Holland/Adams/Brice, Core Concepts in Pharmacology 5th Edition Test Bank
Chapter 31

Question 1

Type: MCMA

The nurse is teaching a client about the structures of the GI tract. Which structures should the nurse include in the teaching session? (Select all that apply.) Note: Credit will be given only if all correct choices and no incorrect choices are selected.

1. Stomach
2. Liver
3. Large intestine
4. Pancreas
5. Gallbladder

Cognitive Level: Remembering

Client Need: Health Promotion and Maintenance

Page Number: 516

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 31-1 Describe the major functions of the digestive system.

Question 2

Type: MCMA

What are the risk factors associated with peptic ulcer disease? (Select all that apply.) Note: Credit will be given only if all correct choices and no incorrect choices are selected.

1. Drinking caffeine
2. Family history
3. Blood type A
4. Smoking tobacco
5. Acetaminophen (Tylenol) intake for pain

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 517

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 31-2 Identify common causes, signs, and symptoms of peptic ulcer disease and gastroesophageal reflux disease (GERD).

Question 3

Type: MCSA

What symptom is more common to a duodenal ulcer than a gastric ulcer?

1. Nausea and vomiting
2. Anorexia
3. Postprandial pain
4. Nighttime pain

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 518

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 31-2 Identify common causes, signs, and symptoms of peptic ulcer disease and gastroesophageal reflux disease (GERD).

Question 4

Type: MCSA

A client has just been diagnosed with peptic ulcer disease. What first-choice drug does the nurse anticipate will be prescribed for this client?

1. Famotidine (Pepcid)
2. Magaldrate (Riopan)
3. Omeprazole (Prilosec)
4. Sodium bicarbonate (Alka-Seltzer)

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 521

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 31-3 Describe general approaches to treating peptic ulcer disease and GERD.

Question 5

Type: MCSA

An ulcer caused by H. pylori can be successfully treated with which classification of drugs?

1. Antacids
2. Proton-pump inhibitors
3. H₂-receptor blockers
4. Antibiotics

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 524

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 31-3 Describe general approaches to treating peptic ulcer disease and GERD.

Question 6

Type: MCSA

A client was placed on ranitidine (Zantac) 2 days ago, and continues to complain of ulcer pain. What is the best response by the nurse?

1. “We’ll switch you to a different medication.”
2. “You probably have something else besides an ulcer.”
3. “You might not notice relief for several weeks.”
4. “You should be taking the medication with food.”

Cognitive Level: Analyzing

Client Need: Physiological Integrity

Page Number: 522

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 31-5 Explain the role of H₂-receptor blockers in the treatment of peptic ulcer disease and GERD.

Question 7

Type: MCSA

A client asks the nurse why two antibiotics have been prescribed to treat H. pylori. What is the best response by the nurse?

1. “Two or more antibiotics are given concurrently to increase the effectiveness of therapy and to lower the potential for bacterial resistance.”
2. “One antibiotic is to treat H. pylori and the other is for a secondary infection.”
3. “The acid in your stomach will make one antibiotic ineffective, so you must take two.”
4. “You should only be prescribed one antibiotic to treat H. pylori.”

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 524

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 31-8 Explain why two or more antibiotics are used concurrently in the treatment of H. pylori.

Question 8

Type: MCMA

A client has been taking an opioid for pain relief following abdominal surgery. The client complains of constipation. Which statements indicate understanding by the client? (Select all that apply.) Note: Credit will be given only if all correct choices and no incorrect choices are selected.

1. “I should only take a laxative when necessary.”
2. “I should increase fluid intake.”
3. “I should strain when I try to have a bowel movement.”
4. “I should increase fiber intake.”
5. “I should decrease my physical activity.”

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 525

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 31-9 Compare and contrast the major classes of laxatives.

Question 9

Type: MCSA

Which type of laxative causes peristalsis by irritating the bowel?

1. Stimulant laxative
2. Bulk-forming laxative
3. Stool softener
4. Saline/osmotic laxative

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 525

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 31-9 Compare and contrast the major classes of laxatives.

Question 10

Type: MCSA

The nurse is caring for a client who is experiencing constipation. Which type of laxative can be taken prophylactically to prevent constipation?

1. Bisacodyl (Dulcolax)
2. Psyllium muciloid (Metamucil)
3. Castor oil (Emulsoil)
4. Magnesium hydroxide (Milk of Magnesia)

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 525

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 31-9 Compare and contrast the major classes of laxatives.

Question 11

Type: MCSA

Which drug produces a bowel movement in 1–6 hours, and should not be used on a regular basis because of the possibility of fluid and electrolyte depletion?

1. Saline/osmotic laxative
2. Bulk-forming laxative
3. Stimulant laxative
4. Stool softener

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 525

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 31-9 Compare and contrast the major classes of laxatives.

Question 12

Type: MCSA

Patients should be advised not to overuse laxatives, because the smooth muscle in the colon can lose its tone. What condition should the nurse warn the client can occur if this happens?

1. Chronic constipation
2. Chronic diarrhea
3. Chronic nausea
4. Frequent vomiting

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 526

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 31-9 Compare and contrast the major classes of laxatives.

Question 13

Type: MCSA

Which client is at the greatest risk for developing an acid–base imbalance or electrolyte disorder?

1. A client who has a gastrostomy tube
2. 18-month-old who has had watery stools for 3 days
3. 70-year-old with constipation
4. 27-year-old with a 24-hour history of nausea and vomiting

Cognitive Level: Analyzing

Client Need: Physiological Integrity

Page Number: 527

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 31-10 Identify the major drug classes used to treat diarrhea.

Question 14

Type: MCMA

Which classifications of medication do antiemetic drugs belong to? (Select all that apply.) Note: Credit will be given only if all correct choices and no incorrect choices are selected.

1. Benzodiazepines
2. Glucocorticoids
3. Antipsychotics
4. Antihistamines
5. Opioids

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 528

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 31-11 Identify the major drug classes used to treat nausea and vomiting.

Question 15

Type: MCSA

A client has been diagnosed with pancreatic insufficiency. Which treatment option does the nurse anticipate for this client?

1. Treatment with PPIs to decrease stomach acid
2. Replacement therapy with pancreatic enzymes
3. Decrease food intake
4. Treatment with stimulant laxatives

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 530

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 31-12 Describe the pharmacotherapy of pancreatic insufficiency.

Question 16

Type: MCMA

Which drugs are the most effective for treating severe diarrhea? (Select all that apply.) Note: Credit will be given only if all correct choices and no incorrect choices are selected.

1. Diphenoxylate (Lomotil)
2. Bismuth salt (Pepto-Bismol)
3. Loperamide (Imodium)
4. Furazolidone (Furoxone)
5. Diphenhydramine (Benadryl)

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 527

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 31-10 Identify the major drug classes used to treat diarrhea.

Question 17

Type: MCSA

A client is discharged from emergency department experiencing severe vomiting and is prescribed prochlorperazine (Compazine) 10 mg, three times daily. What is the most effective route of administration for this medication?

1. IM
2. PR
3. PO
4. IV

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 529

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 31-11 Identify the major drug classes used to treat nausea and vomiting.

Question 16

Type: MCSA

A client complains of nausea and vomiting. Which medication would not be prescribed for this client?

1. Diphenoxylate with atropine (Lomotil)
2. Prochlorperazine (Compazine)
3. Promethazine (Phenergan)
4. Ondansetron (Zofran)

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 528

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 31-11 Identify the major drug classes used to treat nausea and vomiting.

Question 19

Type: MCSA

Which instruction is most appropriate for a client who is prescribed pancrelipase (Cotazym)?

1. Increase dosing with a large meal
2. Decrease fluid intake
3. Take the medication at least 2 hours prior to meals
4. Take the medication with meals

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 530

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 31-12 Describe the pharmacotherapy of pancreatic insufficiency.

Question 20

Type: MCSA

The nurse is caring for a client who is being treated for peptic ulcer disease. Which medication should the client be taught to avoid?

1. Antacids
2. H₂-receptor blockers
3. NSAIDs
4. PPIs

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 519

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 31-3 Describe general approaches to treating peptic ulcer disease and GERD.

Question 21

Type: MCSA

Which instruction is most appropriate for a client who is receiving a bulk-forming laxative?

1. Take with at least two full glasses of water
2. Exercise more than three times a week
3. Increase food intake
4. Decrease water intake

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 525

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 31-9 Compare and contrast the major classes of laxatives.

Question 22

Type: MCMA

Which side effects would the nurse expect a client taking a PPI to report? (Select all that apply.) Note: Credit will be given only if all correct choices and no incorrect choices are selected.

1. Ataxia
2. Hypotension
3. Headache
4. Diarrhea
5. Hyperglycemia

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 520

Nursing/Integrated Concepts: Nursing Process: Evaluation

Learning Outcome: 31-4 Explain the role of proton pump inhibitors in the treatment of peptic ulcer disease and GERD.

Question 23

Type: MCMA

What are the goals of pharmacotherapy for a client with an ulcer? (Select all that apply.) Note: Credit will be given only if all correct choices and no incorrect choices are selected.

1. Prevent recurrence of the disease
2. Promote healing of the ulcer
3. Provide immediate relief from symptoms
4. Reduce frequency of constipation
5. Increase frequency of diarrhea

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 519

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 31-3 Describe general approaches to treating peptic ulcer disease and GERD.

Question 24

Type: MCSA

The nurse is teaching a client about digestion. Which statement reflects that the client understands the teaching?

1. It is the process when food is broken down into molecules that can be absorbed.

2. The amount of blood pumped by the heart through the circulatory system in 1 minute.

3. Smooth muscle movement of the GI tract by way of contractions.

4. Neutralization by use of bicarbonate from pancreatic and biliary secretions.

Cognitive Level: Understanding

Client Need: Health Promotion and Maintenance

Page Number: 516

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 31-1 Describe the major functions of the digestive system.

Question 25

Type: MCMA

Which medications reduce acid secretion by binding irreversibly to the enzyme H⁺, K⁺-ATPase? (Select all that apply.) Note: Credit will be given only if all correct choices and no incorrect choices are selected.

1. Omeprazole (Prilosec)

2. Magnesium hydroxide (Milk of Magnesium)

3. Famotidine (Pepcid)

4. Ranitidine (Zantac)

5. Pantoprazole (Protonix)

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 520

Nursing/Integrated Concepts: Nursing Process: Evaluation

Learning Outcome: 31-4 Explain the role of proton pump inhibitors in the treatment of peptic ulcer disease and GERD.

Question 26

Type: MCSA

A nurse is reviewing the medication administration record of a client who was recently admitted. Ranitidine (Zantac) is listed as one of the medications. Which classification is this medication?

1. Proton-pump inhibitor

2. Antibiotic

3. H₂-receptor antagonist

4. Antacid

Cognitive Level: Understanding

Client Need: Physiological Integrity

Page Number: 521

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 31-5 Explain the role of H₂-receptor blockers in the treatment of peptic ulcer disease and GERD.

Question 27

Type: MCSA

A nurse is preparing to administer medications and notices that two medications are to be administered at the same time: calcium carbonate (Tums) and ranitidine (Zantac). Which is the correct order to administer these medications?

1. Ranitidine (Zantac) first, then wait 1 hour to administer calcium carbonate (Tums)

2. Calcium carbonate (Tums) first, then wait 1 hour to administer raniditine (Zantac)

3. Administer both at the same time

4. Call the prescriber for clarification

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 522

Nursing/Integrated Concepts: Nursing Process: Evaluation

Learning Outcome: 31-6 Explain the role of antacids in the treatment of peptic ulcer disease and GERD.

Question 28

Type: MCSA

Which should be included in a medication teaching plan about antacids?

1. Antacids should be taken before other medications.

2. Antacids are taken 2 hours after other medications.

3. Other medications should be taken 2 hours after antacids.

4. Other medications will decrease acid secretion.

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 523

Nursing/Integrated Concepts: Nursing Process: Evaluation

Learning Outcome: 31-6 Explain the role of antacids in the treatment of peptic ulcer disease and GERD.

Question 29

Type: MCSA

Which is the preferred combination of antibiotics given to clients diagnosed with H. pylori infections?

1. Amoxicillin (Amoxil) and metoclopramide (Reglan)

2. Metronidazole (Flagyl) and ranitidine (Zantac)

3. Clarithromycin (Biaxin) and amoxicillin (Amoxil)

4. Tetracycline (Sumycin) and pantoprazole (Protonix)

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 524

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 31-8 Explain why two or more antibiotics are used concurrently in the treatment of H. pylori.

Question 30

Type: MCMA

A nurse is instructing a client diagnosed with PUD about a new medication, sucralfate (Carafate). Which statements are important to include in the teaching of the medication? (Select all that apply.) Note: Credit will be given only if all correct choices and no incorrect choices are selected.

1. The medication will need to be taken four times a day.

2. The medication works by reducing the acid secretion.

3. The medication will promote healing.

4. The medication will be absorbed by the GI tract.

5. The medication may cause constipation.

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 524

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 31-7 Explain the role of miscellaneous drugs in the treatment of peptic ulcer disease and GERD.

Question 31

Type: MCSA

A nurse is instructing a client with chronic pain about two new prescriptions: ibuprofen (Advil) and misoprostol (Cytotec). The client is asking about why the misoprostol (Cytotec) was added. Which is the nurse’s best response?

1. Ibuprofen (Advil) is toxic and misoprostol (Cytotec) will reduce the toxicity.

2. Misoprostol (Cytotec) will create a protective mucous to decrease irritation from the ibuprofen (Advil).

3. Ibuprofen (Advil) has inflammatory properties that misoprostol (Cytotec) will decrease.

4. Misoprostol (Cytotec) will stimulate gastric production to assist digestion of ibuprofen (Advil).

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 524

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 31-7 Explain the role of miscellaneous drugs in the treatment of peptic ulcer disease and GERD.