NR 511 WEEK 6 CLINICAL CASE STUDY PART
ONE EXAM SCRIPT SOLVED QUESTIONS
AND CORRECT ANSWERS GRADED A+
◉ 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). Answer:
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.. Answer: 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.. 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."
ONE EXAM SCRIPT SOLVED QUESTIONS
AND CORRECT ANSWERS GRADED A+
◉ 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). Answer:
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.. Answer: 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.. 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."
