Nokea
A patient will be taking a 2-week course of combination therapy with omeprazole and another drug for a peptic ulcer caused by Helicobacter pylori. The nurse expects a drug from which class to be ordered with the omeprazole?
- A. Antibiotic
- B. Nonsteroidal anti-inflammatory drug
- C. Antacid
- D. Antiemetic
Correct Answer: A
Rationale: The antibiotic clarithromycin is active against H. pylori and is used in combination with omeprazole to eradicate the bacteria. First-line therapy against H. pylori includes a 10- to 14-day course of a proton pump inhibitor such as omeprazole, plus the antibiotics clarithromycin and either amoxicillin or metronidazole, or a combination of a proton pump inhibitor, bismuth subsalicylate, and the antibiotics tetracycline and metronidazole.
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A 75-year-old woman comes into the clinic and states she has had muscle twitching, nausea, and headache. She tells the nurse that she has been taking sodium bicarbonate five or six times a day for the past 3 weeks. The nurse will assess for which potential problem that may occur with overuse of sodium bicarbonate?
- A. Constipation
- B. Metabolic acidosis
- C. Metabolic alkalosis
- D. Excessive gastric mucus
Correct Answer: C
Rationale: Excessive use of sodium bicarbonate may lead to systemic alkalosis.
At 0900, the nurse is about to give morning medications, and the patient has asked for a dose of antacid for severe heartburn. Which schedule for the antacid and medications is correct?
- A. Give both the antacid and medications at 0900.
- B. Give the antacid at 0900, and then the medications at 0900.
- C. Give the medications at 0900, and then the antacid at 1900.
- D. Give the medications at 0900, and then the antacid at 0915.
Correct Answer: C
Rationale: Medications are not to be taken, unless prescribed, within 1 to 2 hours of taking an antacid because of the impact on the absorption of many medications in the stomach.
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.
A patient is asking advice about which over-the-counter antacid is considered the most safe to use for heartburn. The nurse explains that the reason that calcium antacids are not used as frequently as other antacids is for which of these reasons?
- A. Their use may result in kidney stones.
- B. They cause decreased gastric acid production.
- C. They cause severe diarrhea.
- D. Their use may result in fluid retention and edema.
Correct Answer: A
Rationale: Calcium antacids are not used as frequently as other antacids because their use may lead to the development of kidney stones; they also cause increased gastric acid production.
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.