Nokea
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.
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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 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.
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.
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.
A patient is taking omeprazole for the treatment of gastroesophageal reflux disease (GERD). The nurse will include which statement in the teaching plan about this medication?
- A. Take this medication once a day after breakfast.
- B. You will be on this medication for only 2 weeks for treatment of the reflux disease.
- C. The medication may be dissolved in a liquid for better absorption.
- D. The entire capsule must be taken whole, not crushed, chewed, or opened.
Correct Answer: D
Rationale: Omeprazole needs to be taken before meals, and an entire capsule must be taken whole, not crushed, chewed, opened, or dissolved in liquid when treating GERD. This medication is used on a long-term basis to maintain healing.