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Chapter 27: Histamine-2 Blockers and Proton Pump Inhibitors Test Bank

Chapter 27: Histamine-2 Blockers and Proton Pump Inhibitors Test Bank

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Chapter 27: Histamine-2 Blockers and Proton Pump Inhibitors
Test Bank
MULTIPLE CHOICE
1.   A patient who has severe arthritis and who takes nonsteroidal antiinflammatory drugs (NSAIDs) daily develops a duodenal ulcer. The patient has tried a cyclooxygenase-2 selective NSAID in the past and states that it is not as effective as the current NSAID. The primary care nurse practitioner (NP) should:
a.

prescribe cimetidine (Tagamet).

b.

prescribe omeprazole (Prilosec).

c.

teach the patient about a bland diet.

d.

change the NSAID to a corticosteroid.

2.   A patient is given a diagnosis of peptic ulcer disease. A laboratory test confirms the presence of Helicobacter pylori. The primary care NP orders a proton pump inhibitor (PPI) before meals twice daily, clarithromycin, and amoxicillin. After 14 days of treatment, H. pylori is still present. The NP should order:
a.

continuation of the PPI for 4 to 8 weeks.

b.

a PPI, amoxicillin, and metronidazole for 14 days.

c.

a PPI, clarithromycin, and amoxicillin for 14 more days.

d.

a PPI, bismuth subsalicylate, tetracycline, and metronidazole.

3.   A patient with a diagnosis of peptic ulcer disease asks the primary care NP about nonpharmacologic treatment. Which statement by the NP is correct?
a.

“You should consume a diet that is high in fiber.”

b.

“One or two cups of coffee each day won’t hurt you.”

c.

“Alcoholic beverages are strictly prohibited when you have an ulcer.”

d.

“Lifestyle changes and proper diet may eliminate the need for medication.”

4.   A patient has NSAID-induced ulcer and has started taking ranitidine (Zantac). At a follow-up appointment 3 days later, the patient reports no alleviation of symptoms. The primary care NP should:
a.

order cimetidine (Tagamet).

b.

add metronidazole to the drug regimen.

c.

change from ranitidine to omeprazole (Prilosec).

d.

reassure the patient that drug effects take several weeks.

5.   An 80-year-old patient has a history of renal disease and develops a duodenal ulcer. The primary care NP should order a:
a.

normal dose of a histamine-2 blocker.

b.

decreased dose of a histamine-2 blocker.

c.

normal dose of a PPI.

d.

decreased dose of a PPI.

6.   A patient with peptic ulcer disease is taking a histamine-2 blocker and tells the primary care NP that over-the-counter antacid tablets help with the discomfort. The NP should tell this patient to:
a.

discontinue the antacid.

b.

discontinue the histamine-2 blocker.

c.

take the antacid and the histamine-2 blocker at the same time.

d.

take the histamine-2 blocker 2 hours before taking the antacid.

7.   A patient with erosive esophagitis is taking lansoprazole (Prevacid). The primary care NP performs a medication history and learns that the patient also takes digoxin. The NP should recommend:
a.

decreasing the dose of digoxin.

b.

obtaining a serum digoxin level.

c.

changing the PPI to omeprazole.

d.

increasing the dose of lansoprazole.

8.   A postmenopausal woman develops NSAID-induced ulcer. The primary care NP should prescribe:
a.

ranitidine (Zantac).

b.

omeprazole (Prilosec).

c.

esomeprazole (Nexium).

d.

pantoprazole (Protonix).

(more)
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