NURS 615 Exam 4 UPDATED ACTUAL Questions and CORRECT
Answers
1. PPI long term consequences osteoporosis, B 12 and iron de-
ficiency
2. How would you treat peptic ulcer disease and H-py- Triple therapy:
lori (H-pylori being the leading cause of peptic ul- PPI twice a day
cer with NSAIDS and aspirin being second leading Amoxicillin 1gm BID or metron-
causes) idazole
Clarithromycin 500mg daily for
7-14 days (10 days to 2 weeks
recommended)
Then continue with PPI for 8-12
weeks
3. Step down with GERD Standard dose PPI x 8 weeks. If
not resolved, double PPI dose
for 4-8 weeks. After 4 weeks a
lower dose of PPI is tried, if
no relief after 8 weeks daily PPI
then refer to GI. Step down to
lowest PPI dose or transition to
H2RA blocker if symptoms are
not relieved.
4. If first line GERD therapy fails (triple therapy), what quadruple therapy. PPI bid,
is second line therapy? metronidazole, tetracycline, bis-
muth subsalicylate x 14 days
5. Step up therapy for GERD? Lifestyle changes
antacids
H2RA
PPI
6.
1/6
, NURS 615 Exam 4 UPDATED ACTUAL Questions and CORRECT
Answers
If GERD patient is already on a PPI, what is the next If the pt is already on a once
step? daily PPI, you increase to BID. If
no improvement, referral to GI
for endoscopy.
7. What would you recommend for travelers diar- bismuth salisalate
rhea?
8. After a patient is treated for H. Pylori, what is next? Take PPI for 8-12 weeks
9. What are monitoring parameters for chronic long Anemia, osteoporosis, iron, B12,
term proton pump therapy? calcium, magnesium
10. How does metoclopramide improve GERD symp- It increases lower esophageal
toms? tone due to it's antagonist activ-
ity at the D2 receptors and the
chemoreceptor trigger zone in
the CNS.
11. If you have a GERD patient and they are taking H2RA & PPI
TUMS (calcium carbonate) but their symptoms are
minimally relieved, what is the next step for thera-
py?
12. What is the action of loperamide (immodium) Loperamide acts on the opi-
when treating diarrhea? oid receptors in the myenteric
plexus in the large intestine,
decreasing the activity and de-
creasing the tone of the longitu-
dinal and circular smooth mus-
cles of the intestinal wall. This in-
creases the time that the mater-
ial stays in the intestines, allow-
2/6
Answers
1. PPI long term consequences osteoporosis, B 12 and iron de-
ficiency
2. How would you treat peptic ulcer disease and H-py- Triple therapy:
lori (H-pylori being the leading cause of peptic ul- PPI twice a day
cer with NSAIDS and aspirin being second leading Amoxicillin 1gm BID or metron-
causes) idazole
Clarithromycin 500mg daily for
7-14 days (10 days to 2 weeks
recommended)
Then continue with PPI for 8-12
weeks
3. Step down with GERD Standard dose PPI x 8 weeks. If
not resolved, double PPI dose
for 4-8 weeks. After 4 weeks a
lower dose of PPI is tried, if
no relief after 8 weeks daily PPI
then refer to GI. Step down to
lowest PPI dose or transition to
H2RA blocker if symptoms are
not relieved.
4. If first line GERD therapy fails (triple therapy), what quadruple therapy. PPI bid,
is second line therapy? metronidazole, tetracycline, bis-
muth subsalicylate x 14 days
5. Step up therapy for GERD? Lifestyle changes
antacids
H2RA
PPI
6.
1/6
, NURS 615 Exam 4 UPDATED ACTUAL Questions and CORRECT
Answers
If GERD patient is already on a PPI, what is the next If the pt is already on a once
step? daily PPI, you increase to BID. If
no improvement, referral to GI
for endoscopy.
7. What would you recommend for travelers diar- bismuth salisalate
rhea?
8. After a patient is treated for H. Pylori, what is next? Take PPI for 8-12 weeks
9. What are monitoring parameters for chronic long Anemia, osteoporosis, iron, B12,
term proton pump therapy? calcium, magnesium
10. How does metoclopramide improve GERD symp- It increases lower esophageal
toms? tone due to it's antagonist activ-
ity at the D2 receptors and the
chemoreceptor trigger zone in
the CNS.
11. If you have a GERD patient and they are taking H2RA & PPI
TUMS (calcium carbonate) but their symptoms are
minimally relieved, what is the next step for thera-
py?
12. What is the action of loperamide (immodium) Loperamide acts on the opi-
when treating diarrhea? oid receptors in the myenteric
plexus in the large intestine,
decreasing the activity and de-
creasing the tone of the longitu-
dinal and circular smooth mus-
cles of the intestinal wall. This in-
creases the time that the mater-
ial stays in the intestines, allow-
2/6
