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NUR 141 Pharma Test 3, Questions & Answers, Explained With Rationales

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NUR 141 Pharma Test 3, Questions & Answers, Explained With Rationales-A patient is taking nonsteroidal anti-inflammatory agents for arthritis of the knees and hips. Which of the following diseases is a result of cellular destruction of the gastrointestinal tract from this medication? A) Esophageal...

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NUR 141 Pharma Test 3, Questions & Answers,
Explained With Rationales
A patient is taking nonsteroidal anti-inflammatory agents for arthritis of the knees and hips.
Which of the following diseases is a result of cellular destruction of the gastrointestinal tract
from this medication?
A) Esophageal cancer
B) Bowel obstruction
C) Liver cancer
D) Peptic ulcer disease - D) Peptic ulcer disease

Rationale:
Cell destruction will occur from the ingestion of NSAIDs, which can lead to the development of
peptic ulcer disease. Nonsteroidal anti-inflammatory agents do not cause esophageal cancer,
bowel obstruction, or liver cancer.

A patient has Maalox ordered for administration as needed. Which of the following conditions
contraindicates the administration of Maalox?
A) Hypertension
B) Heart rate of 68
C) Renal dysfunction
D) Stress ulcer - C) Renal dysfunction

Rationale:
Magnesium-based antacids are contraindicated in patients with renal failure. Magnesium-based
antacids are not contraindicated with hypertension, regular heart rate, or stress ulcer.

A patient is diagnosed with peptic ulcer disease complicated by H. pylori. What is the rationale
for adding bismuth to the patient's medication regimen?
A) Increases pepsin activity
B) Decreases gastrin secretion
C) Prevents metabolic alkalosis
D) Protects gastric mucosa from stomach acid - D) Protects gastric mucosa from stomach acid

Rationale:
Health care providers use bismuth subsalicylate to coat ulcers, protecting them from stomach
acid to treat H. pylori. Bismuth does not increase pepsin activity, decrease gastrin secretion, or
prevent metabolic alkalosis.

A patient is in the intensive care unit and being administered ranitidine (Zantac) parenterally.
How long will it take for ranitidine (Zantac) to reach peak blood levels?
A) 15 minutes
B) 30 minutes
C) 1 hour

,D) 2 hours - A) 15 minutes

Rationale:
Parenteral ranitidine reaches peak blood level in 15 minutes. Parenteral ranitidine reaches its
peak prior to 30 minutes, 1 hour, and 2 hours.

The nurse practitioner instructs the patient to use over-the-counter ranitidine (Zantac) instead of
cimetidine (Tagamet). What risk is decreased when using ranitidine rather than cimetidine?
A) Headache
B) Drug-to-drug interaction
C) Diarrhea
D) Bradycardia - B) Drug-to-drug interaction

Rationale:
Unlike cimetidine, ranitidine (Zantac), famotidine (Pepcid, Pepcid RPD), and nizatidine (Axid)
do not affect the cytochrome P450 drug-metabolizing system in the liver and therefore do not
interfere with the metabolism of other drugs. Use of these other drugs may be preferable in
patients who are critically ill because they often require numerous other drugs with which
cimetidine may interact.

A patient is taking cimetidine (Tagamet) for increased gastric pain and hypersecretion. Nurses
should use extreme caution when administering cimetidine to patients with which of the
following conditions?
A) Hepatic disease
B) Cancer
C) Hypertension
D) Diabetes mellitus - A) Hepatic disease

Rationale:
No absolute contraindications exist, but cimetidine should be used cautiously in patients with
impaired hepatic and renal function. The patient with cancer, hypertension, and diabetes mellitus
can take cimetidine safely.

A male patient is taking cimetidine (Tagamet). Which adverse effect is more likely to occur with
cimetidine than with other histamine2 receptor antagonists?
A) Hypoxia
B) Hypertension
C) Gynecomastia
D) Seizures - C) Gynecomastia

Rationale:
Gynecomastia is an adverse effect that is more likely to occur with cimetidine than with other
histamine-2 antagonists. Hypoxia, hypertension, and seizures are not adverse effects of
cimetidine.

, A patient is prescribed a proton pump inhibitor to treat erosive gastritis. How soon will the
patient's symptoms most likely be abolished?
A) 1 to 2 weeks
B) 4 weeks
C) 1 month
D) 6 weeks - A) 1 to 2 weeks

Rationale:
The symptoms of gastroesophageal reflux disease will be abolished in 1 to 2 weeks after the start
of the proton pump inhibitor medication regime. It will not take 4 weeks, 1 month, or 6 weeks to
see a change with the proton pump inhibitor.

A 23-year-old female patient is prescribed misoprostol (Cytotec). Which of the following patient
teaching interventions is most important?
A) Supplement therapy with magnesium antacids.
B) Report postmenopausal bleeding.
C) Use effective contraceptive measures.
D) Administer the drug one time per day. - C) Use effective contraceptive measures.

Rationale:
Misoprostol (Cytotec) is used to prevent NSAID gastric ulcer development. The medication can
cause spontaneous abortion; thus, the medication should be administered with a good form of
birth control. It should not be administered with magnesium antacids. It is not necessary for a
patient aged 23 years to report postmenopausal bleeding. The medication should be administered
two to four times per day.

(SATA)A 62-year-old man is surprised to learn that his recurrent indigestion has been attributed
to a new diagnosis of peptic ulcer disease. The patient states, "I've never been a really anxious
type of person, so I never thought I'd develop ulcers." The nurse has responded with health
education addressing the etiology of peptic ulcer disease. What causative factors should the nurse
cite?

1) Physiologic or psychological stress
2) Diabetes mellitus
3) Cigarette smoking
4) Infections
5) Nonsteroidal anti-inflammatory drugs

A) 1, 3
B) 2, 3, 5
C) 1, 5
D) 1, 3, 4, 5
E) All of these
F) None of these - D) 1, 3, 4, 5

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