NR 511 MIDTERM EXAM COMPREHENSIVE
STUDY GUIDE 2026
◉ 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. 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.
◉ 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."
Answer: 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. Answer: 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. Answer: 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." Answer: 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." Answer: "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. Answer: Icteric
STUDY GUIDE 2026
◉ 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. 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.
◉ 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."
Answer: 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. Answer: 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. Answer: 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." Answer: 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." Answer: "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. Answer: Icteric
