,NURS 6521 Week 7 Quiz | Advanced Pharmacology (2026)
Q&A | Walden University
1. Which of the following best describes the primary mechanism of action of proton
pump inhibitors such as omeprazole?
A) Blocking histamine H2 receptors on gastric parietal cells
B) Irreversibly inhibiting the hydrogen-potassium ATPase pump
C) Neutralizing gastric acid through a chemical reaction
D) Coating the gastric mucosa to form a protective barrier
Correct Answer: Irreversibly inhibiting the hydrogen-potassium ATPase pump
Rationale: Proton pump inhibitors bind irreversibly to the hydrogen-potassium
ATPase pump in gastric parietal cells, suppressing the final step of acid secretion. This
results in profound and prolonged inhibition of both basal and stimulated gastric
acid production. H2 receptor antagonists work through a different mechanism, and
antacids neutralize existing acid.
2. A 60-year-old man reports that his omeprazole is ineffective because he takes it
when heartburn occurs. What is the most appropriate nursing response?
A) Take omeprazole 15 to 30 minutes before meals or drinks that trigger heartburn
B) Switch to a different proton pump inhibitor immediately
C) Double the dose to achieve a faster effect
D) Take omeprazole with an antacid for immediate relief
,Correct Answer: Take omeprazole 15 to 30 minutes before meals or drinks that
trigger heartburn
Rationale: Proton pump inhibitors must be taken before meals to inhibit the proton
pumps that are activated by eating. Taking omeprazole after symptoms begin does
not provide immediate relief because the drug requires time to be absorbed and
reach the parietal cells. Patients should be educated on proper timing for maximum
efficacy. Antacids provide immediate symptom relief but do not address the
underlying acid suppression.
3. Which of the following best describes the mechanism of action of
metoclopramide?
A) Blocking serotonin 5-HT3 receptors in the chemoreceptor trigger zone
B) Stimulating motility of the upper gastrointestinal tract
C) Blocking dopamine D2 receptors in the chemoreceptor trigger zone
D) Inhibiting the hydrogen-potassium ATPase pump
Correct Answer: Stimulating motility of the upper gastrointestinal tract
Rationale: Metoclopramide sensitizes tissues to acetylcholine, promoting motility of
the upper gastrointestinal tract without stimulating gastric, pancreatic, or gallbladder
secretions. It is used for diabetic gastroparesis and postoperative nausea. It does not
block serotonin receptors, inhibit proton pumps, or directly block dopamine
receptors as its primary mechanism. It does have some dopamine antagonist activity,
but its prokinetic effect is mediated through acetylcholine sensitization.
4. A 22-year-old man with Crohn disease has not responded to conventional therapy.
Which targeted therapy has the potential to alleviate his symptoms?
, A) Infliximab
B) Eculizumab
C) Muromonab-CD3
D) Tositumomab
Correct Answer: Infliximab
Rationale: Infliximab is a monoclonal antibody that blocks tumor necrosis factor
(TNF), a key mediator of inflammation in Crohn disease. It is licensed for moderate to
severe Crohn disease that has not responded to conventional therapy. Eculizumab is
used for paroxysmal nocturnal hemoglobinuria, muromonab-CD3 for organ
transplant rejection, and tositumomab for non-Hodgkin lymphoma.
5. A patient with hepatic encephalopathy is prescribed lactulose. The nurse should
monitor which of the following to assess therapeutic efficacy?
A) Serum ammonia levels
B) Number of bowel movements per day
C) Serum potassium levels
D) Abdominal girth
Correct Answer: Number of bowel movements per day
Rationale: Lactulose is a synthetic disaccharide that draws water into the colon,
where bacteria metabolize it into acids that trap ammonia in the stool. The
therapeutic endpoint is typically two to three soft bowel movements per day. Serum
ammonia levels do not correlate well with clinical improvement. Monitoring bowel
movement frequency guides dose titration and confirms that the drug is producing
the desired cathartic effect.
Q&A | Walden University
1. Which of the following best describes the primary mechanism of action of proton
pump inhibitors such as omeprazole?
A) Blocking histamine H2 receptors on gastric parietal cells
B) Irreversibly inhibiting the hydrogen-potassium ATPase pump
C) Neutralizing gastric acid through a chemical reaction
D) Coating the gastric mucosa to form a protective barrier
Correct Answer: Irreversibly inhibiting the hydrogen-potassium ATPase pump
Rationale: Proton pump inhibitors bind irreversibly to the hydrogen-potassium
ATPase pump in gastric parietal cells, suppressing the final step of acid secretion. This
results in profound and prolonged inhibition of both basal and stimulated gastric
acid production. H2 receptor antagonists work through a different mechanism, and
antacids neutralize existing acid.
2. A 60-year-old man reports that his omeprazole is ineffective because he takes it
when heartburn occurs. What is the most appropriate nursing response?
A) Take omeprazole 15 to 30 minutes before meals or drinks that trigger heartburn
B) Switch to a different proton pump inhibitor immediately
C) Double the dose to achieve a faster effect
D) Take omeprazole with an antacid for immediate relief
,Correct Answer: Take omeprazole 15 to 30 minutes before meals or drinks that
trigger heartburn
Rationale: Proton pump inhibitors must be taken before meals to inhibit the proton
pumps that are activated by eating. Taking omeprazole after symptoms begin does
not provide immediate relief because the drug requires time to be absorbed and
reach the parietal cells. Patients should be educated on proper timing for maximum
efficacy. Antacids provide immediate symptom relief but do not address the
underlying acid suppression.
3. Which of the following best describes the mechanism of action of
metoclopramide?
A) Blocking serotonin 5-HT3 receptors in the chemoreceptor trigger zone
B) Stimulating motility of the upper gastrointestinal tract
C) Blocking dopamine D2 receptors in the chemoreceptor trigger zone
D) Inhibiting the hydrogen-potassium ATPase pump
Correct Answer: Stimulating motility of the upper gastrointestinal tract
Rationale: Metoclopramide sensitizes tissues to acetylcholine, promoting motility of
the upper gastrointestinal tract without stimulating gastric, pancreatic, or gallbladder
secretions. It is used for diabetic gastroparesis and postoperative nausea. It does not
block serotonin receptors, inhibit proton pumps, or directly block dopamine
receptors as its primary mechanism. It does have some dopamine antagonist activity,
but its prokinetic effect is mediated through acetylcholine sensitization.
4. A 22-year-old man with Crohn disease has not responded to conventional therapy.
Which targeted therapy has the potential to alleviate his symptoms?
, A) Infliximab
B) Eculizumab
C) Muromonab-CD3
D) Tositumomab
Correct Answer: Infliximab
Rationale: Infliximab is a monoclonal antibody that blocks tumor necrosis factor
(TNF), a key mediator of inflammation in Crohn disease. It is licensed for moderate to
severe Crohn disease that has not responded to conventional therapy. Eculizumab is
used for paroxysmal nocturnal hemoglobinuria, muromonab-CD3 for organ
transplant rejection, and tositumomab for non-Hodgkin lymphoma.
5. A patient with hepatic encephalopathy is prescribed lactulose. The nurse should
monitor which of the following to assess therapeutic efficacy?
A) Serum ammonia levels
B) Number of bowel movements per day
C) Serum potassium levels
D) Abdominal girth
Correct Answer: Number of bowel movements per day
Rationale: Lactulose is a synthetic disaccharide that draws water into the colon,
where bacteria metabolize it into acids that trap ammonia in the stool. The
therapeutic endpoint is typically two to three soft bowel movements per day. Serum
ammonia levels do not correlate well with clinical improvement. Monitoring bowel
movement frequency guides dose titration and confirms that the drug is producing
the desired cathartic effect.
