A client with GERD has been taking omeprazole 40 mg daily for 18 months. The nurse knows that what potential adverse effect is the client as risk for?
Exostosis, or bone overgrowth
Drug induced ototoxicity
Osteoporosis-related fracture risk
Diminished visual acuity
The Correct Answer is C
A. Exostosis, or bone overgrowth.: Omeprazole, a proton pump inhibitor (PPI), does not cause bone overgrowth or exostosis. This condition is typically associated with chronic irritation or mechanical stress rather than medication use.
B. Drug induced ototoxicity.: Ototoxicity is linked to medications such as aminoglycoside antibiotics, loop diuretics, and certain chemotherapeutic agents. Omeprazole does not affect the auditory system or cause hearing loss.
C. Osteoporosis-related fracture risk.: Long-term PPI use, such as omeprazole for more than a year, can decrease calcium absorption by reducing gastric acid secretion. This may lead to decreased bone mineral density, increasing the risk for osteoporosis and fractures, particularly of the hip, wrist, and spine.
D. Diminished visual acuity.: Omeprazole is not associated with visual changes or ocular toxicity. Any vision changes would more likely stem from other systemic conditions such as diabetes or hypertension rather than prolonged PPI therapy.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A. Scopolamine.: Scopolamine is an anticholinergic primarily used to prevent motion sickness or postoperative nausea related to anesthesia. It is not the preferred agent for chemotherapy-induced nausea and vomiting because it does not target serotonin receptors involved in chemotherapy-related emesis.
B. Metoclopramide.: Metoclopramide is a prokinetic and antiemetic that enhances gastric motility and is sometimes used for mild to moderate nausea. However, it is less effective against the severe nausea caused by chemotherapy and may cause extrapyramidal side effects
C. Methylcellulose.: Methylcellulose is a bulk-forming laxative used to treat constipation by increasing stool volume and water content. It has no antiemetic properties and would not be useful in preventing chemotherapy-related nausea or vomiting.
D. Ondansetron.: Ondansetron is a serotonin 5-HT3 receptor antagonist that effectively prevents chemotherapy-induced nausea and vomiting. Administering it 30–60 minutes before treatment blocks serotonin release from the gastrointestinal tract, reducing nausea severity.
Correct Answer is B
Explanation
A. They block histamine H2 receptors on parietal cells.: H2 receptor blockers, such as ranitidine or famotidine, work by inhibiting histamine-stimulated acid secretion. PPIs target the final step of acid production rather than receptor activity.
B. They inhibit the H+/K+ ATPase enzyme in gastric parietal cells.: Proton pump inhibitors block the H+/K+ ATPase (proton pump) in the parietal cells of the stomach. This action irreversibly prevents the secretion of hydrogen ions into the gastric lumen, leading to a profound and long-lasting reduction in gastric acid production.
C. They neutralize gastric acid directly.: Antacids, not PPIs, act by chemically neutralizing existing stomach acid. PPIs do not have an immediate neutralizing effect but reduce acid secretion over time.
D. They increase gastric mucus production: PPIs do not directly increase gastric mucus secretion. Protective mechanisms like mucus production are enhanced by other agents, such as prostaglandin analogs, but are not the primary action of PPIs.
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