Nokea
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.
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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.
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.
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.
When reviewing the health history of a patient who will be receiving antacids, the nurse recalls that antacids containing magnesium need to be used cautiously in patients with which condition?
- A. Peptic ulcer disease
- B. Renal failure
- C. Hypertension
- D. Heart failure
Correct Answer: B
Rationale: Both calcium- and magnesium-based antacids are more likely to accumulate to toxic levels in patients with renal disease and are commonly avoided in this patient group.
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.