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6. A client with a gastric ulcer has a prescription for sucralfate (Carafate), 1 g by mouth four times daily. The nurse should schedule the medication for which times?
a) With meals and at bedtime
b) Every 6 hours around the clock
c) One hour after meals and at bedtime
d) One hour before meals and at bedtime
7. A client who chronically uses nonsteroidal antiinflammatory drugs (NSAIDs) has been taking misoprostol (Cytotec). The nurse determines that the medication is having the intended therapeutic effect if which finding is noted?
a) Resolved diarrhea
b) Relief of epigastric pain
c) Decreased platelet count
d) Decreased white blood cell count
8. Pharmacology NCLEX Questions with Rationale about a client who has been taking omeprazole (Prilosec) for 4 weeks. The ambulatory care nurse evaluates that the client is receiving the optimal intended effect of the medication if the client reports the absence of which symptom?
9. A client with a peptic ulcer is diagnosed with a Helicobacter pylori infection. The nurse is teaching 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?
a) “My ulcer will heal because these medications will kill the bacteria.”
b) “These medications are only taken when I have pain from my ulcer.”
c) “The medications will kill the bacteria and stop the acid production.”
d) “These medications will coat the ulcer and decrease the acid production in my stomach.”
10. A client has a new prescription for metoclopramide (Reglan). On review of the chart, the nurse identifies that this medication can be safely administered with which condition?
a) Intestinal obstruction
b) Peptic ulcer with melena
c) Diverticulitis with perforation
d) Vomiting following cancer chemotherapy
11. 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.
a) Nizatidine (Axid)
b) Ranitidine (Zantac)
c) Famotidine (Pepcid)
d) Cimetidine (Tagamet)
e) Esomeprazole (Nexium)
f) Lansoprazole (Prevacid)
12. The nurse has given instructions to a client who has just been prescribed cholestyramine (Questran). Which statement by the client indicates a need for further instructions?
a) “I will continue taking vitamin supplements.”
b) “This medication will help lower my cholesterol.”
c) “This medication should only be taken with water.”
d) “A high-fiber diet is important while taking this medication.”
Pharmacology NCLEX Questions with Rationale
- 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.
- Test-Taking Strategy: Focus on the subject, times to administer sucralfate. Note the client’s diagnosis and think about the pathophysiology associated with a gastric ulcer to assist in directing you to the correct option.
- Pharmacology NCLEX Questions with Rationale: The client who chronically uses nonsteroidal antiinflammatory 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 C and D are incorrect.
- Test-Taking Strategy: Focus on the subject, the intended therapeutic effect of misoprostol for a client who chronically uses NSAIDs. This indicates that the medication is being given to prevent the occurrence of specific symptoms. Recalling that NSAIDs can cause gastric mucosal injury will direct you to the correct option.
- 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 A, C, and D.
- Test-Taking Strategy: Focus on the subject, the optimal intended effect of omeprazole. Recalling that this medication is a proton pump inhibitor will direct you to the correct option.
- Pharmacology NCLEX Questions with Rationale: Triple therapy for Helicobacter pylori infection usually includes two antibacterial medications 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.
- Test-Taking Strategy: Focus on the subject, the medications and their actions. Eliminate option A because the medications do more than kill the bacteria. These medications are taken not only when there is pain but continually until gone, usually for 1 to 2 weeks. This will eliminate option B. These medications do not coat the ulcer, eliminating option D.
- Rationale: Metoclopramide is a gastrointestinal stimulant and antiemetic. Because it is a gastrointestinal stimulant, it is contraindicated with gastrointestinal obstruction, hemorrhage, or perforation. It is used in the treatment of emesis after surgery, chemotherapy, and radiation.
- Test-Taking Strategy: Focus on the subject, safe use of metoclopramide. Recalling the classification and action of this medication and that it is an antiemetic will direct you to the correct option.
11) A, B, C, D
- Rationale: H2-receptor antagonists suppress secretion of gastric acid, alleviate symptoms of 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.
- Test-Taking Strategy: Focus on the subject, medications that are classified as H2-receptor antagonists. Recalling that these medication names end with -dine will assist in answering this question. Also, recall that proton pump inhibitor medication names end with -zole. Review: H2-receptor antagonists
- Rationale: Cholestyramine (Questran) is a bile acid sequestrant used to lower the cholesterol level, and client compliance is a problem because of its taste and palatability. The use of flavored products or fruit juices can improve the taste. Some side effects of bile acid sequestrants include constipation and decreased vitamin absorption.
- Test-Taking Strategy: Note the strategic words need for further instructions. These words indicate a negative event query and ask you to select an option that is an incorrect statement. Note the closed-ended word only in the correct option.
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Pharmacology NCLEX Questions with Rationale 1-5
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Pharmacology NCLEX Questions with Rationale 13-15