CNM 586 CERTIFIED NURSE
MIDWIVES’ UNIT 4 TEST QUESTIONS
AND ACCURATE SOLUTIONS RATED
A.
,CMN 568 - Unit 4 Test with Verified Answers.
_`- _`- _`- _`- _`- _`- _`- _`- _`-
What kinds of medications should NOT be used for relief of constipation in
patients with a confirmed or suspected obstruction? ⬛ Do NOT give:
+ Bulk-forming agents
+ Stimulant laxatives
+ Intestinal secretagogues (e.g. liposome)
+ Surfactants
+ Methylnaltrexone
Use osmotic laxatives with CAUTION.
(Shimp Table 12-4)
Which infectious bacterial diarrheas can be treated with antimicrobials? ⬛
Shigellosis
Cholera
Extraintestinal salmonellosis
Listeriosis
C. difÏcile
(McPHee p 599)
,When should you refer patients with constipation? ⬛ 1) Pts with
refractory constipation for anorectal testing
2) Pts with defecatory disorders who may benefit from biofeedback
3) Pts with alarm symptoms OR who are over age 50 for colonoscopy
4) Pts with severe colonic inertia may need surgical referral
(McPhee p 595)
Acute onset of severe pain and vomiting suggests what? ⬛ + Peritoneal
irritation
+ Acute gastric or intestinal obstruction
+ Pancreaticobiliary disease
(McPhee p 588)
At what age do IBS sx typically present? ⬛ Late teens early 20s
, Vomiting in the morning suggests what? ⬛ + Pregnancy
+ Uremia
+ ETOH intake
+ ↑ ICP
Vomiting after meals suggests what? ⬛ + Bulimia
+ Peptic ulcer disease
+ Other psychogenic causes
(McPhee p 589, Shimp p 373)
Vomiting of undigested food 1-2 hours after a meal suggests what? ⬛ +
Gastroparesis
+ Small bowel obstruction
+ Gastric outlet obstruction
NOTE: Sucussion splash often heard on auscultation
(McPhee p 589, Shimp p 373)
4 causes of nausea and vomiting ⬛ 1) Visceral afferent stimulation
(seratonin receptors)
2) Vestibular disorders (fibers ↑ in histamine and muscarinic receptors)
3) CNS disorders
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