 ounces of water when taking to ensure that the drug enters
the stomach; more than that will increase gastric emptying time. If possible, antacids
should not be taken with milk or foods high in vitamin D.
DIF: Cognitive Level: Applying (Application) TOP: Nursing Process:
Nursing Intervention: Patient Teaching MSC: NCLEX: Physiological
Integrity: Pharmacological and Parenteral Therapies
2. A patient who has symptoms of peptic ulcer disease will undergo a test that requires
drinking a liquid containing 13C urea and breathing into a container. The nurse will
explain to the patient that this test is performed to
a. assess the level of hydrochloric acid.
b. detect H. pylori antibodies.
c. measure the pH of gastric secretions.
d. test for the presence of H. pylori.
ANS: D
When H. pylori is suspected, a non-invasive test is performed by administering 13C
urea, which, in the presence of H. pylori, will release 13CO2. The test does not
measure the amount of HCl acid or the pH and does not detect H. pylori antibodies.
DIF: Cognitive Level: Understanding (Comprehension) TOP: Nursing
Process: Assessment | Nursing Process: Nursing Intervention MSC:
NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
,3. A patient is taking rabeprazole 20 mg per day to treat a duodenal ulcer. After 10 days of
treatment, the patient reports that the pain has subsided. The nurse will counsel the patient
to
a. continue the medication for up to 4-8 total weeks of treatment.
b. reduce the medication dose by half.
c. stop taking the medication.
d. take the medication every other day.
ANS: A
With treatment, ulcer pain may subside earlier, but the healing process may take 1 to
2 months. Patients should be counseled to take the drug for the length of time
prescribed. Reducing the dose or taking less frequently is not recommended.
DIF: Cognitive Level: Applying (Application) TOP: Nursing Process:
Nursing Intervention: Patient Teaching MSC: NCLEX:
Physiological Integrity: Pharmacological and Parenteral Therapies
4. A patient with a peptic ulcer has been diagnosed with H. pylori. The provider has ordered
lansoprazole, clarithromycin, and metronidazole. The patient asks the nurse why two
antibiotics are needed. The nurse will explain that two antibiotics
a. allow for less toxic dosing.
b. combat bacterial resistance.
c. have synergistic effects.
d. improve acid suppression.
ANS: B
The use of two antibiotics when treating H. pylori peptic ulcer disease helps to
combat bacterial resistance because H. pylori develops resistance rapidly. Giving two
antibiotics, in this case, is not to reduce the dose or to cause synergistic effects.
Antibiotics do not affect acid production.
DIF: Cognitive Level: Understanding (Comprehension) TOP: Nursing
Process: Nursing Intervention: Patient Teaching MSC: NCLEX:
Physiological Integrity: Pharmacological and Parenteral Therapies
5. A patient who takes propantheline bromine and omeprazole for an ulcer will begin taking
an antacid. The nurse will give which instruction to the patient regarding how to take the
antacid?
a. Take the antacid 2 hours after taking the propantheline.
b. Take the antacid along with a meal.
c. Take the antacid with milk.
d. Take the antacid with the propantheline bromine.
ANS: A
Antacids can slow the absorption of anticholinergics and should be taken 2 hours after
anticholinergic administration. Antacids should be given 1 to 3 hours after a meal and
, should not be given with dairy products.
DIF: Cognitive Level: Applying (Application) TOP: Nursing Process:
Nursing Intervention MSC: NCLEX: Physiological Integrity:
Pharmacological and Parenteral Therapies
6. Which antacid is most likely to cause acid rebound?
a. Aluminium hydroxide
b. Calcium carbonate
c. Magnesium hydroxide
d. Magnesium trisilicate
ANS: B
While calcium carbonate is most effective among the listed antacids in neutralizing
acid, a significant amount can be systemically absorbed and can cause acid rebound.
The other antacids do not have significant systemic absorption.
DIF: Cognitive Level: Remembering (Knowledge) TOP: Nursing
Process: Planning MSC: NCLEX: Physiological Integrity:
Pharmacological and Parenteral Therapies
7. An elderly patient reports using magnesium hydroxide frequently to treat acid reflux. The
nurse should notify the patient’s provider to request an order for which laboratory tests?
a. Liver enzymes and serum calcium
b. Liver enzymes and serum magnesium
c. Renal function tests and serum calcium
d. Renal function tests and serum magnesium
ANS: D
Magnesium hydroxide carries a risk of hypermagnesemia, especially with decreased
renal function. Older patients have an increased risk of poor renal function, so this
patient should especially be evaluated for hypermagnesemia.
DIF: Cognitive Level: Applying (Application) TOP: Nursing Process:
Evaluation MSC: NCLEX: Physiological Integrity:
Pharmacological and Parenteral Therapies
8. The nurse is caring for a patient who has Zollinger-Ellison syndrome. Which medication
order would the nurse question for this patient?
a. Cimetidine
b. Pantoprazole
c. Rabeprazole
d. Ranitidine
ANS: A
Cimetidine is not effective for treating Zollinger-Ellison syndrome. The other
medications may be used to treat Zollinger-Ellison syndrome.
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