1. A patient arrives at the health clinic after a week of treating herself at home with
magnesium- based antacids. She complains to the LPN that she has experienced several episodes
of lightheadedness and near fainting over the past 2 days. Which action is most appropriate?
a. Ask the patient how many doses of the drug she has been taking each day.
b. Instruct the patient to maintain a symptom diary to determine aggravating factors.
c. Instruct the patient to bring the bottle of antacid drug to her next appointment.
d. Instruct the patient to switch to an aluminum-based antacid immediately.
ANS: A
For the patient taking a magnesium-based antacid, adverse effects are usually related to
hypermagnesemia such as muscle weakness, low blood pressure, and low heart rate.
Hypotension may develop in cases of extreme hypermagnesemia and could cause
lightheadedness especially if the patient is taking too many doses of the drug. Telling the patient
to keep a symptom diary of aggravating factors or bringing the bottle to the next appointment
does not address the patient’s problem of near-syncopal episodes. Instructing the patient to
change the drug is a decision that a healthcare provider should make.
DIF: Cognitive Level: Applying REF: p. 263
2. The LPN is helping to prepare a teaching plan for a patient who is beginning treatment with
an antacid. The LPN verifies that the patient understands that it is most appropriate to take the
antacid at which time(s)?
a. Immediately on awakening in the morning
b. One hour after each meal and at bedtime
c. Thirty minutes after an H2-receptor agonist
d. Thirty minutes before bedtime
, ANS: B
Antacids neutralize gastric acid. Food also serves as a buffer for gastric acid. Antacids are most
beneficial if given between meals and at bedtime. When taken with H2-receptor agonists,
antacids should be scheduled at least an hour apart, with the antacid taken first.
DIF: Cognitive Level: Understanding REF: p. 264
3. Which patient statement indicates an accurate understanding of taking proton-pump inhibitors?
a. “This drug will cure my gastric ulcer.”
b. “I can stop taking my drug when I feel better.”
c. “I need to avoid excessive exposure to the sun.”
d. “I should decrease my intake of calcium and vitamin D.” ANS: C
The patient should wear sunscreen and protective clothing because the skin may be more
sensitive to light. The patient should avoid driving or using heavy machinery while using this
drug as it may cause dizziness. The patient should contact the healthcare provider for
recommendations about calcium and vitamin D as this drug may increase the risk for
osteoporosis. If the patient is taking prescription proton-pump inhibitors, make sure to take the
full prescription even if feeling better.
DIF: Cognitive Level: Understanding REF: p. 265
4. The nurse is caring for a patient who is receiving famotidine for an ulcer. Which statement
indicates that the patient understands about taking famotidine?
a. “I need to eat three large meals a day.”
b. “I will eat a bedtime snack.”
c. “I will try to stop smoking cigarettes.”
d. “I will notify my healthcare provider if I am not feeling better in a month.” ANS: C
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