1|Page
WILKES NURS 533 TEST 1 PRACTICE EXAM
QUESTIONS WITH VERIFIED ANSWERS 2025
1. Which one of the following GERD symptom is considered atypical and requires
further diagnostic evaluation?
A. Heartburn
B. Regurgitation
C. Wheezing
D. None of the above symptoms is considered atypical - correct-answer-Answer: C
Option C: Correct. Wheezing is an atypical symptom and may be a contributing
factor in certain patients with asthma.
2. Which of the following represents the correct order of gastric acid suppression
from most suppression to least suppression?
a PPI > H2RA > Antacid
b PPI > Antacid > H2RA
c Antacid > H2RA > PPI
d H2RA > PPI > Antacid - correct-answer-Answer: A
Option A: Correct. Dexlansoprazole can be taken without regard to meals.
Option B: Incorrect. Lansoprazole should be taken 30 to 60 minutes prior to a
meal.
,2|Page
Option C: Incorrect. Omeprazole should be taken 30 to 60 minutes prior to a meal.
Option D: Incorrect. Pantoprazole should be taken 30 to 60 minutes prior to a
meal.
3. What would be the best initial pharmacologic option in addition to lifestyle
modification for a patient with typical GERD symptoms 1 day per week?
Pantoprazole 20 mg BID
Omeprazole 20 mg daily
Lansoprazole 15 mg daily as needed for GERD symptoms (on-demand)
Famotidine 20 mg daily as needed for GERD symptoms (on-demand) - correct-
answer-Answer: D
Option A: Incorrect. The patient has symptoms only once a week, so a twice-daily
PPI is not indicated.
Option B: Incorrect. The patient has symptoms only once a week, so a daily PPI is
not indicated.
Option C: Incorrect. The patient has symptoms only once a week, and this is the
initial treatment, so an on-demand PPI is not indicated.
Option D: Correct. The patient has symptoms once per week and is receiving initial
treatment, so an on-demand H2RA is indicated.
4. Which one of the following medications may worsen GERD symptoms by
decreasing lower esophageal sphincter pressure?
Nifedipine
,3|Page
Alendronate
Naproxen
Doxycycline - correct-answer-Answer: A
Option A: Correct. Dihydropyridine calcium channel blockers lower LES pressure.
Option B: Incorrect. Bisphosphonates are direct irritants to esophageal mucosa.
Option C: Incorrect. NSAIDs are direct irritants to esophageal mucosa.
Option D: Incorrect. Doxycycline is a direct irritant to esophageal mucosa.
5. Which of the following would be the LEAST appropriate medication for treating
GERD in pregnancy?
Calcium carbonate tablets
Esomeprazole capsules
Aluminum hydroxide/agnesium trisilicate tablets
Lansoprazole capsules - correct-answer-Answer: C
Option A: Incorrect. Calcium containing antacids are appropriate initial treatment
in mild-to-moderate GERD in pregnancy.
Option B: Incorrect. It is appropriate to use a PPI to treat GERD in pregnant
women with frequent, severe heartburn.
Option C: Correct. Magnesium trisilicate-containing antacids should be avoided in
pregnancy.
Option D: Incorrect. It is appropriate to use a PPI to treat GERD in pregnant
women with frequent, severe heartburn.
, 4|Page
6. PPIs decrease stomach acid by which of the following mechanisms?
Inhibiting gastric H+/K+-adenosine triphosphatase in gastric parietal cells
Inhibiting histamine-2 receptors in gastric parietal cells
Forming a viscous solution that floats on the surface of the gastric contents
Increasing GI motility - correct-answer-6. Answer: A
Option A: Correct. This is the mechanism of action of the PPIs.
Option B: Incorrect. This is the mechanism of action of the H2RAs.
Option C: Incorrect. This is the mechanism of action of sucralfate.
Option D: Incorrect. This is the mechanism of action of metoclopramide.
7. Which of the following would be recommended for preventing complications
due to PPI use?
Magnesium supplementation for potential hypomagnesemia
Sodium bicarbonate supplementation for potential acute kidney injury
Memantine prophylaxis for PPI-associated dementia
Calcium citrate supplementation for documented hypocalcemia - correct-answer-
7. Answer: D
Option A: Incorrect. Prophylactic magnesium supplementation is not indicated.
Option B: Incorrect. Prophylactic sodium bicarbonate supplementation is not
indicated.
Option C: Incorrect. PPI dementia is not well documented. Memantine would not
be appropriate for this indication.
WILKES NURS 533 TEST 1 PRACTICE EXAM
QUESTIONS WITH VERIFIED ANSWERS 2025
1. Which one of the following GERD symptom is considered atypical and requires
further diagnostic evaluation?
A. Heartburn
B. Regurgitation
C. Wheezing
D. None of the above symptoms is considered atypical - correct-answer-Answer: C
Option C: Correct. Wheezing is an atypical symptom and may be a contributing
factor in certain patients with asthma.
2. Which of the following represents the correct order of gastric acid suppression
from most suppression to least suppression?
a PPI > H2RA > Antacid
b PPI > Antacid > H2RA
c Antacid > H2RA > PPI
d H2RA > PPI > Antacid - correct-answer-Answer: A
Option A: Correct. Dexlansoprazole can be taken without regard to meals.
Option B: Incorrect. Lansoprazole should be taken 30 to 60 minutes prior to a
meal.
,2|Page
Option C: Incorrect. Omeprazole should be taken 30 to 60 minutes prior to a meal.
Option D: Incorrect. Pantoprazole should be taken 30 to 60 minutes prior to a
meal.
3. What would be the best initial pharmacologic option in addition to lifestyle
modification for a patient with typical GERD symptoms 1 day per week?
Pantoprazole 20 mg BID
Omeprazole 20 mg daily
Lansoprazole 15 mg daily as needed for GERD symptoms (on-demand)
Famotidine 20 mg daily as needed for GERD symptoms (on-demand) - correct-
answer-Answer: D
Option A: Incorrect. The patient has symptoms only once a week, so a twice-daily
PPI is not indicated.
Option B: Incorrect. The patient has symptoms only once a week, so a daily PPI is
not indicated.
Option C: Incorrect. The patient has symptoms only once a week, and this is the
initial treatment, so an on-demand PPI is not indicated.
Option D: Correct. The patient has symptoms once per week and is receiving initial
treatment, so an on-demand H2RA is indicated.
4. Which one of the following medications may worsen GERD symptoms by
decreasing lower esophageal sphincter pressure?
Nifedipine
,3|Page
Alendronate
Naproxen
Doxycycline - correct-answer-Answer: A
Option A: Correct. Dihydropyridine calcium channel blockers lower LES pressure.
Option B: Incorrect. Bisphosphonates are direct irritants to esophageal mucosa.
Option C: Incorrect. NSAIDs are direct irritants to esophageal mucosa.
Option D: Incorrect. Doxycycline is a direct irritant to esophageal mucosa.
5. Which of the following would be the LEAST appropriate medication for treating
GERD in pregnancy?
Calcium carbonate tablets
Esomeprazole capsules
Aluminum hydroxide/agnesium trisilicate tablets
Lansoprazole capsules - correct-answer-Answer: C
Option A: Incorrect. Calcium containing antacids are appropriate initial treatment
in mild-to-moderate GERD in pregnancy.
Option B: Incorrect. It is appropriate to use a PPI to treat GERD in pregnant
women with frequent, severe heartburn.
Option C: Correct. Magnesium trisilicate-containing antacids should be avoided in
pregnancy.
Option D: Incorrect. It is appropriate to use a PPI to treat GERD in pregnant
women with frequent, severe heartburn.
, 4|Page
6. PPIs decrease stomach acid by which of the following mechanisms?
Inhibiting gastric H+/K+-adenosine triphosphatase in gastric parietal cells
Inhibiting histamine-2 receptors in gastric parietal cells
Forming a viscous solution that floats on the surface of the gastric contents
Increasing GI motility - correct-answer-6. Answer: A
Option A: Correct. This is the mechanism of action of the PPIs.
Option B: Incorrect. This is the mechanism of action of the H2RAs.
Option C: Incorrect. This is the mechanism of action of sucralfate.
Option D: Incorrect. This is the mechanism of action of metoclopramide.
7. Which of the following would be recommended for preventing complications
due to PPI use?
Magnesium supplementation for potential hypomagnesemia
Sodium bicarbonate supplementation for potential acute kidney injury
Memantine prophylaxis for PPI-associated dementia
Calcium citrate supplementation for documented hypocalcemia - correct-answer-
7. Answer: D
Option A: Incorrect. Prophylactic magnesium supplementation is not indicated.
Option B: Incorrect. Prophylactic sodium bicarbonate supplementation is not
indicated.
Option C: Incorrect. PPI dementia is not well documented. Memantine would not
be appropriate for this indication.
