Page | 1
NRSG 220 MIDTERM 2026 LATEST
QUESTIONS AND ANSWERS| ACE
YOUR GRADES.
Major drug classes (PUD)
-proton pump inhibitors (ppis) - turn down volume
-H2 receptor antagonists - change ph of stomach which can
cause more drug-drug interactions
-antacids - minerals are used to neutralize acid within the
stomach, make it significantly harder for drugs to be broken down
and absorbed
-miscellaneous drugs
Prototype drug (proton pump inhibitor)
Omeprazole
Proton pump inhibitors (ppis)
-block gastric acid secretion by H, K, and atpase
-drug of choice for PUD and GERD
-should be taken 20-30 mins before first major meal of day
(activated by food intake)
H2 blockers
-suppress gastric acid secretion
-rapid absorption from the small intestine
-30 minute onset of action
-no known effects on fetus
-excreted by the kidneys
-cannot be given with antacid
, Page | 2
Prototype drug (H2 blockers)
Ranitidine
Antacids
Alkaline substances that neutralize stomach acid to treat
symptoms of heartburn
Adverse effects (antacids)
-constipation
-hypophosphatemia
Contraindications (antacids)
-prolonged use with low serum phosphate
-avoid with suspected bowel obstruction
-avoid taking with any other meds
Considerations (antacids)
-pmhx
-watch kidney lab values
-monitor for bowl changes and worsening symptoms
-hold drug and notify prescriber if patient has symptoms of
appendicitis, undiagnosed GI bleed, or suspected bowl
obstruction
Misoprostol
Prevents gastric ulcers in patients taking high doses of nsaids or
corticosteroids
Metoclopramide
-short-term therapy in patients who fail to respond to first-line
agents
-speeds up peristalsis which is bad if this is a bowel obstruction,
, Page | 3
perforation, GI bleed (increased blood flow to area), or recent GI
surgery (tear at surgical site)
Antiemetic agents
-ondansetron (zofran)
-dimenhydrinate (gravel)
-metoclopramide (regan)
-benzodiazepines
phenothiazine
-anticholinergic agents
Ondansetron
-works on chemoreceptor trigger zone (CTZ) within the brain
-used for chemo induced N/V (give 30 minutes prior to chemo)
-off label use = cholestatic or pruritus
5Bs of benzos
-blood dyscrasias (CBC)
-bile (liver/no ETOH)
-brain (CNS depressant and interactions
-bonkers (makes elderly go delirious)
Prototype drug (anti-emetic)
Ondansetron
Sennosides (laxative)
-pulls water into stool
-implies accelerated, stronger, and more complete bowel
emptying through osmosis
-important to take with a big glass of water as it pulls water in to
reduce constipation/hard stool
-common on bowel protocol
Prototype drug (metamucil)
, Page | 4
Psyllium mucilloid
Prototype drug (anti-diarrheal)
Diphenoxylate with atropine
Adverse effects (diphenoxylate with atropine)
-dizziness
-lethargy
-anticholinergic effects
Considerations (diphenoxylate with atropine)
-pmhx
-perform complete assessment of bowel movement and GI
functioning
-monitor frequency and consistency of stools
-report abdominal distension and signs of decreases peristalsis to
provider
-monitor for S/S of dehydration especially with younger children
-maintain a safe environment as drowsiness/dizziness is common
Inflammatory bowel disease (IBD) treatment
-5-ASA
-immunosuppressants
-biologics
-anti-inflammatory agents
Prototype drug (IBD)
Sulfasalazine
Contraindications (sulfasalazine)
-patients with sulfonamide or salicylate allergy
-patients with urinary obstruction
-may worsen blood dyscrasias
NRSG 220 MIDTERM 2026 LATEST
QUESTIONS AND ANSWERS| ACE
YOUR GRADES.
Major drug classes (PUD)
-proton pump inhibitors (ppis) - turn down volume
-H2 receptor antagonists - change ph of stomach which can
cause more drug-drug interactions
-antacids - minerals are used to neutralize acid within the
stomach, make it significantly harder for drugs to be broken down
and absorbed
-miscellaneous drugs
Prototype drug (proton pump inhibitor)
Omeprazole
Proton pump inhibitors (ppis)
-block gastric acid secretion by H, K, and atpase
-drug of choice for PUD and GERD
-should be taken 20-30 mins before first major meal of day
(activated by food intake)
H2 blockers
-suppress gastric acid secretion
-rapid absorption from the small intestine
-30 minute onset of action
-no known effects on fetus
-excreted by the kidneys
-cannot be given with antacid
, Page | 2
Prototype drug (H2 blockers)
Ranitidine
Antacids
Alkaline substances that neutralize stomach acid to treat
symptoms of heartburn
Adverse effects (antacids)
-constipation
-hypophosphatemia
Contraindications (antacids)
-prolonged use with low serum phosphate
-avoid with suspected bowel obstruction
-avoid taking with any other meds
Considerations (antacids)
-pmhx
-watch kidney lab values
-monitor for bowl changes and worsening symptoms
-hold drug and notify prescriber if patient has symptoms of
appendicitis, undiagnosed GI bleed, or suspected bowl
obstruction
Misoprostol
Prevents gastric ulcers in patients taking high doses of nsaids or
corticosteroids
Metoclopramide
-short-term therapy in patients who fail to respond to first-line
agents
-speeds up peristalsis which is bad if this is a bowel obstruction,
, Page | 3
perforation, GI bleed (increased blood flow to area), or recent GI
surgery (tear at surgical site)
Antiemetic agents
-ondansetron (zofran)
-dimenhydrinate (gravel)
-metoclopramide (regan)
-benzodiazepines
phenothiazine
-anticholinergic agents
Ondansetron
-works on chemoreceptor trigger zone (CTZ) within the brain
-used for chemo induced N/V (give 30 minutes prior to chemo)
-off label use = cholestatic or pruritus
5Bs of benzos
-blood dyscrasias (CBC)
-bile (liver/no ETOH)
-brain (CNS depressant and interactions
-bonkers (makes elderly go delirious)
Prototype drug (anti-emetic)
Ondansetron
Sennosides (laxative)
-pulls water into stool
-implies accelerated, stronger, and more complete bowel
emptying through osmosis
-important to take with a big glass of water as it pulls water in to
reduce constipation/hard stool
-common on bowel protocol
Prototype drug (metamucil)
, Page | 4
Psyllium mucilloid
Prototype drug (anti-diarrheal)
Diphenoxylate with atropine
Adverse effects (diphenoxylate with atropine)
-dizziness
-lethargy
-anticholinergic effects
Considerations (diphenoxylate with atropine)
-pmhx
-perform complete assessment of bowel movement and GI
functioning
-monitor frequency and consistency of stools
-report abdominal distension and signs of decreases peristalsis to
provider
-monitor for S/S of dehydration especially with younger children
-maintain a safe environment as drowsiness/dizziness is common
Inflammatory bowel disease (IBD) treatment
-5-ASA
-immunosuppressants
-biologics
-anti-inflammatory agents
Prototype drug (IBD)
Sulfasalazine
Contraindications (sulfasalazine)
-patients with sulfonamide or salicylate allergy
-patients with urinary obstruction
-may worsen blood dyscrasias
