A patient with peptic ulcer disease (PUD) is prescribed Carafate (sucralfate). What is the primary action of this medication in managing PUD?

Carafate neutralizes gastric acid to reduce irritation.

Carafate enhances gastric emptying to prevent reflux.

Carafate inhibits proton pumps to decrease acid production.

Carafate forms a protective barrier over the ulcer site.

Answer and Explanation

The Correct Answer is D

Rationale:

A. Carafate (sucralfate) does not neutralize gastric acid. Unlike antacids, it does not chemically alter the pH of the stomach. While antacids temporarily reduce acid and provide symptomatic relief, sucralfate’s action is protective rather than neutralizing, focusing on shielding the ulcer from the harmful effects of acid, pepsin, and bile salts.

B. Carafate does not enhance gastric emptying or affect gastrointestinal motility. Prokinetic agents, such as metoclopramide, are used to increase gastric emptying and prevent reflux, but sucralfate’s mechanism is local mucosal protection, not altering the rate at which food or secretions move through the GI tract.

C. Carafate does not inhibit proton pumps or reduce gastric acid production systemically. Proton pump inhibitors (PPIs), like omeprazole, block the hydrogen-potassium ATPase enzyme in gastric parietal cells to suppress acid secretion. Sucralfate’s mechanism is mechanical and local, forming a protective barrier over the ulcer site rather than decreasing acid production.

D. Sucralfate forms a protective barrier over the ulcer site, binding to exposed proteins in the ulcer base to create a viscous, adhesive coating. This protective layer shields the ulcer from gastric acid, digestive enzymes, and bile salts, allowing the mucosal tissue to heal naturally while reducing pain and irritation. This barrier remains intact for several hours, making timing of administration important.

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Free Nursing Study Resources

Correct Answer is A

Explanation

Rationale:

A. "I need to apply sunscreen" is correct. Discoid lupus erythematosus (DLE) is a chronic autoimmune condition that primarily affects the skin, causing red, scaly lesions. Sun exposure can trigger or worsen skin rashes because ultraviolet (UV) light induces inflammatory responses in affected skin. Using broad-spectrum sunscreen, wearing protective clothing, and avoiding direct sunlight are essential strategies to prevent exacerbations.

B. While regular exercise is beneficial for overall health, it does not directly prevent flare-ups of skin lesions in discoid lupus erythematosus. Exercise may help with cardiovascular fitness and stress reduction but is not a primary intervention for skin protection.

C. Washing hands before touching the skin is a good general hygiene practice, but it does not prevent UV-induced rashes in DLE. The main trigger for skin lesions is sun exposure, not contact contamination.

D. Adequate sleep is important for general immune function and well-being, but it does not specifically prevent the exacerbation of discoid lupus skin rashes. Sleep supports overall health but is a supportive measure rather than a direct preventive strategy.

A. "I will drink less fluid." B. "I will consume less caffeine and fewer spicy foods." C. "will try not to gain weight." D. "I will sleep with the head of my bed elevated." E. "I will lie down for one half hour after meals."

Correct Answer is ["B","C","D"]

Explanation

Rationale:

A. Drinking less fluid is not recommended for clients with a hiatal hernia. Adequate hydration is necessary for overall health, digestion, and prevention of constipation, which can increase intra-abdominal pressure. Restricting fluids does not reduce reflux; instead, the focus should be on smaller, more frequent meals and avoiding overfilling the stomach.

B. Consuming less caffeine and fewer spicy foods is correct. Both caffeine and spicy foods can relax the lower esophageal sphincter (LES) or irritate the esophageal mucosa, increasing the risk of acid reflux. Caffeine-containing beverages (coffee, tea, soda) and spicy foods can trigger heartburn, regurgitation, and discomfort, so limiting them helps manage symptoms effectively.

C. Avoiding weight gain is important because excess abdominal fat increases intra-abdominal pressure, which can push stomach contents upward through the hiatal opening into the esophagus. Maintaining a healthy weight reduces reflux episodes and prevents worsening of the hernia, improving overall symptom control.

D. Sleeping with the head of the bed elevated (about 6–8 inches) helps prevent nocturnal reflux. Elevating the head uses gravity to keep gastric contents in the stomach, reducing nighttime heartburn, regurgitation, and potential esophageal irritation. This non-pharmacologic intervention is especially important for improving sleep quality and minimizing complications.

E. Lying down after meals is contraindicated. Remaining upright for at least 2–3 hours after eating allows gravity to help keep stomach contents in place, reducing reflux and associated discomfort. Lying down too soon increases the risk of esophagitis, heartburn, and worsening symptoms.

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A patient with peptic ulcer disease (PUD) is prescribed Carafate (sucralfate). What is the primary action of this medication in managing PUD?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is providing education to a client who has discoid lupus erythematosus. Which of the following statements made by the client indicates understanding of how to prevent exacerbation of skin rashes?

Correct Answer is A

Explanation

A nurse is teaching a client who has a hiatal hernia about dietary recommendations. Which of the following client statements indicates an understanding of the teaching? (Select all that apply.)

Correct Answer is ["B","C","D"]

Explanation

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