Nokea
The nurse is teaching a patient who will be taking a proton pump inhibitor as long-term therapy about potential adverse effects. Which statement is correct?
- A. Proton pump inhibitors can cause diarrhea.
- B. These drugs can cause nausea and anorexia.
- C. Proton pump inhibitors cause drowsiness.
- D. Long-term use of these drugs may contribute to osteoporosis.
Correct Answer: D
Rationale: New concerns have arisen over the potential for long-term users of proton pump inhibitors (PPIs) to develop osteoporosis. This is thought to be due to the inhibition of stomach acid, and it is speculated that PPIs speed up bone mineral loss.
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The nurse is providing patient teaching about antacids. Which statements about antacids are accurate? (Select all that apply.)
- A. Antacids reduce the production of acid in the stomach.
- B. Antacids neutralize acid in the stomach.
- C. Rebound hyperacidity may occur with calcium-based antacids.
- D. Aluminum-based antacids cause diarrhea.
- E. Magnesium-based antacids cause diarrhea.
Correct Answer: B,C,E
Rationale: Antacids neutralize acid in the stomach. Magnesium-based antacids cause diarrhea, and aluminum-based antacids cause constipation. Calcium-based antacids often cause rebound hyperacidity.
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.
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 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.
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.