NURS-172 Exam 2 Questions And All
Updated Correct Answers.
Which of the following would contribute to a client's excessive weight gain? (Select all that apply.)(There
are 3 correct answers)
1. A hypothalamus lesion
2. Hyperthyroidism
3. High levels of serotonin
4. Cushing's disease
5. Diabetes mellitus - Answer 1. A hypothalamus lesion
4. Cushing's disease
5. Diabetes mellitus
Lesions in the appetite and satiety centers in the hypothalamus may contribute to overeating and lead to
obesity. Hypothyroidism, not hyperthyroidism, is a problem that interferes with basal metabolism and
may lead to weight gain. Weight gain can also occur in response to the decreased insulin production of
diabetes mellitus and the increased cortisone production of Cushing's disease. New evidence also exists
to indicate that low levels of the neurotransmitter serotonin may play a role in compulsive eating.
A nurse should identify topiramate (Topamax) as the drug of choice for which of the following
conditions? (Select all that apply.)(There are 2 correct answers)
1. Bingeing and purging with a diagnosis of bulimia nervosa
2. Weight loss with a diagnosis of anorexia nervosa
3. Amenorrhea with a diagnosis of anorexia nervosa
4. Emaciation with a diagnosis of bulimia nervosa
5. Binge eating with a diagnosis of obesity - Answer 1. Bingeing and purging with a diagnosis of bulimia
nervosa
,5. Binge eating with a diagnosis of obesity
The nurse should identify that topiramate is the drug of choice when treating binge eating with a
diagnosis of obesity or bingeing and purging with a diagnosis of bulimia nervosa. Topiramate is an
anticonvulsant that produces a significant decline in binge frequency and reduction in body weight.
A nursing instructor is teaching about the DSM-5 criteria for the diagnosis of binge-eating disorder.
Which of the following student statements indicates that further instruction is needed? (Select all that
apply.)(There are 3 correct answers)
1. "In this disorder, distress regarding binge eating is absent."
2. "In this disorder, binge eating occurs exclusively during the course of bulimia nervosa."
3. "In this disorder, binge eating occurs, on average, at least once a week for three months."
4. "In this disorder, binge eating occurs, on average, at least two days a week for six months."
5. "In this disorder, distress regarding binge eating is present." - Answer 1. "In this disorder, distress
regarding binge eating is absent."
2. "In this disorder, binge eating occurs exclusively during the course of bulimia nervosa."
4. "In this disorder, binge eating occurs, on average, at least two days a week for six months."
According to the DSM-5 criteria for the diagnosis of binge-eating disorder, binge eating should not occur
exclusively during the course of anorexia nervosa or bulimia nervosa. The new time frame criteria in the
DSM-5 states that binge eating must occur, on average, at least once a week for three months not two
days a week for six months. The DSM-5 criteria states that distress regarding binge eating would be
present.
Anorexia nervosa deals with issues of control and a struggle between dependence and independence.
True
False - Answer True. Anorexia nervosa deals with issues of control and a struggle between dependence
and independence. It is often associated with parent-child conflicts about dependency issues. Children
often feel as though their bodies and weight are their only areas of control. It occurs primarily in
adolescents and young adults. It is more common in females than males.
,Bulimia deals with loss of control (binge eating) and guilt (purging).
True
False - Answer True. Bulimia deals with loss of control (binge eating) and guilt (purging). Bulimia is
characterized by eating excessive amounts of food followed by self-induced purging by vomiting, misuse
of laxatives, diuretics or other medications, fasting, and/or excessive exercise.
Fatty foods are the common food intolerances for clients with cholelithiasis.
True
False - Answer True. Fatty foods are the common food intolerances for clients with cholelithiasis.
Teaching in relation to home management following a laparoscopic cholecystectomy should include
a. reporting any bile-colored drainage or pus from any incision.
b. keeping the bandages on the puncture sites for 48 hours.
c. using over-the-counter antiemetics if nausea and vomiting occur.
d. emptying and measuring the contents of the bile bag from the T tube every day. - Answer a.
reporting any bile-colored drainage or pus from any incision.
The following discharge instructions are taught to the patient and caregiver after a laparoscopic
cholecystectomy. First, remove the bandages on the puncture site the day after surgery and shower.
Second, notify the surgeon if any of the following signs and symptoms occur: redness, swelling, bile-
colored drainage or pus from any incision; and severe abdominal pain, nausea, vomiting, fever, or chills.
Third, gradually resume normal activities. Fourth, return to work within 1 week of surgery. Fifth, resume
a usual diet, but a low-fat diet is usually better tolerated for several weeks after surgery. T tube is not
inserted when a lap.chole. is performed.
The nursing management of the client with cholecystitis associated with cholelithiasis is based on the
knowledge that
a. laparoscopic cholecystectomy is the treatment of choice in most clients who are symptomatic.
, b. shock-wave therapy sould be tried initially.
c. once gallstones are removed, they tend not to recur.
d. the disorder can be successfully treated with oral bile salts that dissolve gallstones. - Answer a.
laparoscopic cholecystectomy is the treatment of choice in most clients who are symptomatic.
Laparoscopic cholecystectomy is the treatment of choice for symptomatic cholelithiasis because of its
success. Approximately 90% of cholecystectomies are done laparoscopically. Usually shock-wave therapy
(ESWL) and oral dissolution therapy are used together. Gallstones are not usually treated with drugs
because gallstones may recur. Endoscopic retrograde cholangiopancreatography (ERCP) is especially
effective in removing common bile duct stones.
To care for a T-tube in a client following an open/incisional cholecystectomy, the nurse
a. attaches the tube to low continuous suction.
b. keeps the tube supported and free of kinks.
c. clamps the tube when ambulating the client.
d. irrigates the tube with 10-mL sterile saline every 2 to 4 hours. - Answer b. keeps the tube supported
and free of kinks.
The T-tube drains bile from the common bile duct until swelling from trauma has subsided and bile can
freely enter the duodenum. The tube is placed to gravity drainage and should be kept open and free
from kinks to prevent bile from backing up into the liver. The tube is not normally irrigated. Drainage
from the T-tube is initially bloody and then turns a greenish-brown color. The drainage is measured as
output. The amount of the expected drainage will range from 500 to 1000 mL/day.
A client with chronic cholecystitis asks the nurse whether she will need to continue a low-fat diet after
she has a cholecystectomy. The best response by the nurse is,
a. "A low-fat diet will prevent the development of further gallstones and should be continued."
b. "Yes, because you will not have a gallbladder to store bile, you will not be able to digest fats
adequately."
c. "Removal of the gallbladder will eliminate the source of your pain associated with fat intake, so you
may eat whatever you like."
