A patient with peptic ulcer disease is scheduled to receive doses of pantoprazole IV and sucralfate PO before breakfast at 0800. The patient reports experiencing heartburn. The nurse brings the scheduled medications. Which action should the nurse take?

Provide a PRN dose of antacid along with the scheduled medications.

Instruct the client to take the dose of sucralfate PO while eating breakfast.

Hold the dose of IV pantoprazole until the client has finished eating breakfast.

Administer both of the medications before breakfast as scheduled.

Answer and Explanation

The Correct Answer is D

Choice A Reason:

Providing a PRN dose of antacid along with the scheduled medications is not the best option. Antacids can interfere with the absorption of other medications, including sucralfate and pantoprazole. Sucralfate works by forming a protective barrier on the ulcer site, and pantoprazole is a proton pump inhibitor that reduces stomach acid production. Adding an antacid could alter the effectiveness of these medications.

Choice B Reason:

Instructing the client to take the dose of sucralfate PO while eating breakfast is incorrect. Sucralfate should be taken on an empty stomach, typically one hour before meals, to ensure it can effectively coat the ulcer site and provide protection. Taking it with food can reduce its efficacy.

Choice C Reason:

Holding the dose of IV pantoprazole until the client has finished eating breakfast is not advisable. Pantoprazole is most effective when taken before meals, as it helps to reduce stomach acid production in anticipation of food intake. Delaying the dose could result in less effective acid suppression and increased discomfort for the patient.

Choice D Reason:

Administering both of the medications before breakfast as scheduled is the correct action. Sucralfate should be taken on an empty stomach to form a protective barrier on the ulcer site, and pantoprazole should be administered before meals to reduce stomach acid production. This timing ensures both medications work optimally to manage the patient’s peptic ulcer disease and alleviate symptoms like heartburn.

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Correct Answer is C

Explanation

Choice A reason: Potassium levels are not directly affected by calcium acetate. Calcium acetate is primarily used to manage hyperphosphatemia in patients with CKD by binding to dietary phosphate and preventing its absorption1. Therefore, a decrease in potassium levels would not indicate the effectiveness of calcium acetate.

Choice B reason: Calcium acetate can actually increase calcium levels in the blood, especially if taken in high doses or if the patient has other sources of calcium intake. Monitoring calcium levels is important to avoid hypercalcemia, but a decrease in calcium levels is not the desired effect of this medication.

Choice C reason: Calcium acetate is used to reduce serum phosphate levels in patients with CKD. It works by binding to dietary phosphate in the gastrointestinal tract, forming insoluble calcium phosphate, which is then excreted in the stool. A decrease in serum phosphate levels indicates that the medication is effectively reducing phosphate absorption and managing hyperphosphatemia.

Choice D reason: The pH level of the blood is not directly influenced by calcium acetate. While maintaining acid-base balance is important in CKD management, the primary goal of calcium acetate therapy is to control phosphate level. Therefore, changes in blood pH are not a measure of the medication’s effectiveness.

A. Take the medication early in the day. B. Stand and sit up slowly. C. Reduce daily fluid intake. D. Use a twice-a-week dosing schedule.

Correct Answer is B

Explanation

Choice A reason: Taking tamsulosin early in the day is not necessary. Tamsulosin should be taken approximately 30 minutes after the same meal each day to ensure consistent absorption and effectiveness1. The timing of the dose is less critical than ensuring it is taken after the same meal daily.

Choice B reason: Tamsulosin can cause orthostatic hypotension, which is a sudden drop in blood pressure when standing up from a sitting or lying position. This can lead to dizziness or fainting. Therefore, it is crucial to instruct patients to stand and sit up slowly to prevent falls and injuries.

Choice C reason: Reducing daily fluid intake is not recommended for patients taking tamsulosin. Adequate hydration is important for overall health and can help manage urinary symptoms associated with BPH. There is no evidence suggesting that fluid restriction improves the effectiveness of tamsulosin.

Choice D reason: Tamsulosin should be taken daily, not on a twice-a-week dosing schedule. Consistent daily dosing is necessary to maintain stable blood levels of the medication and ensure its effectiveness in managing urinary retention due to BPH.

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A patient with peptic ulcer disease is scheduled to receive doses of pantoprazole IV and sucralfate PO before breakfast at 0800. The patient reports experiencing heartburn. The nurse brings the scheduled medications. Which action should the nurse take?

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Naxlex Comprehensive Predictor Exams

A client with chronic kidney disease (CKD) is receiving calcium acetate 667 mg PO. A decrease in which blood value indicates to the nurse that the medication is having the desired effect?

Correct Answer is C

Explanation

A client is receiving tamsulosin, an alpha-adrenergic blocking agent, for the management of urinary retention due to benign prostatic hyperplasia (BPH). Which instruction is most important for the nurse to provide?

Correct Answer is B

Explanation

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