Chapter 17 - Drugs Affecting the Gastrointestinal System questions and answers.docx

  Many patients self-medicate with antacids. Which patients should be counseled to not takecalcium carbonate antacids without discussing it with their provider or a pharmacist first? 1.Patients with kidney stones 2.Pregnant patients 3.Patients with heartburn 4.Postmenopausal women - Correct Answers: 1 Patients taking antacids should be educated regarding these drugs, including letting them know that: 1.They may cause constipation or diarrhea 2.Many are high in sodium 3.They should separate antacids from other medications by 1 hour 4.All of the above - Correct Answers: 4 Kelly has diarrhea and is wondering if she can take loperamide (Imodium) for the diarrhea. Loperamide: 1.Can be given to patients of all ages, including infants and children, for viralgastroenteritis 2.Slows gastric motility and reduces fluid and electrolyte loss from diarrhea 3.Is the treatment of choice for the diarrhea associated with E. coli 0157 4.May be used in pregnancy and by lactating women - Correct Answers: 2 Bismuth subsalicylate (Pepto Bismol) is a common OTC remedy for gastrointestinal complaints. Bismuth subsalicylate: 1.May lead to toxicity if taken with aspirin 2.Is contraindicated in children with flu-like illness 3.Has antimicrobial effects against bacterial and viral enteropathogens 4.All of the above - Correct Answers: 4 Hannah will be traveling to Mexico with her church group over spring break to build houses. She isconcerned she may develop traveler's diarrhea. Advice includes following normal food and waterprecautions as well as taking: 1.Loperamide four times a day throughout the trip 2.Bismuth subsalicylate with each meal and at bedtime 3.A prescription for diphenoxylate with atropine to use if she gets diarrhea 4.None of the above - Correct Answers: 2 Josie is a 5-year-old patient who presents to the clinic with a 48-hour history of nausea, vomiting,and some diarrhea. She is unable to keep fluids down and her weight is 4 pounds less than her lastrecorded weight. Besides IV fluids, her exam warrants the use of an antinausea medication. Whichof the following would be the appropriate drug to order for Josie? 1.Prochlorperazine (Compazine) 2.Meclizine (Antivert) 3.Promethazine (Phenergan) 4.Ondansetron (Zofran) - Correct Answers: 4 Jim presents with complaints of "heartburn" that is minimally relieved with Tums (calcium carbonate) and is diagnosed with gastroesophageal reflux disease (GERD). An appropriate first- step therapy would be: 1. Omeprazole (Prilosec) twice a day 2. Ranitidine (Zantac) twice a day 3. Famotidine (Pepcid) once a day 4. Metoclopramide (Reglan) four times a day - Correct Answers: 2 Patients who are on chronic long-term proton pump inhibitor therapy require monitoring for: 1. Iron deficiency anemia, vitamin B12 and calcium deficiency 2. Folate and magnesium deficiency 3. Elevated uric acid levels leading to gout 4. Hypokalemia and hypocalcemia - Correct Answers: 1 Sadie is a 72-year-old patient who takes omeprazole for her chronic GERD. Chronic long-term omeprazole use places her at increased risk for: 1. Megaloblastic anemia 2. Osteoporosis 3. Hypertension 4. Strokes - Correct Answers: 1 Patrick is a 10-year-old patient who presents with uncomfortable constipation. Along with diet changes, a laxative is ordered to provide more rapid relief of constipation. An appropriate choice of medication for a 10-year-old child would be: 1. PEG 3350 (Miralax) 2. Bisacodyl (Dulcolax) suppository 3. Docusate (Colace) suppository 4. Polyethylene glycol electrolyte solution - Correct Answers: 2 Methylnaltrexone is used to treat constipation in: 1. Patients with functional constipation 2. Patients with irritable bowel syndrome-associated constipation 3. Children with encopresis 4. Opioid-associated constipation - Correct Answers: 4 An elderly person has been prescribed lactulose for treatment of chronic constipation. Monitoring with long-term treatment would include: 1. Electrolytes, including potassium and chloride 2. Bone mineral density for osteoporosis 3. Magnesium level 4. Liver function - Correct Answers: 1