NSG533 Advanced Pharmacology week 4 Exam NSG 533

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NSG533 Advanced Pharmacology week 4 Exam | NSG 533 Advanced Pharmacology Exam Questions and Verified Answers 100% Correct, Latest 2025 /2026 Grade A – Wilkes

• ----- is GERD symptom is considered complicated and requires further diagnostic evaluation?:

Difficulty swallowing

2. Extraesophageal syndrome associated with GERD refers to?:

Gastroesophageal reflux symptoms associated with disease processes in organs other than the esophagus

• In a 60 year old patient which PPI regimens is/are preferred if the patient has erosive

esophagitis?:

Esomeprazole 20 mg once daily X 8 weeks

4. Which PPI's offer dosing flexibility relative to meal timing?:

Dexlansoprazole & Omeprazole/Sodium bicarbonate

5. On demand therapy would be most appropriate in patients with?:

Intermittent reflux symptoms

• What medication(s) would worsen the symptoms of Gerd due to decreasing lower esophageal

sphincter pressure:

Nifedipine

• In a 55 year old patient with difficulty swallowing for 3 months the best treatment regimen is:
• weeks standard dose PPI once daily plus further diagnostic evaluation by physician for

complicated symptoms

8. Gerd Treatment goals are to:

Alleviate symptoms, promote healing of mucosal injury, and prevent complications 1 / 4

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• A patient has intermittent GERD Symptoms. The provider is considering putting the patient on

a PPI, however, the provider decides against it because the patient is taking what other medication?: clopidogrel (because PPIs such as omeprazole may increase cardiac risks through interaction via CYP 2C19 enzyme, placing the patient at risk for clots --- The FDA recommends against omeeprazole and clopidogrel co-administration)

• In a 24 year-0ld woman taking omeprazole 20 mg once daily for GERD what would be the

most appropriate recommendation regarding calcium supplementation to prevent bone

fractures?:

None, Calcium is not needed because she dose not have risk factors for osteoporosis or fractures

• The best treatment option for patients with GERD symptoms that are refractory to the initial

PPI regimen?:

Change to a different PPI and/or increase frequency of the current PPI to twice daily

12. PPI's decrease stomach acid by what mechanism(s)?:

Inhibiting gastric H+/K+ - adenosine triphosphatase in gastric parietal cells

13. Maintenance therapy is indicated for patients with:

Continued symptoms after PPI discontinued, Barrett esophagus, Erosive esophagitis, and extraesophageal syndromes associated with GERD

14. Risk factors associated with the use of PPIs include:

Clostridium difficile infections Community Acquired pneumonia bone fractures hypomagnesemia

• What surgical option for GERD would be perferred in a morbidly obese patient?:

Bariatric surgery with Roux-en-Y gastric bypass

• Common causes of peptic ulcer disease include

Nonsteroidal antiinflammatory drugs (NSAIDS) Stress-Related mucosal changes Helicobacter pylori infection 2 / 4

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17. A complication of PUD:

GI Bleeding Perforation Obstruction

• According to the 1000 American Society of Health-Systems Pharmacists (ASHP) published

guidelines what is an indication for stress ulcer prophylaxis (SUP) in critically ill patients?: Mechanical ventilation for longer than 48 hours

19. Important mechanisms for prostaglandin mucosal protection are?:

Stimulation of both mucus and phospholipid production Promotion of bicarbonate secretion Increased mucosal cell turnover

• A patient who is 65 presents with new onset epigastric pain, recent 10 pount (4.5 kg) weight

loss and anemia; what diagnostic test should the patient have done/ordered?:

Esophagogastroduodenoscopy (EGD)

• Prophylactic medications to prevent NSAID-induced ulcers would not be recommended in?:

A 30 year old patient who takes NSAID for occasional tension headaches

• A preferred first line option for treating a newly diagnosed patient with H. pylori infection

and a penicillin allergy is:

A quadruple-drug regimen with bismuth subsalicylate, metronidazole, tetracycline, and a PPI.

• In a patient who has failed H. pylori eradication therapy what should be considered during

evaluation of the patient?:

Potential reinfection Preexisting antimicrobial resistance patient adherence

24. What test confirm eradication of H. pylori?:

Urea breath test & Serologic testing

25. Misoprostol use is limmited by?: 3 / 4

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A high frequency of GI side effects

• What are the independent risk factors for development of NSAID-induced peptic ulcers?:

Smoking

• What type of resistance happens in approximately 10% of H. pylori isolates?:

Clarithromycin resistance

28. Goals of PUD therapy include?:

Resolve the symptoms promote epithelial healing prevent ulcer-related complications prevent ulcer recurrence

29. Refractory peptic ulcers most likely require what interventions?:

H2RA & PPI combination therapy

• A patient 50 year-old patient had chronic back pain and is managed with ibuprofen 400 mg

PO three time daily. He reinjured his back moving boxes and 2 days ago was started on hydrocodone 5 mg/acetaminophen 325 mg every 4 hours as needed for pain. He also takes lisinopril 20 mg daily, hydrochlorothiazide 25 mg daily, fluticasone 250 mcg/salmeterol 50 mcg twice daily and albuterol MDI two pufs as needed for SOB due asthma. Today he complains of nausea with one episode of vomiting this AM. What is the most likely cause of his nausea and

vomiting?:

Hydrocodone

31. Nausea causes what other symptoms to occur?:

Tachycardia Increased Salivation Diaphoresis

32. The adverse effects of doxylamine include:

Dry mouth constipation Drowsiness

• Benzodiazepines are associated with all of the following adverse effects:- :
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