NR 511 Midterm Exam
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) ANS: 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. ANS: 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. ANS: 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." ANS: 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. ANS: 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. ANS: 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." ANS: 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."
ANS: "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. ANS: Icteric
rationale: In the icteric stage of viral hepatitis, there is jaundice, dark urine, and light-colored stools.
There are continued prodromal complaints, with gradual improvement.
Rose, a client with gastroesophageal reflux disease (GERD), has many other concurrent conditions. In
teaching Rose about medications to avoid, what do you recommend she refrain from using?
1.Antibiotics.
2.Nonsteroidal anti-inflammatory drugs (NSAIDs).
3.Oral contraceptives.
4.Antifungals. ANS: NSAIDS
rationale: Clients with GERD should avoid taking NSAIDs because they tend to aggravate the already
irritated gastric mucosa.
Lucy, age 49, has pain in both the left and right lower quadrants. What might you suspect?
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) ANS: 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. ANS: 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. ANS: 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." ANS: 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. ANS: 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. ANS: 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." ANS: 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."
ANS: "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. ANS: Icteric
rationale: In the icteric stage of viral hepatitis, there is jaundice, dark urine, and light-colored stools.
There are continued prodromal complaints, with gradual improvement.
Rose, a client with gastroesophageal reflux disease (GERD), has many other concurrent conditions. In
teaching Rose about medications to avoid, what do you recommend she refrain from using?
1.Antibiotics.
2.Nonsteroidal anti-inflammatory drugs (NSAIDs).
3.Oral contraceptives.
4.Antifungals. ANS: NSAIDS
rationale: Clients with GERD should avoid taking NSAIDs because they tend to aggravate the already
irritated gastric mucosa.
Lucy, age 49, has pain in both the left and right lower quadrants. What might you suspect?
