1
HESI Exit Exam GI Pharmacology Bank:
Anti-Ulcer & Laxative Therapies NCLEX
Review
Table of Contents
Subtopic 1: Proton Pump Inhibitors (PPIs) and H2 Receptor Antagonists.........2
Subtopic 2: Antacids and Mucosal Protectants................................................9
Subtopic 3: Prokinetics and GERD Adjunct Therapies....................................17
Subtopic 4: H. pylori Eradication Therapies...................................................25
Subtopic 5: Laxatives – Bulk Forming and Stool Softeners............................32
Subtopic 6: Stimulant and Osmotic Laxatives................................................40
Subtopic 7: Lubricant and Saline Laxatives...................................................47
Subtopic 8: Laxatives in Special Populations (Pediatrics, Pregnancy, Elderly)
.......................................................................................................................55
Subtopic 9: Contraindications, Side Effects, and Interactions in GI Laxative
Therapy..........................................................................................................63
Subtopic 10: Clinical Scenarios and Case-Based Applications in GI
Pharmacology................................................................................................70
, 2
Subtopic 1: Proton Pump Inhibitors (PPIs) and
H2 Receptor Antagonists
Questions 1–20
Question 1:
A nurse is educating a patient prescribed omeprazole for GERD. Which
instruction is most appropriate?
A. Take the medication at bedtime with food
B. Take the medication as needed for symptoms
C. Take the medication 30 minutes before meals
D. Crush the capsule and mix it with applesauce
Correct Answer: C
Rationale: PPIs like omeprazole are best taken 30 minutes before meals to
ensure maximum suppression of gastric acid secretion during meals.
Question 2:
Which of the following adverse effects should the nurse monitor for in a
patient taking long-term pantoprazole therapy?
A. Hyperkalemia
B. Liver failure
C. Osteoporosis-related fractures
D. Renal calculi
Correct Answer: C
Rationale: Long-term PPI use can reduce calcium absorption, increasing the
risk for osteoporosis-related fractures.
Question 3:
, 3
Ranitidine was removed from the U.S. market due to concerns about which
contaminant?
A. Benzene
B. NDMA (N-nitrosodimethylamine)
C. Dioxin
D. BPA
Correct Answer: B
Rationale: Ranitidine was found to contain NDMA, a probable human
carcinogen, leading to its withdrawal.
Question 4:
What is the primary therapeutic action of famotidine?
A. Coats the stomach lining
B. Inhibits histamine at H2 receptors in the stomach
C. Stimulates gastric motility
D. Neutralizes gastric acid directly
Correct Answer: B
Rationale: Famotidine is an H2 receptor antagonist that reduces acid
secretion by blocking histamine receptors in the stomach.
Question 5:
A nurse is administering IV pantoprazole. What is a priority nursing action?
A. Administer with potassium chloride
B. Mix with dextrose only
C. Use a separate IV line or flush well before/after
D. Give as a bolus over 10 seconds
Correct Answer: C
, 4
Rationale: PPIs can be incompatible with other IV drugs; flushing ensures line
patency and avoids reactions.
Question 6:
Which symptom would indicate a potential adverse effect of H2 blockers in
older adults?
A. Dry mouth
B. Diarrhea
C. Confusion and agitation
D. Bradycardia
Correct Answer: C
Rationale: Older adults are more prone to CNS effects such as confusion
when taking H2 blockers like famotidine or cimetidine.
Question 7:
A client with peptic ulcer disease is prescribed esomeprazole. What is the
expected pharmacologic effect?
A. Increased gastric pH
B. Inhibition of the H+/K+ ATPase enzyme in parietal cells
C. Decreased gastric motility
D. Increased secretion of pepsin
Correct Answer: B
Rationale: Esomeprazole, a PPI, inhibits the final step in acid production by
blocking the H+/K+ ATPase enzyme.
Question 8:
Which client should be closely monitored when prescribed cimetidine?
A. A client taking oral contraceptives
HESI Exit Exam GI Pharmacology Bank:
Anti-Ulcer & Laxative Therapies NCLEX
Review
Table of Contents
Subtopic 1: Proton Pump Inhibitors (PPIs) and H2 Receptor Antagonists.........2
Subtopic 2: Antacids and Mucosal Protectants................................................9
Subtopic 3: Prokinetics and GERD Adjunct Therapies....................................17
Subtopic 4: H. pylori Eradication Therapies...................................................25
Subtopic 5: Laxatives – Bulk Forming and Stool Softeners............................32
Subtopic 6: Stimulant and Osmotic Laxatives................................................40
Subtopic 7: Lubricant and Saline Laxatives...................................................47
Subtopic 8: Laxatives in Special Populations (Pediatrics, Pregnancy, Elderly)
.......................................................................................................................55
Subtopic 9: Contraindications, Side Effects, and Interactions in GI Laxative
Therapy..........................................................................................................63
Subtopic 10: Clinical Scenarios and Case-Based Applications in GI
Pharmacology................................................................................................70
, 2
Subtopic 1: Proton Pump Inhibitors (PPIs) and
H2 Receptor Antagonists
Questions 1–20
Question 1:
A nurse is educating a patient prescribed omeprazole for GERD. Which
instruction is most appropriate?
A. Take the medication at bedtime with food
B. Take the medication as needed for symptoms
C. Take the medication 30 minutes before meals
D. Crush the capsule and mix it with applesauce
Correct Answer: C
Rationale: PPIs like omeprazole are best taken 30 minutes before meals to
ensure maximum suppression of gastric acid secretion during meals.
Question 2:
Which of the following adverse effects should the nurse monitor for in a
patient taking long-term pantoprazole therapy?
A. Hyperkalemia
B. Liver failure
C. Osteoporosis-related fractures
D. Renal calculi
Correct Answer: C
Rationale: Long-term PPI use can reduce calcium absorption, increasing the
risk for osteoporosis-related fractures.
Question 3:
, 3
Ranitidine was removed from the U.S. market due to concerns about which
contaminant?
A. Benzene
B. NDMA (N-nitrosodimethylamine)
C. Dioxin
D. BPA
Correct Answer: B
Rationale: Ranitidine was found to contain NDMA, a probable human
carcinogen, leading to its withdrawal.
Question 4:
What is the primary therapeutic action of famotidine?
A. Coats the stomach lining
B. Inhibits histamine at H2 receptors in the stomach
C. Stimulates gastric motility
D. Neutralizes gastric acid directly
Correct Answer: B
Rationale: Famotidine is an H2 receptor antagonist that reduces acid
secretion by blocking histamine receptors in the stomach.
Question 5:
A nurse is administering IV pantoprazole. What is a priority nursing action?
A. Administer with potassium chloride
B. Mix with dextrose only
C. Use a separate IV line or flush well before/after
D. Give as a bolus over 10 seconds
Correct Answer: C
, 4
Rationale: PPIs can be incompatible with other IV drugs; flushing ensures line
patency and avoids reactions.
Question 6:
Which symptom would indicate a potential adverse effect of H2 blockers in
older adults?
A. Dry mouth
B. Diarrhea
C. Confusion and agitation
D. Bradycardia
Correct Answer: C
Rationale: Older adults are more prone to CNS effects such as confusion
when taking H2 blockers like famotidine or cimetidine.
Question 7:
A client with peptic ulcer disease is prescribed esomeprazole. What is the
expected pharmacologic effect?
A. Increased gastric pH
B. Inhibition of the H+/K+ ATPase enzyme in parietal cells
C. Decreased gastric motility
D. Increased secretion of pepsin
Correct Answer: B
Rationale: Esomeprazole, a PPI, inhibits the final step in acid production by
blocking the H+/K+ ATPase enzyme.
Question 8:
Which client should be closely monitored when prescribed cimetidine?
A. A client taking oral contraceptives
