Chapter 33 Drugs Used to Treat Gastroesophageal Reflux and Peptic Ulcer Diseases

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Chapter 33  Drugs Used to Treat Gastroesophageal Reflux and Peptic Ulcer Diseases

 

 

Complete Chapter Questions And Answers
 

Sample Questions

 

MULTIPLE CHOICE

1. Which medication is used in the treatment of gastric reflux esophagitis and diabetic gastroparesis?
a.
Metoclopramide
b.
Misoprostol
c.
Pantoprazole
d.
Ranitidine

ANS: A
Metoclopramide is a gastric stimulant used to relieve the symptoms of gastric reflux esophagitis and diabetic gastroparesis, aid in small bowel intubation, and stimulate gastric emptying and intestinal transit of barium after radiologic examination of the upper gastrointestinal (GI) tract. Misoprostol is used to prevent and treat gastric ulcers caused by NSAIDs, including aspirin. Pantoprazole and ranitidine do not treat gastroparesis.

DIF: Cognitive Level: Comprehension REF: p. 530 OBJ: 4
TOP: Nursing Process Step: Implementation
MSC: NCLEX Client Needs Category: Physiological Integrity

2. The nurse is preparing to administer medications and notes that a patient has sucralfate ordered qid. When is the best time to administer this medication?
a.
1 hour before meals
b.
With meals
c.
1 hour after meals
d.
With a bedtime snack

ANS: A
This medication should be administered on an empty stomach. Taking the medication with meals, 1 hour after meals, or with a bedtime snack does not allow the medication to form its protective coat of the gastric mucosa.

DIF: Cognitive Level: Comprehension REF: p. 529 OBJ: 4 | 5
TOP: Nursing Process Step: Implementation
MSC: NCLEX Client Needs Category: Physiological Integrity

3. Which is a common adverse effect of magnesium based antacid preparations?
a.
Heartburn
b.
Rebound indigestion
c.
Constipation
d.
Diarrhea

ANS: D
Magnesium oxide, magnesium hydroxide, and magnesium trisilicate are used in antacid preparations. All magnesium products can cause diarrhea. Milk of Magnesia is often taken for constipation. Antacids are given to relieve heartburn. Calcium based antacids are likely to cause rebound indigestion. Magnesium is often given as a laxative, in antacid form or as magnesium sulfate.

DIF: Cognitive Level: Knowledge REF: p. 523 OBJ: 5
TOP: Nursing Process Step: Implementation
MSC: NCLEX Client Needs Category: Physiological Integrity

4. Cimetidine (Tagamet) is an example of which class of drug?
a.
Protokinetic agent
b.
Proton pump inhibitor
c.
Histamine (H2) receptor antagonist
d.
Coating agent

ANS: C
All H2 receptor antagonists end in “ dine.” Examples in this category include cimetidine, ranitidine, famotidine, and nizatidine. An example of a protokinetic agent is metoclopramide. An example of a proton pump inhibitor is omeprazole.
An example of a coating agent is sucralfate.

DIF: Cognitive Level: Knowledge REF: p. 524 OBJ: 4
TOP: Nursing Process Step: Implementation
MSC: NCLEX Client Needs Category: Physiological Integrity

5. A postoperative appendectomy patient has a nasogastric tube and wonders why the previous nurse told him that he was receiving an IV “ulcer preventing” medication called ranitidine. The patient states that he has never had any stomach problems in his life. Which is the best response by the nurse?
a.
“This medication will cause the pH in your stomach to drop.”
b.
“This medication helps coat your stomach while the nasogastric tube is in place.”
c.
“Because you are not eating after surgery, this medication will help reduce the hydrochloric acid your stomach is still secreting.”
d.
“The nasogastric tube will cause peptic ulcer disease. This medication will help prevent that.”

ANS: C
Patients who are not eating still secrete hydrochloric acid from the stomach’s parietal cells. H2 receptor antagonists block the H2 receptors, resulting in a decrease in the amount of acid secreted. The pH of the stomach contents then becomes less acidic, which reduces the stress of the mucosal lining of the stomach. Ranitidine causes the stomach contents to become less acidic as the amount of acid secreted decreases; consequently, the pH of the stomach rises. This is not a coating agent, and giving it parenterally will not work to coat the stomach. Increased gastric acid, not nasogastric tubes, causes peptic ulcer disease (PUD).

DIF: Cognitive Level: Application REF: pp. 524-525 OBJ: 3 | 5
TOP: Nursing Process Step: Implementation
MSC: NCLEX Client Needs Category: Health Promotion and Maintenance

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