C HAPTER 32: D RUGS U SED TO T REAT
G ASTROESOPHAGEAL R EFLUX AND P EPTIC
U LCER D ISEASE
Willihnganz: Clayton’s Basic Pharmacology for Nurses, 19th Edition
MULTIPLE CHOICE
1. Which explanation by the nurse is accurate when a patient who is taking
NSAIDs to treat arthritis asks why misoprostol has also been prescribed?
a. NSAIDs often cause G I irritation that can result in peptic ulcers.
b. NSAIDs promote the production of prostaglandins and reduce the
incidence of gastric irritation.
c. Antiulcer medications eradicate the presence of bacteria in the
stomach that cause ulcers.
d. Drug interactions are prevented when antiulcer medications are used
in combination with NSAIDs.
ANS: A
Misoprostol, a GI prostaglandin, is used to prevent and treat gastric ulcers
caused by NSAIDs. Prostaglandin inhibition is effective in reducing pain and
inflammation, especiall y in arthritis, but makes the patient more predisposed
to peptic ulcers. Prostaglandins are normall y present in the GI tract to inhibit
gastric acid and pepsin secretion to protect the stomach and duodenal lining
against ulceration. NSAIDs inhib it prostaglandin production. Bismuth
subsalicylate, metronidazole, and tetracycline combination (Helidac), as well
as lansoprazole, clarithrom ycin, and amoxicillin combination (Prevpac), are
used to treat infections caused by Helicobacter pylori. Drug int eractions are
not prevented by the presence of antiulcer medications.
, DIF: Cognitive Level: Comprehension REF: p. 523 OBJ: 3 |
4
NAT: NCLEX Client Needs Category: Physiological Integrit y
TOP: Nursing Process Step: Assessment
CON: Clinical Judg ment | Patient Education
2. Which organism or disorder is responsible for many cases of PUD?
a. H. pylori
b. Candida albicans
c. Escherichia coli
d. Herpes zoster
ANS: A
Various combinations of antibiotics (e.g., amoxicillin, tetracycline,
metronidazole, cl arithrom ycin), bismuth, and antisecretory agents (e.g., H2
antagonists, proton pump inhibitors) are used to eradicate H. pylori. Candida
albicans is the causative agent of candidiasis. Escherichia coli is a normal
bowel flora. Herpes zoster is also known as shingles.
DIF: Cognitive Level: Knowledge REF: p. 518 OBJ: 1 | 2
NAT: NCLEX Client Needs Category: Physiological Integrit y
TOP: Nursing Process Step: Implementation
CON: Clinical Judgment
3. Which explanation by the nurse is accurate when a patient diagnosed with
PUD asks the nurse about the action of prokinetic medications?
a. Blocks the formation of hydrochloric acid, reducing irritation of the
gastric mucosa.
b. Increases the lower esophageal sphincter muscle pressure and
peristalsis.
G ASTROESOPHAGEAL R EFLUX AND P EPTIC
U LCER D ISEASE
Willihnganz: Clayton’s Basic Pharmacology for Nurses, 19th Edition
MULTIPLE CHOICE
1. Which explanation by the nurse is accurate when a patient who is taking
NSAIDs to treat arthritis asks why misoprostol has also been prescribed?
a. NSAIDs often cause G I irritation that can result in peptic ulcers.
b. NSAIDs promote the production of prostaglandins and reduce the
incidence of gastric irritation.
c. Antiulcer medications eradicate the presence of bacteria in the
stomach that cause ulcers.
d. Drug interactions are prevented when antiulcer medications are used
in combination with NSAIDs.
ANS: A
Misoprostol, a GI prostaglandin, is used to prevent and treat gastric ulcers
caused by NSAIDs. Prostaglandin inhibition is effective in reducing pain and
inflammation, especiall y in arthritis, but makes the patient more predisposed
to peptic ulcers. Prostaglandins are normall y present in the GI tract to inhibit
gastric acid and pepsin secretion to protect the stomach and duodenal lining
against ulceration. NSAIDs inhib it prostaglandin production. Bismuth
subsalicylate, metronidazole, and tetracycline combination (Helidac), as well
as lansoprazole, clarithrom ycin, and amoxicillin combination (Prevpac), are
used to treat infections caused by Helicobacter pylori. Drug int eractions are
not prevented by the presence of antiulcer medications.
, DIF: Cognitive Level: Comprehension REF: p. 523 OBJ: 3 |
4
NAT: NCLEX Client Needs Category: Physiological Integrit y
TOP: Nursing Process Step: Assessment
CON: Clinical Judg ment | Patient Education
2. Which organism or disorder is responsible for many cases of PUD?
a. H. pylori
b. Candida albicans
c. Escherichia coli
d. Herpes zoster
ANS: A
Various combinations of antibiotics (e.g., amoxicillin, tetracycline,
metronidazole, cl arithrom ycin), bismuth, and antisecretory agents (e.g., H2
antagonists, proton pump inhibitors) are used to eradicate H. pylori. Candida
albicans is the causative agent of candidiasis. Escherichia coli is a normal
bowel flora. Herpes zoster is also known as shingles.
DIF: Cognitive Level: Knowledge REF: p. 518 OBJ: 1 | 2
NAT: NCLEX Client Needs Category: Physiological Integrit y
TOP: Nursing Process Step: Implementation
CON: Clinical Judgment
3. Which explanation by the nurse is accurate when a patient diagnosed with
PUD asks the nurse about the action of prokinetic medications?
a. Blocks the formation of hydrochloric acid, reducing irritation of the
gastric mucosa.
b. Increases the lower esophageal sphincter muscle pressure and
peristalsis.
