Certified Gastroenterology RN Gastroenterology Pharmacology 2

Question 1

A patient on long-term omeprazole therapy should be monitored for deficiency of which nutrient?

Accepted Answer

Vitamin B12

Answer

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?

Accepted Answer

Lactulose

Answer

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?

Accepted Answer

On an empty stomach, 1 hour before meals

Answer

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?

Accepted Answer

Tardive dyskinesia

Answer

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?

Accepted Answer

Pregnant women

Answer

Misoprostol is a prostaglandin analog that stimulates uterine contractions and can cause abortion or preterm labor.

Certified Gastroenterology RN Practice Test