UPPER GI
Question 3
Type: MCSA
The physician orders misoprostol (Cytotec) for the female client with peptic ulcer disease
(PUD). What is a priority question for the nurse to ask the client prior to administration
of this medication?
1. "Do you plan on becoming pregnant?"
2. "Are you sexually active?"
3. "Are you pregnant?"
4. "Are your menstrual cycles irregular?"
Correct Answer: 3
Rationale 1: Misoprostol (Cytotec) is safe as long as the client is not currently pregnant.
Rationale 2: Asking if a client is sexually active could be appropriate, but the nurse
would also ask if the client is using birth control.
Rationale 3: Misoprostol (Cytotec) is contraindicated during pregnancy; it is sometimes
used to terminate pregnancies.
Rationale 4: There is no contraindication for misoprostol (Cytotec) in a client with
irregular menstrual cycles.
Global Rationale: Misoprostol (Cytotec) is contraindicated during pregnancy; it is
sometimes used to terminate pregnancies. Misoprostol (Cytotec) is safe as long as the
client is not currently pregnant. Asking if a client is sexually active could be appropriate,
but the nurse would also ask if the client is using birth control. There is no
contraindication for misoprostol (Cytotec) in a client with irregular menstrual cycles.
Question 4
Type: MCSA
The client receives esomeprazole (Nexium). He asks the nurse why that medication is
better than his cimetidine (Tagamet). What is the best response by the nurse?
1. "It is about the same but a lot cheaper than your cimetidine (Tagamet)."
,2. "It decreases acid in your stomach better than cimetidine (Tagamet)."
3. "It is about the same but has fewer side effects than your cimetidine (Tagamet)."
4. "It is not as effective as cimetidine (Tagamet) but kills bacteria better."
Correct Answer: 2
Rationale 1: Esomeprazole (Nexium) is not cheaper than cimetidine (Tagamet).
Rationale 2: Proton-pump inhibitors reduce acid secretion to a greater extent than H2-
receptor antagonists, and have a longer duration of action.
Rationale 3: Esomeprazole (Nexium) does not have fewer side effects than cimetidine
(Tagamet).
Rationale 4: Esomeprazole (Nexium) is more effective than cimetidine (Tagamet) but
will not kill bacteria.
Global Rationale: Proton-pump inhibitors reduce acid secretion to a greater extent than
H2-receptor antagonists and have a longer duration of action. Esomeprazole (Nexium) is
not cheaper than or have fewer side effects than cimetidine (Tagamet). Esomeprazole
(Nexium) is more effective than cimetidine (Tagamet) but will not kill bacteria.
Question 6
Type: MCSA
The nurse has completed education about peptic ulcer disease (PUD) with the client. The
nurse evaluates that learning has occurred when the client makes which statement?
1. "I will limit my intake of caffeine products."
2. "I will take ibuprofen (Motrin) for my headaches."
3. "I will drink more milk and limit spicy foods."
4. "I will join a gym and increase my exercise."
Correct Answer: 1
Rationale 1: Caffeine is a risk factor for peptic ulcer disease (PUD), so limiting caffeine
will be beneficial in the treatment of peptic ulcer disease (PUD).
Rationale 2: Nonsteroidal anti-inflammatory drugs (NSAIDs) are a primary cause of
peptic ulcer disease (PUD).
,Rationale 3: Milk can increase acid production, and spicy foods are not an issue with
peptic ulcer disease (PUD).
Rationale 4: There is no correlation between exercise and the management of peptic
ulcer disease (PUD).
Global Rationale: Caffeine is a risk factor for peptic ulcer disease (PUD), so limiting
caffeine will be beneficial in the treatment of peptic ulcer disease (PUD). Nonsteroidal
anti-inflammatory drugs (NSAIDs) are a primary cause of peptic ulcer disease (PUD).
Milk can increase acid production, and spicy foods are not an issue with peptic ulcer
disease (PUD). There is no correlation between exercise and the management of peptic
ulcer disease (PUD).
Question 7
Type: MCSA
An older adult client comes to the emergency department with his wife. He has a history
of peptic ulcer disease (PUD) and is currently experiencing confusion and severe
headaches. What does the best plan by the nurse include?
1. Ask the client if he has experienced any head injuries recently.
2. Obtain a complete blood count (CBC), chemistry profile, and urine drug screen.
3. Ask the client's wife for a list of medications that the client has taken.
4. Obtain a magnetic resonance imaging (MRI) exam to assess if the client has
experienced a stroke.
Correct Answer: 3
Rationale 1: Since the client has PUD, it would be logical to ask about medication prior
to asking about injury.
Rationale 2: A complete blood count (CBC), chemistry profile, and urine drug screen are
worthwhile tests, but the first priority for a client with a history of peptic ulcer disease
(PUD) should be to find out what medications he has been taking.
Rationale 3: There is a known correlation between H2-receptor antagonists and confusion
and headaches in the older adult population; the nurse should ascertain what medications
the client is taking.
Rationale 4: It is premature to obtain a magnetic resonance imaging (MRI) exam until
other causes have been ruled out.
, Global Rationale: There is a known correlation between H2-receptor antagonists and
confusion and headaches in the older adult population; the nurse should ascertain what
medications the client is taking. Since the client has PUD, it would be logical to ask about
medication prior to asking about injury. A complete blood count (CBC), chemistry
profile, and urine drug screen are worthwhile tests, but the first priority for a client with a
history of peptic ulcer disease (PUD) should be to find out what medications he has been
taking. It is premature to obtain a magnetic resonance imaging (MRI) exam until other
causes have been ruled out.
Question 8
Type: MCSA
A client who has gastroesophageal reflux disease (GERD) has been taking proton pump
inhibitors (PPIs) for many years. The nurse discusses which potential complication of this
long-term therapy?
1. Increased risk of anemia
2. Increased risk of osteopenia
3. Increased risk of hypertension
4. Increased risk of intestinal irritation
Correct Answer: 2
Rationale 1: Anemia is not a consequence of long-term use of PPIs.
Rationale 2: Long-term use of PPIs increases risk of osteopenia and osteoporosis.
Rationale 3: Hypertension is not a consequence of long-term use of PPIs.
Rationale 4: Intestinal irritation is not a consequence of long-term use of PPIs.
Global Rationale: Long-term use of PPIs increases risk of osteopenia and osteoporosis.
It does not increase risk of anemia, hypertension, or intestinal irritation.
Question 9
Type: MCSA
Question 3
Type: MCSA
The physician orders misoprostol (Cytotec) for the female client with peptic ulcer disease
(PUD). What is a priority question for the nurse to ask the client prior to administration
of this medication?
1. "Do you plan on becoming pregnant?"
2. "Are you sexually active?"
3. "Are you pregnant?"
4. "Are your menstrual cycles irregular?"
Correct Answer: 3
Rationale 1: Misoprostol (Cytotec) is safe as long as the client is not currently pregnant.
Rationale 2: Asking if a client is sexually active could be appropriate, but the nurse
would also ask if the client is using birth control.
Rationale 3: Misoprostol (Cytotec) is contraindicated during pregnancy; it is sometimes
used to terminate pregnancies.
Rationale 4: There is no contraindication for misoprostol (Cytotec) in a client with
irregular menstrual cycles.
Global Rationale: Misoprostol (Cytotec) is contraindicated during pregnancy; it is
sometimes used to terminate pregnancies. Misoprostol (Cytotec) is safe as long as the
client is not currently pregnant. Asking if a client is sexually active could be appropriate,
but the nurse would also ask if the client is using birth control. There is no
contraindication for misoprostol (Cytotec) in a client with irregular menstrual cycles.
Question 4
Type: MCSA
The client receives esomeprazole (Nexium). He asks the nurse why that medication is
better than his cimetidine (Tagamet). What is the best response by the nurse?
1. "It is about the same but a lot cheaper than your cimetidine (Tagamet)."
,2. "It decreases acid in your stomach better than cimetidine (Tagamet)."
3. "It is about the same but has fewer side effects than your cimetidine (Tagamet)."
4. "It is not as effective as cimetidine (Tagamet) but kills bacteria better."
Correct Answer: 2
Rationale 1: Esomeprazole (Nexium) is not cheaper than cimetidine (Tagamet).
Rationale 2: Proton-pump inhibitors reduce acid secretion to a greater extent than H2-
receptor antagonists, and have a longer duration of action.
Rationale 3: Esomeprazole (Nexium) does not have fewer side effects than cimetidine
(Tagamet).
Rationale 4: Esomeprazole (Nexium) is more effective than cimetidine (Tagamet) but
will not kill bacteria.
Global Rationale: Proton-pump inhibitors reduce acid secretion to a greater extent than
H2-receptor antagonists and have a longer duration of action. Esomeprazole (Nexium) is
not cheaper than or have fewer side effects than cimetidine (Tagamet). Esomeprazole
(Nexium) is more effective than cimetidine (Tagamet) but will not kill bacteria.
Question 6
Type: MCSA
The nurse has completed education about peptic ulcer disease (PUD) with the client. The
nurse evaluates that learning has occurred when the client makes which statement?
1. "I will limit my intake of caffeine products."
2. "I will take ibuprofen (Motrin) for my headaches."
3. "I will drink more milk and limit spicy foods."
4. "I will join a gym and increase my exercise."
Correct Answer: 1
Rationale 1: Caffeine is a risk factor for peptic ulcer disease (PUD), so limiting caffeine
will be beneficial in the treatment of peptic ulcer disease (PUD).
Rationale 2: Nonsteroidal anti-inflammatory drugs (NSAIDs) are a primary cause of
peptic ulcer disease (PUD).
,Rationale 3: Milk can increase acid production, and spicy foods are not an issue with
peptic ulcer disease (PUD).
Rationale 4: There is no correlation between exercise and the management of peptic
ulcer disease (PUD).
Global Rationale: Caffeine is a risk factor for peptic ulcer disease (PUD), so limiting
caffeine will be beneficial in the treatment of peptic ulcer disease (PUD). Nonsteroidal
anti-inflammatory drugs (NSAIDs) are a primary cause of peptic ulcer disease (PUD).
Milk can increase acid production, and spicy foods are not an issue with peptic ulcer
disease (PUD). There is no correlation between exercise and the management of peptic
ulcer disease (PUD).
Question 7
Type: MCSA
An older adult client comes to the emergency department with his wife. He has a history
of peptic ulcer disease (PUD) and is currently experiencing confusion and severe
headaches. What does the best plan by the nurse include?
1. Ask the client if he has experienced any head injuries recently.
2. Obtain a complete blood count (CBC), chemistry profile, and urine drug screen.
3. Ask the client's wife for a list of medications that the client has taken.
4. Obtain a magnetic resonance imaging (MRI) exam to assess if the client has
experienced a stroke.
Correct Answer: 3
Rationale 1: Since the client has PUD, it would be logical to ask about medication prior
to asking about injury.
Rationale 2: A complete blood count (CBC), chemistry profile, and urine drug screen are
worthwhile tests, but the first priority for a client with a history of peptic ulcer disease
(PUD) should be to find out what medications he has been taking.
Rationale 3: There is a known correlation between H2-receptor antagonists and confusion
and headaches in the older adult population; the nurse should ascertain what medications
the client is taking.
Rationale 4: It is premature to obtain a magnetic resonance imaging (MRI) exam until
other causes have been ruled out.
, Global Rationale: There is a known correlation between H2-receptor antagonists and
confusion and headaches in the older adult population; the nurse should ascertain what
medications the client is taking. Since the client has PUD, it would be logical to ask about
medication prior to asking about injury. A complete blood count (CBC), chemistry
profile, and urine drug screen are worthwhile tests, but the first priority for a client with a
history of peptic ulcer disease (PUD) should be to find out what medications he has been
taking. It is premature to obtain a magnetic resonance imaging (MRI) exam until other
causes have been ruled out.
Question 8
Type: MCSA
A client who has gastroesophageal reflux disease (GERD) has been taking proton pump
inhibitors (PPIs) for many years. The nurse discusses which potential complication of this
long-term therapy?
1. Increased risk of anemia
2. Increased risk of osteopenia
3. Increased risk of hypertension
4. Increased risk of intestinal irritation
Correct Answer: 2
Rationale 1: Anemia is not a consequence of long-term use of PPIs.
Rationale 2: Long-term use of PPIs increases risk of osteopenia and osteoporosis.
Rationale 3: Hypertension is not a consequence of long-term use of PPIs.
Rationale 4: Intestinal irritation is not a consequence of long-term use of PPIs.
Global Rationale: Long-term use of PPIs increases risk of osteopenia and osteoporosis.
It does not increase risk of anemia, hypertension, or intestinal irritation.
Question 9
Type: MCSA
