Chapter 78: Drugs for Peptic Ulcer Disease

Chapter 78: Drugs for Peptic Ulcer Disease

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

MULTIPLE CHOICE

 

1. A patient who takes nonsteroidal anti-inflammatory drugs (NSAIDs) for arthritis asks a nurse what can be done to prevent ulcers. The nurse will recommend asking the provider about using which medication?

a.	Antibiotics
b.	Histamine-2 receptor antagonists
c.	Proton pump inhibitors
d.	Mucosal protectants

 

 

ANS:  C

Patients taking NSAIDs should use proton pump inhibitors for ulcer prophylaxis. The other agents are not used for prophylaxis.

 

PTS:   1                    DIF:    Cognitive Level: Application           REF:   pp. 947-948

TOP:   Nursing Process: Planning

MSC:  NCLEX Client Needs Category: Physiologic Integrity: Pharmacologic and Parenteral Therapies

 

2. A patient admitted to the hospital has a history of peptic ulcer disease. The patient takes ranitidine [Zantac] and sucralfate [Carafate]. The patient tells the nurse that discomfort is usually controlled but that symptoms occasionally flare up. What will the nurse do?

a.	Ask the provider about ordering an endoscopic examination.
b.	Contact the provider to discuss serologic testing and an antibiotic.
c.	Contact the provider to discuss switching to a proton pump inhibitor.
d.	Counsel the patient to avoid beverages containing caffeine.

 

 

ANS:  B

The recommendation for all patients with gastric or duodenal ulcers and documented Helicobacter pylori infection is treatment with antibiotics. The nurse is correct to ask about serologic testing for this organism and to suggest adding an antibiotic to this patient’s regimen. An endoscopic examination is not recommended. Changing to a proton pump inhibitor may not change the symptoms. There is no evidence that caffeine contributes to peptic ulcer disease (PUD).

 

PTS:   1                    DIF:    Cognitive Level: Application           REF:   p. 949

TOP:   Nursing Process: Assessment

MSC:  NCLEX Client Needs Category: Physiologic Integrity: Physiologic Adaptation

 

3. A patient newly diagnosed with PUD reports taking low-dose aspirin (ASA) for prevention of cardiovascular disease. The nurse learns that the patient drinks 2 to 3 cups of coffee each day and has a glass of wine with dinner 3 or 4 nights per week. The patient eats three meals a day. The nurse will counsel this patient to:

a.	change the meal pattern to five or six smaller meals per day.
b.	discontinue taking aspirin, because it can irritate the stomach.
c.	stop drinking wine or any other alcoholic beverage.
d.	switch to a decaffeinated coffee and reduce the number of servings.

 

 

ANS:  A

Consumption of five or six smaller meals a day can reduce fluctuations in the intragastric pH, which may facilitate recovery. ASA should be avoided, along with other NSAIDs except for low-dose ASA used for the prevention of cardiovascular disease. No hard data implicate alcohol as a contributor to PUD. No data indicate that caffeine contributes to PUD.

 

PTS:   1                    DIF:    Cognitive Level: Application           REF:   p. 950

TOP:   Nursing Process: Planning

MSC:  NCLEX Client Needs Category: Physiologic Integrity: Physiologic Adaptation

 

4. A patient is diagnosed with peptic ulcer disease. The patient is otherwise healthy. The nurse learns that the patient does not smoke and that he drinks 1 or 2 glasses of wine with meals each week. The nurse anticipates that the provider will prescribe which drugs?

a.	Amoxicillin [Amoxil], clarithromycin, and omeprazole [Prilosec]
b.	Amoxicillin [Amoxil], metronidazole [Flagyl], and cimetidine [Tagamet]
c.	Clarithromycin, metronidazole [Flagyl], and omeprazole [Prilosec]
d.	Tetracycline, cimetidine [Tagamet], and lansoprazole [Prevacid]

 

 

ANS:  A

The regimen recommended for the treatment of PUD includes two antibiotics and an antisecretory agent. Amoxicillin, clarithromycin, and omeprazole would meet this recommendation. Patients taking metronidazole cannot consume alcohol, as this would precipitate a disulfiram-like reaction. The last option does not include two antibiotics.

 

PTS:   1                    DIF:    Cognitive Level: Application           REF:   pp. 948-949

TOP:   Nursing Process: Implementation

MSC:  NCLEX Client Needs Category: Physiologic Integrity: Pharmacologic and Parenteral Therapies