NURS 615 2027 Exam 4 Questions and Answers

NURS 615 2027 Exam 4 Questions and Answers

Question 1.
Peptic ulcer disease and H-pylori treatment

Correct Answer: Triple therapy: PPI twice a day, Amoxicillin 1gm BID or
metronidazole, Clarithromycin 500mg daily for 7-14 days (10 days to 2 weeks
recommended), then continue with PPI for 8-12 weeks


Question 2.
Step down with GERD

Correct Answer: 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.


Question 3.
Second line therapy for GERD if first line fails

Correct Answer: quadruple therapy: PPI bid, metronidazole, tetracycline,
bismuth subsalicylate x 14 days


Question 4.
Step up therapy for GERD

Correct Answer: Lifestyle changes, antacids, H2RA, PPI


Question 5.
Next step if GERD patient is on PPI

Correct Answer: If the patient is already on a once daily PPI, increase to BID. If
no improvement, referral to GI for endoscopy.


Question 6.
Recommendation for travelers diarrhea

Correct Answer: bismuth salicylate


Question 7.
Next step after treating H. Pylori

Correct Answer: Take PPI for 8-12 weeks

,Question 8.
Monitoring parameters for chronic long term proton pump therapy

Correct Answer: Anemia, osteoporosis, iron, B12, calcium, magnesium
• How metoclopramide improves GERD symptoms -✓✓It increases lower
esophageal tone due to its antagonist activity at the D2 receptors and the
chemoreceptor trigger zone in the CNS.


Question 9.
Next step if GERD patient taking TUMS

Correct Answer: H2RA & PPI


Question 10.
Action of loperamide (immodium) when treating diarrhea

Correct Answer: Loperamide acts on the opioid receptors in the myenteric
plexus in the large intestine, decreasing the activity and decreasing the tone
of the longitudinal and circular smooth muscles of the intestinal wall. This
increases the time that the material stays in the intestines, allowing more
water to be absorbed from the fecal matter. It also decreases colonic mass
movements in the presence of the gastric colonic reflex.


Question 11.
Important counseling points when administering antacids

Correct Answer: Antacids can cause constipation when aluminum based or
diarrhea when magnesium based.


Question 12.
Monitoring parameters when adding loop diuretic to heart failure regimen

Correct Answer: Important monitoring parameters when a loop diuretic like
furosemide is added to a patient's heart failure regimen when they are
already taking a cardiac glycoside like digoxin.


Question 13.
Potassium, magnesium, and digitalis toxicity

Correct Answer: Conditions that require careful monitoring when using
diuretics.


Question 14.
Kidney function

, Correct Answer: Check BUN/creatinine; if on thiazide, ensure GFR is higher
than mid 40s.


Question 15.
Tiotropium

Correct Answer: Primary use is for COPD.
• Phenylephrine -✓✓Should be avoided in patients 4 years old or younger, or
those with hypertension or BPH.


Question 16.
Upper respiratory infection in a 3 year old

Correct Answer: Treated with supportive therapy: fluids and rest.


Question 17.
Singulair (montelukast) counseling points

Correct Answer: Potential for depression, anxiety, aggression, and suicidal
ideation.


Question 18.
SABA

Correct Answer: Albuterol, an anti-asthma agent that aggravates pulmonary
beta receptors and increases cyclic AMP.


Question 19.
Antihistamine avoidance conditions

Correct Answer: Avoid in patients under 6 years, over 60 years, and those with
BPH.


Question 20.
Beta agonists for asthma

Correct Answer: Use SABA for asthma attacks, not LABA.


Question 21.
Corticosteroids method of action

Correct Answer: Selection glucocorticoid agonists with negligible effects on
androgen, estrogen, and corticoid receptors; produce anti- inflammatory and
vasoconstricting effects.