NURS 615, EXAM 4 | COMPLETE QUESTIONS & ANSWERS (100%
VERIFIED SOLUTIONS) LATEST UPDATE
PPI - CORRECT ANSWER -Directly inhibits acid, better than H2RA
1st line treatment for peptic ulcer disease and H pylori - CORRECT ANSWER -PPI, amoxicillin,
and macrolide
What can amoxicillin be substituted with if patient has allergy to PNC - CORRECT ANSWER -
Metronidazole
2nd line treatment for peptic ulcer disease and H pylori - CORRECT ANSWER -PPI,
metronidazole, tetracycline, and bismuth subsalicylate
GERD step up approach - CORRECT ANSWER -Lifestyle changes, OTC antacids, H2RA, PPI 4-8
weeks, if there is erosive disease- PPI daily then BID, best for patients with mild or occasional
symptoms
GERD step down therapy - CORRECT ANSWER -Start with PPI 8 weeks, PPI BID 4-8 weeks, then
lower dose of PPI, if symptoms continue refer to GI doctor. Goal is to step down to lowest PPI
dose or transition to H2RA
Treatment of Traveler's Diarrhea - CORRECT ANSWER -Bismuth subsalicylate
Side effects of bismuth subsalicylate - CORRECT ANSWER -Black tongue or stool, toxic to cats
Mechanism of Action of bismuth subsalicylate - CORRECT ANSWER -Bonds to toxins made by E.
coli
, What is next step after treatment for H. pylori is complete? - CORRECT ANSWER -Chronic
suppressive therapy with PPI or H2RA in patients at high risk
Mechanism of action of metoclopramide - CORRECT ANSWER -Increase lower esophageal
sphincter tone, stimulates GI motility, dopamine receptor agonist in the CNS and
chemoreceptor trigger zone to prevent emesis
Patient using TUMS, what is next step if there is minimal relief - CORRECT ANSWER -If mild
symptoms: try H2RA, if severe symptoms or erosion: PPI
What is the mechanism of action of loperamide? - CORRECT ANSWER -Binds to opiate receptors
in the intestinal wall leading to slower GI motility
Patient counseling when taking antacids - CORRECT ANSWER -Aluminum and calcium based
antacids can cause constipation. Magnesium based antacids cause diarrhea
When should parents take antacids? - CORRECT ANSWER -1-3 hours after each meal and at
bedtime, 2 hours separate from other medications.
What foods should be avoided when taking antacids? - CORRECT ANSWER -Foods containing
large amounts of oxalic acid (spinach/rhubarb) and phytic acid (brans) will decrease calcium
absorption. Food high in phosphorus (milk and dairy) can cause milk-alkali syndrome
What should you check if patient is taking loop diuretic with digoxin - CORRECT ANSWER -
Potassium, hypokalemia can increase risk of digoxin toxicity
What to consider when choosing diuretic for hypertension - CORRECT ANSWER -Kidney
function: GFR shyness 30-40, creatinine clearance 25-30 ml/min
VERIFIED SOLUTIONS) LATEST UPDATE
PPI - CORRECT ANSWER -Directly inhibits acid, better than H2RA
1st line treatment for peptic ulcer disease and H pylori - CORRECT ANSWER -PPI, amoxicillin,
and macrolide
What can amoxicillin be substituted with if patient has allergy to PNC - CORRECT ANSWER -
Metronidazole
2nd line treatment for peptic ulcer disease and H pylori - CORRECT ANSWER -PPI,
metronidazole, tetracycline, and bismuth subsalicylate
GERD step up approach - CORRECT ANSWER -Lifestyle changes, OTC antacids, H2RA, PPI 4-8
weeks, if there is erosive disease- PPI daily then BID, best for patients with mild or occasional
symptoms
GERD step down therapy - CORRECT ANSWER -Start with PPI 8 weeks, PPI BID 4-8 weeks, then
lower dose of PPI, if symptoms continue refer to GI doctor. Goal is to step down to lowest PPI
dose or transition to H2RA
Treatment of Traveler's Diarrhea - CORRECT ANSWER -Bismuth subsalicylate
Side effects of bismuth subsalicylate - CORRECT ANSWER -Black tongue or stool, toxic to cats
Mechanism of Action of bismuth subsalicylate - CORRECT ANSWER -Bonds to toxins made by E.
coli
, What is next step after treatment for H. pylori is complete? - CORRECT ANSWER -Chronic
suppressive therapy with PPI or H2RA in patients at high risk
Mechanism of action of metoclopramide - CORRECT ANSWER -Increase lower esophageal
sphincter tone, stimulates GI motility, dopamine receptor agonist in the CNS and
chemoreceptor trigger zone to prevent emesis
Patient using TUMS, what is next step if there is minimal relief - CORRECT ANSWER -If mild
symptoms: try H2RA, if severe symptoms or erosion: PPI
What is the mechanism of action of loperamide? - CORRECT ANSWER -Binds to opiate receptors
in the intestinal wall leading to slower GI motility
Patient counseling when taking antacids - CORRECT ANSWER -Aluminum and calcium based
antacids can cause constipation. Magnesium based antacids cause diarrhea
When should parents take antacids? - CORRECT ANSWER -1-3 hours after each meal and at
bedtime, 2 hours separate from other medications.
What foods should be avoided when taking antacids? - CORRECT ANSWER -Foods containing
large amounts of oxalic acid (spinach/rhubarb) and phytic acid (brans) will decrease calcium
absorption. Food high in phosphorus (milk and dairy) can cause milk-alkali syndrome
What should you check if patient is taking loop diuretic with digoxin - CORRECT ANSWER -
Potassium, hypokalemia can increase risk of digoxin toxicity
What to consider when choosing diuretic for hypertension - CORRECT ANSWER -Kidney
function: GFR shyness 30-40, creatinine clearance 25-30 ml/min
