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“ NSG 533 ADVANCED PHARM EXAM “ NEWEST
UPDATED EXAM 2025 – 2026 SOLVED QUESTIONS &
ANSWERS VERIFIED 100% GRADED A+ (LATEST
VERSION)
An older client recently has been taking cimetidine (Tagamet). The nurse
monitors the client for which most frequent central nervous system side effect
of this medication?
1. Tremors
2. Dizziness
3. Confusion
4. Hallucinations
3.Confusion
Rationale:
Cimetidine is a histamine 2 (H2)-receptor antagonist. Older clients are especially
susceptible to central nervous system side effects of cimetidine. The most frequent
of these is confusion. Less common central nervous system side effects include
headache, dizziness, drowsiness, and hallucinations.
The client with a gastric ulcer has a prescription for sucralfate (Carafate), 1 g
by mouth four times daily. The nurse schedules the medication for which
times?
1. With meals and at bedtime
2. Every 6 hours around the clock
3. One hour after meals and at bedtime
4. One hour before meals and at bedtime
4. One hour before meals and at bedtime
, Page 2 of 63
Rationale:
Sucralfate is a gastric protectant. The medication should be scheduled for
administration 1 hour before meals and at bedtime. The medication is timed to allow
it to form a protective coating over the ulcer before food intake stimulates gastric acid
production and mechanical irritation. The other options are incorrect.
The client who chronically uses nonsteroidal anti-inflammatory drugs has
been taking misoprostol (Cytotec). The nurse determines that the medication
is having the intended therapeutic effect if which of the following is noted?
1. Resolved diarrhea
2. Relief of epigastric pain
3. Decreased platelet count
4. Decreased white blood cell count
2. Relief of epigastric pain
Rationale:
The client who chronically uses nonsteroidal anti-inflammatory drugs (NSAIDs) is
prone to gastric mucosal injury. Misoprostol is a gastric protectant and is given
specifically to prevent this occurrence. Diarrhea can be a side effect of the
medication, but is not an intended effect. Options 3 and 4 are incorrect
The client has been taking omeprazole (Prilosec) for 4 weeks. The ambulatory
care nurse evaluates that the client is receiving optimal intended effect of the
medication if the client reports the absence of which symptom?
1. Diarrhea
2. Heartburn
3. Flatulence
4. Constipation
2.Heartburn
Rationale:
Omeprazole is a proton pump inhibitor classified as an antiulcer agent. The intended
effect of the medication is relief of pain from gastric irritation, often called heartburn
by clients. Omeprazole is not used to treat the conditions identified in options 1, 3,
and 4.
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42.) A client with a peptic ulcer is diagnosed with a Helicobacter pylori
infection. The nurse is reinforcing teaching for the client about the
medications prescribed, including clarithromycin (Biaxin), esomeprazole
(Nexium), and amoxicillin (Amoxil). Which statement by the client indicates the
best understanding of the medication regimen?
1. "My ulcer will heal because these medications will kill the bacteria."
2. "These medications are only taken when I have pain from my ulcer."
3. "The medications will kill the bacteria and stop the acid production."
4. "These medications will coat the ulcer and decrease the acid production in
my stomach."
3. "The medications will kill the bacteria and stop the acid production."
Rationale:
Triple therapy for Helicobacter pylori infection usually includes two antibacterial
drugs and a proton pump inhibitor. Clarithromycin and amoxicillin are antibacterials.
Esomeprazole is a proton pump inhibitor. These medications will kill the bacteria and
decrease acid production.
A histamine (H2)-receptor antagonist will be prescribed for a client. The nurse
understands that which medications are H2-receptor antagonists? Select all
that apply.
1. Nizatidine (Axid)
2. Ranitidine (Zantac)
3. Famotidine (Pepcid)
4. Cimetidine (Tagamet)
5. Esomeprazole (Nexium)
6. Lansoprazole (Prevacid)
1. Nizatidine (Axid)
2. Ranitidine (Zantac)
3. Famotidine (Pepcid)
4. Cimetidine (Tagamet)
Rationale:
H2-receptor antagonists suppress secretion of gastric acid, alleviate symptoms of
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heartburn, and assist in preventing complications of peptic ulcer disease. These
medications also suppress gastric acid secretions and are used in active ulcer
disease, erosive esophagitis, and pathological hypersecretory conditions. The other
medications listed are proton pump inhibitors.H2-receptor antagonists medication
names end with -dine.Proton pump inhibitors medication names end with -zole.
A client is receiving acetylcysteine (Mucomyst), 20% solution diluted in 0.9%
normal saline by nebulizer. The nurse should have which item available for
possible use after giving this medication?
1. Ambu bag
2. Intubation tray
3. Nasogastric tube
4. Suction equipment
4. Suction equipment
Rationale:
Acetylcysteine can be given orally or by nasogastric tube to treat acetaminophen
overdose, or it may be given by inhalation for use as a mucolytic. The nurse
administering this medication as a mucolytic should have suction equipment
available in case the client cannot manage to clear the increased volume of liquefied
secretions.
A client has a prescription to take guaifenesin (Humibid) every 4 hours, as
needed. The nurse determines that the client understands the most effective
use of this medication if the client states that he or she will:
1. Watch for irritability as a side effect.
2. Take the tablet with a full glass of water.
3. Take an extra dose if the cough is accompanied by fever.
4. Crush the sustained-release tablet if immediate relief is needed.
2. Take the tablet with a full glass of water.
Rationale:
Guaifenesin is an expectorant. It should be taken with a full glass of water to
decrease viscosity of secretions. Sustained-release preparations should not be
broken open, crushed, or chewed. The medication may occasionally cause
“ NSG 533 ADVANCED PHARM EXAM “ NEWEST
UPDATED EXAM 2025 – 2026 SOLVED QUESTIONS &
ANSWERS VERIFIED 100% GRADED A+ (LATEST
VERSION)
An older client recently has been taking cimetidine (Tagamet). The nurse
monitors the client for which most frequent central nervous system side effect
of this medication?
1. Tremors
2. Dizziness
3. Confusion
4. Hallucinations
3.Confusion
Rationale:
Cimetidine is a histamine 2 (H2)-receptor antagonist. Older clients are especially
susceptible to central nervous system side effects of cimetidine. The most frequent
of these is confusion. Less common central nervous system side effects include
headache, dizziness, drowsiness, and hallucinations.
The client with a gastric ulcer has a prescription for sucralfate (Carafate), 1 g
by mouth four times daily. The nurse schedules the medication for which
times?
1. With meals and at bedtime
2. Every 6 hours around the clock
3. One hour after meals and at bedtime
4. One hour before meals and at bedtime
4. One hour before meals and at bedtime
, Page 2 of 63
Rationale:
Sucralfate is a gastric protectant. The medication should be scheduled for
administration 1 hour before meals and at bedtime. The medication is timed to allow
it to form a protective coating over the ulcer before food intake stimulates gastric acid
production and mechanical irritation. The other options are incorrect.
The client who chronically uses nonsteroidal anti-inflammatory drugs has
been taking misoprostol (Cytotec). The nurse determines that the medication
is having the intended therapeutic effect if which of the following is noted?
1. Resolved diarrhea
2. Relief of epigastric pain
3. Decreased platelet count
4. Decreased white blood cell count
2. Relief of epigastric pain
Rationale:
The client who chronically uses nonsteroidal anti-inflammatory drugs (NSAIDs) is
prone to gastric mucosal injury. Misoprostol is a gastric protectant and is given
specifically to prevent this occurrence. Diarrhea can be a side effect of the
medication, but is not an intended effect. Options 3 and 4 are incorrect
The client has been taking omeprazole (Prilosec) for 4 weeks. The ambulatory
care nurse evaluates that the client is receiving optimal intended effect of the
medication if the client reports the absence of which symptom?
1. Diarrhea
2. Heartburn
3. Flatulence
4. Constipation
2.Heartburn
Rationale:
Omeprazole is a proton pump inhibitor classified as an antiulcer agent. The intended
effect of the medication is relief of pain from gastric irritation, often called heartburn
by clients. Omeprazole is not used to treat the conditions identified in options 1, 3,
and 4.
, Page 3 of 63
42.) A client with a peptic ulcer is diagnosed with a Helicobacter pylori
infection. The nurse is reinforcing teaching for the client about the
medications prescribed, including clarithromycin (Biaxin), esomeprazole
(Nexium), and amoxicillin (Amoxil). Which statement by the client indicates the
best understanding of the medication regimen?
1. "My ulcer will heal because these medications will kill the bacteria."
2. "These medications are only taken when I have pain from my ulcer."
3. "The medications will kill the bacteria and stop the acid production."
4. "These medications will coat the ulcer and decrease the acid production in
my stomach."
3. "The medications will kill the bacteria and stop the acid production."
Rationale:
Triple therapy for Helicobacter pylori infection usually includes two antibacterial
drugs and a proton pump inhibitor. Clarithromycin and amoxicillin are antibacterials.
Esomeprazole is a proton pump inhibitor. These medications will kill the bacteria and
decrease acid production.
A histamine (H2)-receptor antagonist will be prescribed for a client. The nurse
understands that which medications are H2-receptor antagonists? Select all
that apply.
1. Nizatidine (Axid)
2. Ranitidine (Zantac)
3. Famotidine (Pepcid)
4. Cimetidine (Tagamet)
5. Esomeprazole (Nexium)
6. Lansoprazole (Prevacid)
1. Nizatidine (Axid)
2. Ranitidine (Zantac)
3. Famotidine (Pepcid)
4. Cimetidine (Tagamet)
Rationale:
H2-receptor antagonists suppress secretion of gastric acid, alleviate symptoms of
, Page 4 of 63
heartburn, and assist in preventing complications of peptic ulcer disease. These
medications also suppress gastric acid secretions and are used in active ulcer
disease, erosive esophagitis, and pathological hypersecretory conditions. The other
medications listed are proton pump inhibitors.H2-receptor antagonists medication
names end with -dine.Proton pump inhibitors medication names end with -zole.
A client is receiving acetylcysteine (Mucomyst), 20% solution diluted in 0.9%
normal saline by nebulizer. The nurse should have which item available for
possible use after giving this medication?
1. Ambu bag
2. Intubation tray
3. Nasogastric tube
4. Suction equipment
4. Suction equipment
Rationale:
Acetylcysteine can be given orally or by nasogastric tube to treat acetaminophen
overdose, or it may be given by inhalation for use as a mucolytic. The nurse
administering this medication as a mucolytic should have suction equipment
available in case the client cannot manage to clear the increased volume of liquefied
secretions.
A client has a prescription to take guaifenesin (Humibid) every 4 hours, as
needed. The nurse determines that the client understands the most effective
use of this medication if the client states that he or she will:
1. Watch for irritability as a side effect.
2. Take the tablet with a full glass of water.
3. Take an extra dose if the cough is accompanied by fever.
4. Crush the sustained-release tablet if immediate relief is needed.
2. Take the tablet with a full glass of water.
Rationale:
Guaifenesin is an expectorant. It should be taken with a full glass of water to
decrease viscosity of secretions. Sustained-release preparations should not be
broken open, crushed, or chewed. The medication may occasionally cause
