NURS 615 Exam 4 Questions and Answers
100% Verified Graded A+
1. PPI long term consequences
Answer: osteoporosis, B 12 and iron deficiency
2. Peptic ulcer disease and H-pylori treatment
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
3. Step down with GERD
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.
4. Second line therapy for GERD if first line fails
Answer: quadruple therapy PPI bid, metronidazole, tetracycline, bismuth subsalicylate x 14 days
5. Step up therapy for GERD
, Answer: Lifestyle changes, antacids, H2RA, PPI
6. Next step if GERD patient is on PPI
Answer: If the patient is already on a once daily PPI, increase to BID. If no improvement, referral to GI for
endoscopy.
7. Recommendation for travelers diarrhea
Answer: bismuth salicylate
8. Next step after treating H. Pylori
Answer: Take PPI for 8-12 weeks
9. Monitoring parameters for chronic long term proton pump therapy
Answer: Anemia, osteoporosis, iron, B12, calcium, magnesium
10. How metoclopramide improves GERD symptoms
Answer: It increases lower esophageal tone due to its antagonist activity at the D2 receptors and the
chemoreceptor trigger zone in the CNS.
11. Next step if GERD patient taking TUMS
Answer: H2RA & PPI
12. Action of loperamide (immodium) when treating diarrhea
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.
13. Important counseling points when administering antacids
Answer: Antacids can cause constipation when aluminum based or diarrhea when magnesium based.
14. Monitoring parameters when adding loop diuretic to heart failure regimen-
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.
15. Potassium, magnesium, and digitalis toxicity
Answer: Conditions that require careful monitoring when using diuretics.
16. Kidney function
Answer: Check BUN/creatinine; if on thiazide, ensure GFR is higher than mid 40s.
17. Tiotropium
Answer: Primary use is for COPD.
18. Phenylephrine
Answer: Should be avoided in patients 4 years old or younger, or those with hypertension or BPH.
19. Upper respiratory infection in a 3 year old
Answer: Treated with supportive therapy fluids and rest.
20. Singulair (montelukast) counseling points
Answer: Potential for depression, anxiety, aggression, and suicidal ideation.
100% Verified Graded A+
1. PPI long term consequences
Answer: osteoporosis, B 12 and iron deficiency
2. Peptic ulcer disease and H-pylori treatment
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
3. Step down with GERD
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.
4. Second line therapy for GERD if first line fails
Answer: quadruple therapy PPI bid, metronidazole, tetracycline, bismuth subsalicylate x 14 days
5. Step up therapy for GERD
, Answer: Lifestyle changes, antacids, H2RA, PPI
6. Next step if GERD patient is on PPI
Answer: If the patient is already on a once daily PPI, increase to BID. If no improvement, referral to GI for
endoscopy.
7. Recommendation for travelers diarrhea
Answer: bismuth salicylate
8. Next step after treating H. Pylori
Answer: Take PPI for 8-12 weeks
9. Monitoring parameters for chronic long term proton pump therapy
Answer: Anemia, osteoporosis, iron, B12, calcium, magnesium
10. How metoclopramide improves GERD symptoms
Answer: It increases lower esophageal tone due to its antagonist activity at the D2 receptors and the
chemoreceptor trigger zone in the CNS.
11. Next step if GERD patient taking TUMS
Answer: H2RA & PPI
12. Action of loperamide (immodium) when treating diarrhea
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.
13. Important counseling points when administering antacids
Answer: Antacids can cause constipation when aluminum based or diarrhea when magnesium based.
14. Monitoring parameters when adding loop diuretic to heart failure regimen-
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.
15. Potassium, magnesium, and digitalis toxicity
Answer: Conditions that require careful monitoring when using diuretics.
16. Kidney function
Answer: Check BUN/creatinine; if on thiazide, ensure GFR is higher than mid 40s.
17. Tiotropium
Answer: Primary use is for COPD.
18. Phenylephrine
Answer: Should be avoided in patients 4 years old or younger, or those with hypertension or BPH.
19. Upper respiratory infection in a 3 year old
Answer: Treated with supportive therapy fluids and rest.
20. Singulair (montelukast) counseling points
Answer: Potential for depression, anxiety, aggression, and suicidal ideation.
