NCLEX-RN Pharmacology
Gastrointestinal System Exam Questions
& Answers
20 Original GI Drug NCLEX Practice
Questions with Rationales
Nursing Pharmacology Study Guide
Question 1
Clinical Scenario
A 58-year-old client with Gastroesophageal reflux disease
reports persistent heartburn despite lifestyle modifications. The
provider prescribes Omeprazole 40 mg orally once daily.
Question Stem
Which instruction should the nurse provide regarding
administration of this medication?
Options
• A. Take the medication at bedtime after a snack.
• B. Take the medication 30–60 minutes before breakfast.
, • C. Crush the capsule and mix it with food.
• D. Take the medication only when heartburn occurs.
Correct Answer: B. Take the medication 30–60 minutes before
breakfast.
Detailed Rationale
Omeprazole is a proton pump inhibitor (PPI) that irreversibly
inhibits the gastric parietal cell H+/K+ ATPase pump. PPIs are
most effective when taken 30–60 minutes before a meal,
usually breakfast, because proton pumps are activated by food
intake. Administering the drug before breakfast maximizes acid
suppression and therapeutic benefit.
Option A is incorrect because bedtime administration is
generally less effective for once-daily dosing unless specifically
prescribed. Option C is incorrect because delayed-release
capsules should not be crushed, as this destroys the protective
coating and reduces efficacy. Option D is incorrect because PPIs
are not intended for immediate symptom relief; they are taken
consistently to reduce gastric acid production.
Key nursing considerations include assessing for long-term
adverse effects such as vitamin B12 deficiency,
hypomagnesemia, and increased fracture risk with prolonged
therapy. Clients should also be advised to report persistent
abdominal pain, black stools, or dysphagia.
,Learning Objective
After completing this question, the learner should be able to:
• Explain the proper timing of proton pump inhibitor
administration.
• Differentiate PPIs from as-needed antacid therapy.
• Identify important long-term monitoring considerations for
PPI therapy.
Patient educationAdministration timingMonitoring
Question 2
Clinical Scenario
A 72-year-old client is hospitalized with Peptic ulcer disease and
receives Sucralfate 1 g four times daily. The medication
administration record also includes Ciprofloxacin 500 mg orally
twice daily.
Question Stem
Which action should the nurse take to prevent a clinically
significant drug interaction?
Options
• A. Administer both medications together with meals.
• B. Hold the ciprofloxacin until the ulcer heals.
, • C. Separate administration of ciprofloxacin and sucralfate
by at least 2 hours.
• D. Crush both medications and administer through a
feeding tube.
Correct Answer: C. Separate administration of ciprofloxacin and
sucralfate by at least 2 hours.
Detailed Rationale
Sucralfate contains aluminum and forms a protective barrier
over ulcerated mucosa. It can bind to fluoroquinolones such as
Ciprofloxacin, significantly reducing antibiotic absorption and
therapeutic effectiveness. The nurse should administer
ciprofloxacin at least 2 hours before or after sucralfate to
minimize this interaction.
Option A is unsafe because concurrent administration decreases
ciprofloxacin absorption. Option B is unnecessary and could
delay treatment of infection. Option D does not prevent the
interaction and may alter medication delivery.
Nursing care includes reviewing the medication schedule,
educating the client about separation of doses, and monitoring
for signs of unresolved infection. This interaction is commonly
tested because it reflects medication reconciliation and
administration safety principles.
Learning Objective
Gastrointestinal System Exam Questions
& Answers
20 Original GI Drug NCLEX Practice
Questions with Rationales
Nursing Pharmacology Study Guide
Question 1
Clinical Scenario
A 58-year-old client with Gastroesophageal reflux disease
reports persistent heartburn despite lifestyle modifications. The
provider prescribes Omeprazole 40 mg orally once daily.
Question Stem
Which instruction should the nurse provide regarding
administration of this medication?
Options
• A. Take the medication at bedtime after a snack.
• B. Take the medication 30–60 minutes before breakfast.
, • C. Crush the capsule and mix it with food.
• D. Take the medication only when heartburn occurs.
Correct Answer: B. Take the medication 30–60 minutes before
breakfast.
Detailed Rationale
Omeprazole is a proton pump inhibitor (PPI) that irreversibly
inhibits the gastric parietal cell H+/K+ ATPase pump. PPIs are
most effective when taken 30–60 minutes before a meal,
usually breakfast, because proton pumps are activated by food
intake. Administering the drug before breakfast maximizes acid
suppression and therapeutic benefit.
Option A is incorrect because bedtime administration is
generally less effective for once-daily dosing unless specifically
prescribed. Option C is incorrect because delayed-release
capsules should not be crushed, as this destroys the protective
coating and reduces efficacy. Option D is incorrect because PPIs
are not intended for immediate symptom relief; they are taken
consistently to reduce gastric acid production.
Key nursing considerations include assessing for long-term
adverse effects such as vitamin B12 deficiency,
hypomagnesemia, and increased fracture risk with prolonged
therapy. Clients should also be advised to report persistent
abdominal pain, black stools, or dysphagia.
,Learning Objective
After completing this question, the learner should be able to:
• Explain the proper timing of proton pump inhibitor
administration.
• Differentiate PPIs from as-needed antacid therapy.
• Identify important long-term monitoring considerations for
PPI therapy.
Patient educationAdministration timingMonitoring
Question 2
Clinical Scenario
A 72-year-old client is hospitalized with Peptic ulcer disease and
receives Sucralfate 1 g four times daily. The medication
administration record also includes Ciprofloxacin 500 mg orally
twice daily.
Question Stem
Which action should the nurse take to prevent a clinically
significant drug interaction?
Options
• A. Administer both medications together with meals.
• B. Hold the ciprofloxacin until the ulcer heals.
, • C. Separate administration of ciprofloxacin and sucralfate
by at least 2 hours.
• D. Crush both medications and administer through a
feeding tube.
Correct Answer: C. Separate administration of ciprofloxacin and
sucralfate by at least 2 hours.
Detailed Rationale
Sucralfate contains aluminum and forms a protective barrier
over ulcerated mucosa. It can bind to fluoroquinolones such as
Ciprofloxacin, significantly reducing antibiotic absorption and
therapeutic effectiveness. The nurse should administer
ciprofloxacin at least 2 hours before or after sucralfate to
minimize this interaction.
Option A is unsafe because concurrent administration decreases
ciprofloxacin absorption. Option B is unnecessary and could
delay treatment of infection. Option D does not prevent the
interaction and may alter medication delivery.
Nursing care includes reviewing the medication schedule,
educating the client about separation of doses, and monitoring
for signs of unresolved infection. This interaction is commonly
tested because it reflects medication reconciliation and
administration safety principles.
Learning Objective
