NR 511 Midterm Differential Diagnosis & Primary Care Practicum.pdf file:///C:/Users/HP/Desktop/New%20folder%20(2)/NR%20511%20M
NR 511 Midterm Exam Differential Diagnosis
& Primary Care Practicum
Questions & Answers
1. 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):
AnswerAntidopaminergic andcholinergic agents, such as metoclopramide (Reglan)
rationale: Metoclopramide (Reglan) is used for diabetic gastroparesis and postop-
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erative nausea and vomiting. It works by affecting the chemoreceptor trigger zone,
thereby stimulating upper gastrointestinal motility and increasing lower esophageal
sphincter pressure
2. 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.:
Answer IBS
rationale: IBS does not produce a friction rub
3. 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.
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3.Prehydrolyzed milk.
4.Oranges.: Answer 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.
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4. Simon, age 72, states that he is worried because he has a bowel movementonly
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.": Answer There is no
suchthing 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.
5. 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.
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