A client with peptic ulcer disease (PUD) receives a new prescription for cimetidine. Which statement provided by the client requires additional instruction by the nurse?

Take the medication an hour after antacids.

Notify the healthcare provider (HCP) of lethargy.

Monitor for any signs of sexual dysfunction.

Decrease cigarette use to a pack per day.

Answer and Explanation

The Correct Answer is D

A. Take the medication an hour after antacids: Antacids can interfere with the absorption of cimetidine, so spacing them apart is a correct approach. This statement indicates appropriate understanding of medication timing and does not require further instruction.

B. Notify the healthcare provider (HCP) of lethargy: Cimetidine can cause central nervous system effects like confusion or lethargy, particularly in older adults or those with renal impairment. Reporting such symptoms is appropriate and reflects safe medication awareness.

C. Monitor for any signs of sexual dysfunction: Cimetidine has been associated with gynecomastia, decreased libido, and impotence in some cases. The client should be aware of and monitor for these potential effects.

D. Decrease cigarette use to a pack per day: Smoking impairs ulcer healing and increases gastric acid secretion, which can counteract the effects of cimetidine. Reducing to a pack per day is still harmful; the client should be encouraged to stop smoking entirely, not just cut back.

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Correct Answer is B

Explanation

A. Document the client's refusal of the medication at this time: While documentation is necessary if a medication is refused, the priority is to educate the client first. The nurse should explain the proper timing of sucralfate to promote understanding and adherence rather than simply accepting refusal.

B. Explain the need to take the medication at least 1 hour before meals: Sucralfate acts by forming a protective barrier over ulcerated mucosa and must be taken on an empty stomach for maximum effectiveness. Administering it one hour before meals ensures the stomach lining is properly coated before food intake.

C. Allow the client to take the medication up to 1 hour after breakfast: Taking sucralfate after a meal diminishes its ability to bind effectively to the mucosa. Food interferes with its action, so post-meal dosing is inappropriate for achieving therapeutic benefit.

D. Instruct the client to take it when the meal tray is delivered: Taking sucralfate at mealtime is too late for optimal therapeutic effect. At that point, gastric contents may interfere with its binding to ulcerated areas, reducing its protective action.

A. History of glaucoma. B. Taking an antiemetic medication. C. Currently pregnant. D. D Allergy to aspirin.

Correct Answer is C

Explanation

A. History of glaucoma: Glaucoma history is relevant for some medications that increase intraocular pressure, but misoprostol primarily affects the gastrointestinal and reproductive systems. It does not typically worsen glaucoma or require caution for that condition.

B. Taking an antiemetic medication: Although gastrointestinal side effects like nausea can occur with misoprostol, concurrent antiemetic use is not a contraindication. This information is less critical before the first dose compared to other more serious concerns.

C. Currently pregnant: Misoprostol is contraindicated during pregnancy because it can stimulate uterine contractions and cause miscarriage. Determining pregnancy status is crucial before administering the drug to prevent serious harm to both the client and fetus.

D. Allergy to aspirin: While clients with certain allergies require careful medication review, misoprostol is not a nonsteroidal anti-inflammatory drug (NSAID) and does not cross-react with aspirin allergies. Confirming pregnancy status is the more immediate priority.

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A client with peptic ulcer disease (PUD) receives a new prescription for cimetidine. Which statement provided by the client requires additional instruction by the nurse?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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