Certified Gastroenterology RN Gastroenterology Pharmacology 2 — Questions and Answers
Question 1: A patient on long-term omeprazole therapy should be monitored for deficiency of which nutrient?
- Vitamin B12 (Correct answer)
- Vitamin K
- Folic acid
- Vitamin C
Correct answer: Vitamin B12
Chronic acid suppression from PPIs impairs vitamin B12 absorption, which requires gastric acid to release B12 from food proteins.
Question 2: Which medication used for hepatic encephalopathy works by acidifying the colon to trap ammonia?
- Lactulose (Correct answer)
- Rifaximin
- Neomycin
- Metronidazole
Correct answer: Lactulose
Lactulose is fermented by colonic bacteria into acids that convert ammonia to non-absorbable ammonium, which is then excreted in stool.
Question 3: A patient taking sucralfate should be instructed to take the medication at what time?
- On an empty stomach, 1 hour before meals (Correct answer)
- With meals
- Immediately after meals
- Only at bedtime with a snack
Correct answer: On an empty stomach, 1 hour before meals
Sucralfate requires an acidic empty stomach to form its protective barrier over ulcerated mucosa.
Question 4: Which adverse effect is most associated with long-term metoclopramide use?
- Tardive dyskinesia (Correct answer)
- Ototoxicity
- Pulmonary fibrosis
- Nephrolithiasis
Correct answer: Tardive dyskinesia
Metoclopramide's dopamine antagonism can cause irreversible tardive dyskinesia, prompting an FDA boxed warning limiting use beyond 12 weeks.
Question 5: Misoprostol is contraindicated in which patient population?
- Pregnant women (Correct answer)
- Patients with diabetes
- Patients over age 65
- Patients with GERD
Correct answer: Pregnant women
Misoprostol is a prostaglandin analog that stimulates uterine contractions and can cause abortion or preterm labor.
Question 6: A patient with C. difficile infection is most appropriately treated first-line with which oral agent?
- Vancomycin (Correct answer)
- Ciprofloxacin
- Amoxicillin
- Azithromycin
Correct answer: Vancomycin
Oral vancomycin (or fidaxomicin) is first-line for C. difficile because it achieves high colonic concentrations without systemic absorption.
Question 7: Which drug class does infliximab belong to?
- Anti-TNF monoclonal antibody (Correct answer)
- Integrin receptor antagonist
- Interleukin-12/23 inhibitor
- JAK inhibitor
Correct answer: Anti-TNF monoclonal antibody
Infliximab is a chimeric monoclonal antibody that binds and neutralizes tumor necrosis factor-alpha in IBD.
Certified Gastroenterology RN Gastroenterology Pharmacology 2
A patient on long-term omeprazole therapy should be monitored for deficiency of which nutrient?