Nurs 415 Exam 1 Deck – UPDATED Questions with 100% Verified Answers
Nurs 415 Exam 1 Deck – UPDATED Questions with
100% Verified Answers
Section 1: Antacid, Gerd, Antacids (Q1–Q13)
Question & Answer
Q1 GERD nonpharmacologic therapy
A Avoid trigger foods/drinks and overeating; avoid bending, strenuous exercise, or lying supine for 3
hours after intake; elevate the head of the bed; lose weight when indicated; stop smoking.
Q2 Antacids in GERD
A Adjunctive/as-needed therapy for infrequent symptoms; not monotherapy for significant disease or
frequent symptoms.
Q3 First-line medication for frequent GERD symptoms
A A proton pump inhibitor (PPI), especially when esophagitis or other serious complications are
present.
Q4 Role of H2 receptor antagonists in GERD
A They reduce gastric acid and can treat GERD, but PPIs are preferred in most cases.
Q5 Role of prokinetic agents in GERD
A Reserved for persistent symptoms after maximal acid suppression and lifestyle modification
because serious adverse effects are possible.
Q6 Antacid mechanism of action
A Weak bases react with hydrochloric acid to form salt and water, neutralizing acid and raising
gastric/duodenal pH; they also inhibit pepsin activity and may improve LES tone.
Q7 Aluminum-based antacid effect on motility
A Slows gastric motility by locally inhibiting smooth muscle contraction.
Q8 Calcium- and aluminum-based antacids in renal failure
A May bind phosphate and lower serum phosphate, but aluminum/magnesium products require major
caution or avoidance because accumulation can occur.
Q9 Antacid adverse effects by ingredient
A Aluminum and calcium commonly cause constipation; magnesium commonly causes diarrhea.
Q10 Antacid risk in renal failure
A Alkalosis can occur; magnesium products may cause hypermagnesemia and aluminum may worsen
osteomalacia.
Q11 High-sodium antacid precaution
A Avoid when sodium/fluid overload could worsen heart failure, hypertension, or renal failure.
Page 1 of 17
,Nurs 415 Exam 1 Deck – UPDATED Questions with 100% Verified Answers
Question & Answer
Q12 Calcium antacid contraindications
A Avoid with hypercalcemia or a history of renal stones.
Q13 Antacid drug interaction teaching
A Separate antacids from other medications because they can alter drug absorption; verify the
required interval for each drug.
Section 2: Long-Term, Mechanism, Action (Q14–Q26)
Question & Answer
Q14 Antacid follow-up teaching
A Contact the provider if symptoms persist or worsen within 2 weeks or if new symptoms develop.
Q15 PPI examples
A Omeprazole is the emphasized example; PPIs are used for GERD, PUD, and hypersecretory states
such as Zollinger-Ellison syndrome.
Q16 PPI mechanism of action
A Blocks the H+/K+-ATPase proton pump in gastric parietal cells, preventing hydrogen ion secretion
needed to form hydrochloric acid.
Q17 Result of profound PPI acid suppression
A Can produce hypochlorhydria or achlorhydria, decrease pepsin activity, increase pepsinogen, and
cause compensatory gastrin elevation.
Q18 Short-term PPI adverse effects
A Nausea, abdominal pain, flatulence, constipation or diarrhea, dizziness, and drowsiness; acute
interstitial nephritis can also occur.
Q19 Long-term PPI nutrient deficiencies
A Iron, magnesium, vitamin B12, and calcium deficiencies.
Q20 Long-term PPI infection risks
A Increased risk of Clostridioides difficile infection and pneumonia.
Q21 Long-term PPI renal risks
A Acute interstitial nephritis, acute kidney injury, and chronic kidney disease.
Q22 Long-term PPI bone risk
A Reduced calcium absorption may contribute to osteoporosis and hip fracture risk.
Q23 PPI monitoring
A Monitor magnesium, calcium, iron, vitamin B12, renal function, CBC as clinically indicated, and bone
health in long-term therapy.
Page 2 of 17
, Nurs 415 Exam 1 Deck – UPDATED Questions with 100% Verified Answers
Question & Answer
Q24 PPI precautions
A Use cautiously with hepatic dysfunction and in older adults; evaluate benefit versus risk in
pregnancy and lactation.
Q25 PPI administration principle
A Take consistently as prescribed; therapy should be combined with ongoing lifestyle modifications.
Inadequate response should prompt assessment of adherence.
Q26 H2RA mechanism of action
A Blocks histamine-2 receptors on gastric parietal cells, reducing hydrochloric acid production and
raising gastric pH.
Section 3: Adverse, Effects, Gerd (Q27–Q39)
Question & Answer
Q27 H2RA examples and potency pearl
A Famotidine is emphasized as the most potent at lowering gastric acid secretion, although the
clinical advantage is unclear.
Q28 Ranitidine status
A No longer available in the United States because NDMA, a likely human carcinogen, was detected in
formulations.
Q29 Cimetidine endocrine adverse effects
A Antiandrogenic effects including gynecomastia and erectile dysfunction.
Q30 H2RA CNS adverse effects
A Cognitive changes, agitation, psychosis, depression, headache, and seizures; risk is greater in older
adults and with renal or hepatic dysfunction.
Q31 H2RA hematologic monitoring
A Rare cell-line deficiencies or pancytopenia may occur; monitor CBC when indicated.
Q32 Nizatidine precaution
A Can cause hepatic cell injury; avoid or use cautiously in liver disease and monitor liver function
tests.
Q33 Long-term H2RA deficiency
A Vitamin B12 deficiency, which can cause anemia and neurologic deficits; monitor B12 and CBC
when indicated.
Q34 H2RAs and anticholinergic effects
A H2RAs do not block H1 receptors and are not anticholinergic.
Q35 Metoclopramide role in GERD
A Improves LES tone and gastric motility/emptying; used as add-on/lower-tier therapy, not
monotherapy, and does not directly heal esophageal lesions.
Page 3 of 17
Nurs 415 Exam 1 Deck – UPDATED Questions with
100% Verified Answers
Section 1: Antacid, Gerd, Antacids (Q1–Q13)
Question & Answer
Q1 GERD nonpharmacologic therapy
A Avoid trigger foods/drinks and overeating; avoid bending, strenuous exercise, or lying supine for 3
hours after intake; elevate the head of the bed; lose weight when indicated; stop smoking.
Q2 Antacids in GERD
A Adjunctive/as-needed therapy for infrequent symptoms; not monotherapy for significant disease or
frequent symptoms.
Q3 First-line medication for frequent GERD symptoms
A A proton pump inhibitor (PPI), especially when esophagitis or other serious complications are
present.
Q4 Role of H2 receptor antagonists in GERD
A They reduce gastric acid and can treat GERD, but PPIs are preferred in most cases.
Q5 Role of prokinetic agents in GERD
A Reserved for persistent symptoms after maximal acid suppression and lifestyle modification
because serious adverse effects are possible.
Q6 Antacid mechanism of action
A Weak bases react with hydrochloric acid to form salt and water, neutralizing acid and raising
gastric/duodenal pH; they also inhibit pepsin activity and may improve LES tone.
Q7 Aluminum-based antacid effect on motility
A Slows gastric motility by locally inhibiting smooth muscle contraction.
Q8 Calcium- and aluminum-based antacids in renal failure
A May bind phosphate and lower serum phosphate, but aluminum/magnesium products require major
caution or avoidance because accumulation can occur.
Q9 Antacid adverse effects by ingredient
A Aluminum and calcium commonly cause constipation; magnesium commonly causes diarrhea.
Q10 Antacid risk in renal failure
A Alkalosis can occur; magnesium products may cause hypermagnesemia and aluminum may worsen
osteomalacia.
Q11 High-sodium antacid precaution
A Avoid when sodium/fluid overload could worsen heart failure, hypertension, or renal failure.
Page 1 of 17
,Nurs 415 Exam 1 Deck – UPDATED Questions with 100% Verified Answers
Question & Answer
Q12 Calcium antacid contraindications
A Avoid with hypercalcemia or a history of renal stones.
Q13 Antacid drug interaction teaching
A Separate antacids from other medications because they can alter drug absorption; verify the
required interval for each drug.
Section 2: Long-Term, Mechanism, Action (Q14–Q26)
Question & Answer
Q14 Antacid follow-up teaching
A Contact the provider if symptoms persist or worsen within 2 weeks or if new symptoms develop.
Q15 PPI examples
A Omeprazole is the emphasized example; PPIs are used for GERD, PUD, and hypersecretory states
such as Zollinger-Ellison syndrome.
Q16 PPI mechanism of action
A Blocks the H+/K+-ATPase proton pump in gastric parietal cells, preventing hydrogen ion secretion
needed to form hydrochloric acid.
Q17 Result of profound PPI acid suppression
A Can produce hypochlorhydria or achlorhydria, decrease pepsin activity, increase pepsinogen, and
cause compensatory gastrin elevation.
Q18 Short-term PPI adverse effects
A Nausea, abdominal pain, flatulence, constipation or diarrhea, dizziness, and drowsiness; acute
interstitial nephritis can also occur.
Q19 Long-term PPI nutrient deficiencies
A Iron, magnesium, vitamin B12, and calcium deficiencies.
Q20 Long-term PPI infection risks
A Increased risk of Clostridioides difficile infection and pneumonia.
Q21 Long-term PPI renal risks
A Acute interstitial nephritis, acute kidney injury, and chronic kidney disease.
Q22 Long-term PPI bone risk
A Reduced calcium absorption may contribute to osteoporosis and hip fracture risk.
Q23 PPI monitoring
A Monitor magnesium, calcium, iron, vitamin B12, renal function, CBC as clinically indicated, and bone
health in long-term therapy.
Page 2 of 17
, Nurs 415 Exam 1 Deck – UPDATED Questions with 100% Verified Answers
Question & Answer
Q24 PPI precautions
A Use cautiously with hepatic dysfunction and in older adults; evaluate benefit versus risk in
pregnancy and lactation.
Q25 PPI administration principle
A Take consistently as prescribed; therapy should be combined with ongoing lifestyle modifications.
Inadequate response should prompt assessment of adherence.
Q26 H2RA mechanism of action
A Blocks histamine-2 receptors on gastric parietal cells, reducing hydrochloric acid production and
raising gastric pH.
Section 3: Adverse, Effects, Gerd (Q27–Q39)
Question & Answer
Q27 H2RA examples and potency pearl
A Famotidine is emphasized as the most potent at lowering gastric acid secretion, although the
clinical advantage is unclear.
Q28 Ranitidine status
A No longer available in the United States because NDMA, a likely human carcinogen, was detected in
formulations.
Q29 Cimetidine endocrine adverse effects
A Antiandrogenic effects including gynecomastia and erectile dysfunction.
Q30 H2RA CNS adverse effects
A Cognitive changes, agitation, psychosis, depression, headache, and seizures; risk is greater in older
adults and with renal or hepatic dysfunction.
Q31 H2RA hematologic monitoring
A Rare cell-line deficiencies or pancytopenia may occur; monitor CBC when indicated.
Q32 Nizatidine precaution
A Can cause hepatic cell injury; avoid or use cautiously in liver disease and monitor liver function
tests.
Q33 Long-term H2RA deficiency
A Vitamin B12 deficiency, which can cause anemia and neurologic deficits; monitor B12 and CBC
when indicated.
Q34 H2RAs and anticholinergic effects
A H2RAs do not block H1 receptors and are not anticholinergic.
Q35 Metoclopramide role in GERD
A Improves LES tone and gastric motility/emptying; used as add-on/lower-tier therapy, not
monotherapy, and does not directly heal esophageal lesions.
Page 3 of 17
