Nokea
A patient is receiving an aluminum-containing antacid. The nurse will inform the patient to watch for which possible adverse effect?
- A. Diarrhea
- B. Constipation
- C. Nausea
- D. Abdominal cramping
Correct Answer: B
Rationale: Aluminum-based antacids have a constipating effect as well as an acid-neutralizing capacity.
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A patient in the intensive care unit has a nasogastric tube and is also receiving a proton pump inhibitor (PPI). The nurse recognizes that the purpose of the PPI is which effect?
- A. Prevent stress ulcers.
- B. Reduce bacteria levels in the stomach.
- C. Reduce gastric gas formation (flatulence).
- D. Promote gastric motility.
Correct Answer: A
Rationale: Stress-related mucosal damage is an important issue for critically ill patients. Stress ulcer prophylaxis (or therapy to prevent severe gastrointestinal [GI] damage) is undertaken in almost every critically ill patient in an intensive care unit and for many patients on general medical surgical units. Guidelines suggest that all such patients receive either a histamine receptor-blocking drug or a proton pump inhibitor.
A patient who has been taking cimetidine for hyperacidity calls the clinic to say that the medication has not been effective. The nurse reviews his history and notes that which factor may be influencing the effectiveness of this drug?
- A. He takes the cimetidine with meals.
- B. He smokes two packs of cigarettes a day.
- C. He drinks a glass of water with each dose.
- D. He takes an antacid 3 hours after the cimetidine dose.
Correct Answer: B
Rationale: Smoking may impair the absorption of H2 antagonists.
An older adult patient had gastric surgery due to a gastrointestinal bleed 3 days ago, and he has been stable since the surgery. This evening, his daughter tells the nurse, 'He seems to be more confused this afternoon. He's never been like this.' What could be the problem? The nurse reviews the patient's medication record and suspects that which drug could be the cause of the patient's confusion?
- A. Cimetidine
- B. Pantoprazole
- C. Clarithromycin
- D. Sucralfate
Correct Answer: A
Rationale: Sometimes H2 receptor antagonists such as cimetidine may cause adverse effects related to the central nervous system in the older adult, including confusion and disorientation.
The nurse is reviewing the medication orders for a patient who will be taking an H2 antagonist. Which drug may have an interaction if taken along with the H2 antagonist?
- A. Ibuprofen
- B. Cimetidine
- C. Tetracycline
- D. Ketoconazole
Correct Answer: D
Rationale: All H2 receptor antagonists may inhibit the absorption of certain drugs, such as the antifungal ketoconazole, that require an acidic gastrointestinal environment for gastric absorption.
During an admission assessment, the patient tells the nurse that he has been self-treating his heartburn for 1 year with over-the-counter Prilosec OTC (omeprazole, a proton pump inhibitor). The nurse is aware that this self-treatment may have which result?
- A. No serious consequences
- B. Prevention of more serious problems, such as an ulcer
- C. Chronic constipation
- D. Masked symptoms of serious underlying diseases
Correct Answer: D
Rationale: Long-term self-medication with antacids may mask symptoms of serious underlying diseases, such as bleeding ulcer or malignancy. Patients with ongoing symptoms need to undergo regular medical evaluations, because additional medications or other interventions may be needed.