BSN 315 - Elimination/GI
1. Which condition is treated with a histamine2 blocker? Select all
that apply.
Gastric carcinoma
Gastric ulcer
Duodenal ulcer
Gastroparesis
Gastroesophageal reflux disease: Gastric ulcer
Histamine2 blockers are effective in treating gastric ulcers.
Duodenal ulcer
Histamine2 blockers are effective in treating duodenal ulcers.
Gastroesophageal reflux disease
Histamine2 blockers are effective in treating gastroesophageal reflux disease.
2. Which statement regarding the pharmacodynamics of
cimetidine is accurate?Cimetidine has an onset of action of 15
minutes.
Cimetidine's duration of action is 8 to 12 hours.
The drug reaches its peak effect in 2 to 3 hours.
The elimination half-life of cimetidine is 1.5 to 2 hours.: The elimination half-
life of cimetidine is 1.5 to 2 hours.
Rationale for Incorrect:
Cimetidine's onset of action is expected within 30 minutes of administration, not 15
minutes.
The duration of action for cimetidine is 4 to 5 hours, not 8 to 12 hours. It is dosed
three to four times daily.
Cimetidine reaches its peak concentration in 45 to 90 minutes, not 2 to 3 hours.
3. Which statement regarding the pharmacokinetics of cimetidine is
accurate?
Food enhances the absorption of cimetidine.
Cimetidine readily and easily crosses the blood-brain barrier.
Cimetidine is primarily excreted in the urine.
, BSN 315 - Elimination/GI
The drug is not metabolized by the liver.: Cimetidine is primarily excreted in the
urine.
The histamine2 receptor antagonist, cimetidine, is primarily excreted in the urine.
Accumulation of the drug may occur in patients with renal impairment.
Rationale for Incorrect:
Food slows, not enhances, the absorption of cimetidine; however, the overall
effect of cimetidine is not impacted.
Cimetidine has difficulty crossing the blood-brain barrier.
Cimetidine does, in fact, undergo metabolism by the liver.
4. Which instructions would the nurse provide Mr. Evans about when to take
the prescribed cimetidine?
Case Study Details
Mr. Evans is a 47-year-old male patient who came into the clinic reporting an
upset stomach with heartburn. He reports he has been having these
symptoms for a couple of weeks, and over-the-counter therapy has not
helped. Mr. Evans reports taking antacids on a daily basis. Upon physical
assessment, the nurse determines Mr. Evans is stable and that his vital
signs are within normal limits. After assessing Mr. Evans, the health care
provider prescribes cimetidine. Because Mr. Evans has never taken
cimetidine before, the nurse needs to teach him about his new medication.
Just before meals and first thing upon awakening in the morning.
Just before meals and at bedtime.
After meals and first thing upon awakening in the morning.
After meals and at bedtime.: Just before meals and at bedtime.
Histamine2 receptor antagonists, such as cimetidine are to be taken just before
meals and at bedtime to decrease food-induced acid secretion.
5. Before administering cimetidine to a 27-year-old female patient, which
patient parameter would a nurse ensure has been assessed? Select all that
apply.
, BSN 315 - Elimination/GI
Hepatic function
Renal function
Thyroid function
Pregnancy status
Fluid and electrolyte status: Hepatic function
The patient's liver function must be assessed before administering cimetidine.
Renal function
The patient's kidney function must be assessed before administering cimetidine.
Pregnancy status
Pregnancy status must be assessed in this female patient of childbearing age
before receiving cimetidine.
Fluid and electrolyte status
Fluid and electrolyte status must be assessed before administering cimetidine.
6. Which respiratory complication associated with cimetidine is a
concern, as the drug increases gastric pH?
Pneumonia
Asthma attacks
Interstitial lung disease
Exacerbation of chronic obstructive pulmonary disease (COPD): Pneumonia
Pneumonia is a concern in patients receiving cimetidine. As the drug increases
gastric pH, the risk for pneumonia also increases.
7. Which effect would a nurse anticipate may occur if a patient taking
phenytoin is given cimetidine? Increased effect of cimetidine
Decreased effect of cimetidine
Increased effect of phenytoin
Decreased effect of phenytoin: Increased effect of phenytoin
When taken together, cimetidine increases the concentration of phenytoin, thus
increasing its effect. The patient must be monitored closely to determine whether
a dosage reduction in phenytoin is warranted.
, BSN 315 - Elimination/GI
8. With which medical condition would a nurse expect the health care
provider to reduce the dosage of cimetidine due to potential accumulation of
the drug? Kidney disease
Crohn disease
Diabetes
Cardiovascular disease: Kidney disease
Accumulation of cimetidine may occur with renal impairment, and a dosage
reduction is needed in these patients.
9. Which outcome is anticipated as a result of histamine2 receptor
blockers obstructing histamine2 receptors in the parietal cells in the
stomach?
Increase in hydrogen ions and gastric acid
Decrease in hydrogen ions and gastric acid
Increase in hydrogen ions and decrease in gastric acid
Decrease in hydrogen ions and increase in gastric acid: Decrease in
hydrogen ions and gastric acid
The concentration of both hydrogen ions and gastric acid is decreased when the
histamine2 receptors are obstructed by histamine2 receptor blockers.
10. Which teaching point will the nurse provide a patient who is newly
prescribed cimetidine for gastroesophageal reflux disease (GERD)?
"Breast enlargement and a reduction in libido may occur with cimetidine."
"The effects of a dose of cimetidine last for about 12 hours."
"The health care provider will likely need to increase your dose of
theophylline while you take cimetidine."
"You can expect the drug to start working in 15 minutes to reduce your
symptoms.": "Breast enlargement and a reduction in libido may occur with
cimetidine." Antiandrogenic effects such as decreased libido and breast
enlargement may occur with cimetidine. This is because cimetidine binds to
androgen receptors. Discontinuation of therapy generally results in a reversal of
these effects.
11. Which patient would a nurse determine will likely receive a dosage
reduction in cimetidine for gastroesophageal reflux disease? Select all that
apply.
A 40-year-old patient with dyslipidemia
1. Which condition is treated with a histamine2 blocker? Select all
that apply.
Gastric carcinoma
Gastric ulcer
Duodenal ulcer
Gastroparesis
Gastroesophageal reflux disease: Gastric ulcer
Histamine2 blockers are effective in treating gastric ulcers.
Duodenal ulcer
Histamine2 blockers are effective in treating duodenal ulcers.
Gastroesophageal reflux disease
Histamine2 blockers are effective in treating gastroesophageal reflux disease.
2. Which statement regarding the pharmacodynamics of
cimetidine is accurate?Cimetidine has an onset of action of 15
minutes.
Cimetidine's duration of action is 8 to 12 hours.
The drug reaches its peak effect in 2 to 3 hours.
The elimination half-life of cimetidine is 1.5 to 2 hours.: The elimination half-
life of cimetidine is 1.5 to 2 hours.
Rationale for Incorrect:
Cimetidine's onset of action is expected within 30 minutes of administration, not 15
minutes.
The duration of action for cimetidine is 4 to 5 hours, not 8 to 12 hours. It is dosed
three to four times daily.
Cimetidine reaches its peak concentration in 45 to 90 minutes, not 2 to 3 hours.
3. Which statement regarding the pharmacokinetics of cimetidine is
accurate?
Food enhances the absorption of cimetidine.
Cimetidine readily and easily crosses the blood-brain barrier.
Cimetidine is primarily excreted in the urine.
, BSN 315 - Elimination/GI
The drug is not metabolized by the liver.: Cimetidine is primarily excreted in the
urine.
The histamine2 receptor antagonist, cimetidine, is primarily excreted in the urine.
Accumulation of the drug may occur in patients with renal impairment.
Rationale for Incorrect:
Food slows, not enhances, the absorption of cimetidine; however, the overall
effect of cimetidine is not impacted.
Cimetidine has difficulty crossing the blood-brain barrier.
Cimetidine does, in fact, undergo metabolism by the liver.
4. Which instructions would the nurse provide Mr. Evans about when to take
the prescribed cimetidine?
Case Study Details
Mr. Evans is a 47-year-old male patient who came into the clinic reporting an
upset stomach with heartburn. He reports he has been having these
symptoms for a couple of weeks, and over-the-counter therapy has not
helped. Mr. Evans reports taking antacids on a daily basis. Upon physical
assessment, the nurse determines Mr. Evans is stable and that his vital
signs are within normal limits. After assessing Mr. Evans, the health care
provider prescribes cimetidine. Because Mr. Evans has never taken
cimetidine before, the nurse needs to teach him about his new medication.
Just before meals and first thing upon awakening in the morning.
Just before meals and at bedtime.
After meals and first thing upon awakening in the morning.
After meals and at bedtime.: Just before meals and at bedtime.
Histamine2 receptor antagonists, such as cimetidine are to be taken just before
meals and at bedtime to decrease food-induced acid secretion.
5. Before administering cimetidine to a 27-year-old female patient, which
patient parameter would a nurse ensure has been assessed? Select all that
apply.
, BSN 315 - Elimination/GI
Hepatic function
Renal function
Thyroid function
Pregnancy status
Fluid and electrolyte status: Hepatic function
The patient's liver function must be assessed before administering cimetidine.
Renal function
The patient's kidney function must be assessed before administering cimetidine.
Pregnancy status
Pregnancy status must be assessed in this female patient of childbearing age
before receiving cimetidine.
Fluid and electrolyte status
Fluid and electrolyte status must be assessed before administering cimetidine.
6. Which respiratory complication associated with cimetidine is a
concern, as the drug increases gastric pH?
Pneumonia
Asthma attacks
Interstitial lung disease
Exacerbation of chronic obstructive pulmonary disease (COPD): Pneumonia
Pneumonia is a concern in patients receiving cimetidine. As the drug increases
gastric pH, the risk for pneumonia also increases.
7. Which effect would a nurse anticipate may occur if a patient taking
phenytoin is given cimetidine? Increased effect of cimetidine
Decreased effect of cimetidine
Increased effect of phenytoin
Decreased effect of phenytoin: Increased effect of phenytoin
When taken together, cimetidine increases the concentration of phenytoin, thus
increasing its effect. The patient must be monitored closely to determine whether
a dosage reduction in phenytoin is warranted.
, BSN 315 - Elimination/GI
8. With which medical condition would a nurse expect the health care
provider to reduce the dosage of cimetidine due to potential accumulation of
the drug? Kidney disease
Crohn disease
Diabetes
Cardiovascular disease: Kidney disease
Accumulation of cimetidine may occur with renal impairment, and a dosage
reduction is needed in these patients.
9. Which outcome is anticipated as a result of histamine2 receptor
blockers obstructing histamine2 receptors in the parietal cells in the
stomach?
Increase in hydrogen ions and gastric acid
Decrease in hydrogen ions and gastric acid
Increase in hydrogen ions and decrease in gastric acid
Decrease in hydrogen ions and increase in gastric acid: Decrease in
hydrogen ions and gastric acid
The concentration of both hydrogen ions and gastric acid is decreased when the
histamine2 receptors are obstructed by histamine2 receptor blockers.
10. Which teaching point will the nurse provide a patient who is newly
prescribed cimetidine for gastroesophageal reflux disease (GERD)?
"Breast enlargement and a reduction in libido may occur with cimetidine."
"The effects of a dose of cimetidine last for about 12 hours."
"The health care provider will likely need to increase your dose of
theophylline while you take cimetidine."
"You can expect the drug to start working in 15 minutes to reduce your
symptoms.": "Breast enlargement and a reduction in libido may occur with
cimetidine." Antiandrogenic effects such as decreased libido and breast
enlargement may occur with cimetidine. This is because cimetidine binds to
androgen receptors. Discontinuation of therapy generally results in a reversal of
these effects.
11. Which patient would a nurse determine will likely receive a dosage
reduction in cimetidine for gastroesophageal reflux disease? Select all that
apply.
A 40-year-old patient with dyslipidemia
