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NR 511 Midterm Exam/204 Questions and Answers
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NR 511 Midterm Exam/204 Questions and Answers
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NR 511 Midterm Exam/204 Questionsand Answers
All of the following medications are used for the control of nausea and
vomiting. Which medication works by affecting the chemoreceptor trigger
zone, thereby stimulating upper gastrointestinal motility and increasing
lower esophageal sphincter pressure?
1.Anticholinergics, such as scopolamine (Donnatal).
2.Antidopaminergic agents, such as prochlorperazine (Compazine).
3.Antidopaminergic and cholinergic agents, such as metoclopramide
(Reglan).
4.Tetrahydrocannabinols, such as dronabinol (Marinol) - -Antidopaminergic
and cholinergic agents, such as metoclopramide (Reglan)
rationale: Metoclopramide (Reglan) is used for diabetic gastroparesis and
postoperative nausea and vomiting. It works by affecting the chemoreceptor
trigger zone, thereby stimulating upper gastrointestinal motility and
increasing lower esophageal sphincter pressure
-You auscultate Julie's abdomen and hear a peritoneal friction rub. Which
condition do you rule out?
1.Peritonitis.
2.A liver or spleen abscess.
3.A liver or spleen metastatic tumor.
4.Irritable bowel syndrome. - -IBS
rationale: IBS does not produce a friction rub
-You are counseling Lillian, who is lactose intolerant, about foods to avoid.
You know she misunderstands the teaching when she tells you she can have:
1. Yogurt.
2.Foods containing whey.
3.Prehydrolyzed milk.
4.Oranges. - -Foods containing whey
rationale: Advise clients who are lactose intolerant to avoid foods containing
whey. Whey is a lactose-rich ingredient found in some foods, so clients who
are lactose intolerant need to read labels on all foods. To control symptoms,
dietary lactose should be reduced or restricted by using lactose-reduced and
lactose-free dairy products or by eating lactose-rich foods in small amounts
or in combination with low-lactose or lactose-free foods.
, -Simon, age 72, states that he is worried because he has a bowel movement
only every third day. You respond:
1."You should have two to three stools per day."
2."You should defecate once a day."
3."You should have at least three stools per week."
4."There is no such thing as a 'normal' pattern of defecation." - -There is no
such thing as a normal pattern of defecation
rationale: There is no such thing as a "normal" pattern of defecation.
Patterns of defecation vary widely and may in part be affected by dietary
habits, fluid intake, bacteria in the stool, psychological stress, or voluntary
postponement of defecation. Defecating every third day could be the routine
pattern for Simon. He should be questioned if this is routine for him.
-Timothy, age 68, complains of an abrupt change in his defecation pattern.
You evaluate him for:
1.Constipation.
2.Colorectal cancer.
3.Irritable bowel syndrome.
4.Acute appendicitis. - -Colorectal cancer
rationale: A middle-aged or older client with an abrupt change in defecation
pattern must be evaluated for colorectal cancer
-Ruby has a colostomy and complains that her stools are too loose. What
food(s) do you suggest to help thicken the stools?
1.Cheese.
2.Leafy green vegetables.
3.Raw fruits and vegetables.
4.Dried beans. - -Cheese
rationale: Cheese, bread, pasta, rice, pretzels, and yogurt all help to thicken
stools.
-Tina has a chronic hepatitis C infection. She asks you how to prevent its
transmission. You respond:
1."Do not donate blood until one year after diagnosis."
2."Abstain from sex altogether."
3."There is no possibility of transmission through razors or toothbrushes."
4."Abstain from sex during your period." - -Abstain from sex during your
period
rationale: Because the hepatitis C virus is transmitted in blood, including
menstrual blood, clients should abstain from sex during menstruation. You
might also test Tina to see which genotype her hepatitis C is to see if she is a
candidate for Harvoni or Epclusa.
, -Your client's 2-month-old daughter is admitted with gastroenteritis and
dehydration after 2 days of vomiting and diarrhea. When the father asks you
what is causing the child's diarrhea, how do you respond?
1."She must be lactose intolerant from the formula, and this is altering the
fluid balance."
2."Her body's telling you that it's time to introduce some solids into her
system."
3."The virus is causing irritation of the gastrointestinal lining, which causes
diarrhea."
4."The infectious agent invaded the stomach lining and is affecting the
balance of water and nutrients." - -"The infectious agent invaded the
stomach lining and is affecting the balance of water and nutrients."
rationale: In 80% of cases, gastroenteritis is viral in nature. This viral
infection causes diarrhea by stimulating the secretion of electrolytes into the
intestine. This is rapidly followed by water along the osmotic gradient,
resulting in watery stools.
-Sandy, age 52, presents with jaundice, dark urine, and light-colored stools,
stating that she is slightly improved over last week's symptoms. Which stage
of viral hepatitis do you suspect?
1.Incubation.
2.Prodromal.
3.Icteric.
4.Convalescent. - -Icteric
rationale: In the icteric stage of viral hepatitis, there is jaundice, dark urine,
and light-colored stools. There are continued prodromal complaints, with
gradual improvement.
-Rose, a client with gastroesophageal reflux disease (GERD), has many other
concurrent conditions. In teaching Rose about medications to avoid, what do
you recommend she refrain from using?
1.Antibiotics.
2.Nonsteroidal anti-inflammatory drugs (NSAIDs).
3.Oral contraceptives.
4.Antifungals. - -NSAIDS
rationale: Clients with GERD should avoid taking NSAIDs because they tend
to aggravate the already irritated gastric mucosa.
-Lucy, age 49, has pain in both the left and right lower quadrants. What
might you suspect?
1.A gastric ulcer.
2.Gastritis.
, 3.Pelvic inflammatory disease.
4.Pancreatitis. - -PID
rationale: The pain associated with pelvic inflammatory disease can be
palpated in both the right and left lower quadrants.
-In a 2-month-old infant with vomiting and diarrhea, the most effective way
of determining a fluid deficit is to check for:
1.Decreased peripheral perfusion.
2.Hyperventilation.
3.Irritability.
4. Hyperthermia. - -Decreased peripheral perfusion
rationale: In a 2-month-old infant with vomiting and diarrhea, the most
effective way of determining a fluid deficit is to check for decreased
peripheral perfusion, dry oral mucous membranes, and sunken fontanels.
The body compensates for loss of fluid by shifting the interstitial fluid into
the intravascular space, thereby maintaining perfusion of vital organs. If the
fluid loss continues, circulating volume is diminished and vasoconstriction
occurs in the peripheral vessels, resulting in decreased perfusion
-You suspect that Harry has a peptic ulcer and tell him that it has been
found to be strongly associated with:
1.Anxiety and panic attacks.
2.Long-term use of nonsteroidal anti-inflammatory drugs (NSAIDs).
3.Infection by Helicobacter pylori.
4.A family history of peptic ulcers. - -Infection by H. Pylori
rationale: About 90% of cases of peptic ulcers have been found to be caused
by infection with the bacteria H pylori
-You suspect that Nikki has a gastroduodenal ulcer caused by Helicobacter
pylori and plan to treat her empirically. What medications should you order?
1.A proton pump inhibitor (omeprazole), tetracycline or amoxicillin, and
metronidazole (Flagyl).
2.Bismuth subsalicylate (Pepto-Bismol) and omeprazole (Prilosec).
3.Amoxicillin (Amoxil) and omeprazole (Prilosec).
4.Clarithromycin (Biaxin) and metronidazole (Flagyl) - -Amoxicillin (Amoxil)
and omeprazole (Prilosec)
rationale: Both drugs listed are used in the eradication of H pylori, but do not
complete the regimen.
-A 7-year-old male presents with his mother to the urgent care clinic
complaining of abdominal pain. He started to complain of pain prior to going
to bed; however, it has gotten progressively worse and is now preventing
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