NR511 QUESTIONS AND VERIFIED SOLUTIONS
Mr. Johnson, age 69, has had Meniere disease for several years. He has some hearing loss
but now has persistent vertigo. What treatment might be instituted to relieve the vertigo?
1.A labyrinthectomy. 2.Pharmacological therapy. 3.A vestibular neurectomy. 4.Wearing an
earplug in the ear that has the most hearing loss. - ✔✔3. A vestibular neurectomy.
Treatment for achalasia may include: 1. Balloon dilation of the lower esophageal
sphincter. 2. Beta blockers. 3. A fundoplication. 4. An esophagogastrectomy. - ✔✔1.
Balloon dilation of the LES Which oral medication might be used to treat a client with
chronic cholelithiasis who is a poor candidate for surgery? 1.Ursodiol (Actigall).
2.Ibuprofen (Advil). 3.Prednisone (Deltasone). 4.Surgery is the only answer. - ✔✔1.
Ursodiol (Actigall) 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). - ✔✔3.Antidopaminergic and cholinergic agents, such as metoclopramide
(Reglan). 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. - ✔✔4. IBS Which is the most common
presenting symptom of gastric cancer? 1.Weight loss. 2.Dysphagia. 3.Hematemesis.
4.Gastrointestinal bleeding. - ✔✔1. Weight loss The metabolism of which drug is not
affected in Marsha, age 74? 1.Alcohol. 2.Anticonvulsants. 3.Psychotropics. 4.Oral
anticoagulants. - ✔✔1. Alcohol Nausea is difficult to discern in a young child. What
question might you ask to determine if a child has nausea? 1."Are you sick to your tummy?"
2."Are you hungry?" 3."Are you eating the way you normally eat?" 4."Are you nauseous?" -
✔✔2. "Are you hungry?" Zena just had a hemorrhoidectomy. You know she has not
understood your teaching when she tells you she will: 1.Take a sitz bath after each bowel
movement for 1 to 2 weeks after surgery. 2.Drink at least 2000 mL of fluids per day.
3.Decrease her dietary fiber for 1 month. 4.Take stool softeners as prescribed. -
✔✔3.Decrease her dietary fiber for 1 month. Stacy, a nursing student, is to begin her series
of hepatitis B vaccinations. You test her for a serological marker, and the results show
hepatitis B surface antibodies (HBsAb). You tell Stacy that she: 1.Needs to begin the
hepatitis B series as soon as possible. 2.Needs to be tested again because one reading is
not indicative of immunity. 3.Is permanently immune to hepatitis B. 4.Has an acute
hepatitis B infection. - ✔✔3. Is permanently immune to hepatitis B. Margie, age 52, has an
,extremely stressful job and was just given a diagnosis of gastric ulcer. She tells you she is
sure it is going to be malignant. How do you respond? 1."Don't worry. Gastric ulcers are not
cancerous." 2."About 95% of gastric ulcers are benign." 3."You have about a 50% chance
of having gastric cancer from your ulcer." 4."Even if it is cancer, surgery is 100%
successful." - ✔✔2."About 95% of gastric ulcers are benign." 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. - ✔✔2.Foods containing whey. Susan, age 59, has no
specific complaints when she comes in for her annual examination. She does, however,
have type 2 diabetes mellitus (DM), slight hypertension, dyslipidemia, and central obesity.
How would you diagnose her? 1.As a healthy adult with several problems. 2.As having a
glycemic event. 3.As having metabolic syndrome. 4.As having multiple organ dysfunction -
✔✔3. As having metabolic syndrome. Tom has just been diagnosed with celiac disease.
Which of the following might you tell him? 1.There is a new pharmaceutical cure for celiac
disease. 2.A strict gluten-free diet is the only treatment for celiac disease. 3.Your children
will not be at a higher risk for developing this disease. 4.The presence of celiac disease is
decreasing dramatically in the United States. - ✔✔2.A strict gluten-free diet is the only
treatment for celiac disease. 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." - ✔✔4. "There is no
such thing as a 'normal' pattern of defecation." Matt, age 26, recently returned from a
camping trip and has gastroenteritis. He says that he has been eating only canned food.
Which of the following pathogens do you suspect? 1.Campylobacter jejuni. 2.Clostridium
botulinum. 3.Clostridium perfringens. 4.Staphylococcus. - ✔✔2. Clostridium botulinum.
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. - ✔✔2. 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. - ✔✔1. Cheese
Martina, age 34, has AIDS and currently suffers from diarrhea. You suspect she has which
protozoal infection of the bowel? 1.Giardiasis. 2.Amebiasis. 3.Cryptosporidiosis.
4.Escherichia coli. - ✔✔3. Cryptosporidiosis. Anson tells you he thinks his antacids are
causing his diarrhea. You respond: 1."Antacids contain fructose, which may not be totally
absorbed, resulting in fluid being drawn into the bowel." 2."Antacids contain sorbitol or
mannitol, which are sugars that aren't absorbed and can cause fluid to be drawn into the
bowel." 3."Antacids contain caffeine, which decreases bowel transit time." 4."Antacids
, may contain magnesium, which decreases bowel transit time and may contain poorly
absorbed salts that draw fluid into the bowel." - ✔✔4."Antacids may contain magnesium,
which decreases bowel transit time and may contain poorly absorbed salts that draw fluid
into the bowel." 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." - ✔✔4. "Abstain from sex during
your period." Marcie just returned from Central America with traveler's diarrhea. Which is
the best treatment? 1.Metronidazole (Flagyl). 2.Supportive care. 3.Quinolone antibiotics.
4.Gastric lavage. - ✔✔2. Supportive care. 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." - ✔✔4. "The infectious
agent invaded the stomach lining and is affecting the balance of water and nutrients."
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. - ✔✔3. Icteric. When
Sammy asks you what he can do to help his wife, who has dumping syndrome, what do you
suggest he encourage her to do? 1.Eat foods higher in carbohydrates. 2.Eat 3 large meals
plus 3 snacks per day. 3.Eat foods with a moderate fat and protein content. 4.Drink fluids
with each meal. - ✔✔3.Eat foods with a moderate fat and protein content. Cydney has
been given a diagnosis of ascariasis. Which symptoms would you expect to see? 1.Low-
grade fever, productive cough with blood-tinged sputum, wheezing, and dyspnea.
2.Nocturnal perianal and perineal pruritus. 3.Diarrhea, cramps, and malaise. 4.Ascites and
facial and extremity edema. - ✔✔1.Low-grade fever, productive cough with blood-tinged
sputum, wheezing, and dyspnea. 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. - ✔✔2. Nonsteroidal
anti-inflammatory drugs (NSAIDs). Ellie, age 42, has a seizure disorder and has been taking
phenytoin (Dilantin) for years. Which supplement should she also be taking if no other
problems exist? 1.Vitamin B12. 2.Iron. 3.Folic acid. 4.Calcium. - ✔✔3. Folic acid.
Samantha, age 28, is 100 lb overweight and wants to have a gastroplasty performed. In
discussing this with her, you explain that by having this procedure she may: 1.Develop
Mr. Johnson, age 69, has had Meniere disease for several years. He has some hearing loss
but now has persistent vertigo. What treatment might be instituted to relieve the vertigo?
1.A labyrinthectomy. 2.Pharmacological therapy. 3.A vestibular neurectomy. 4.Wearing an
earplug in the ear that has the most hearing loss. - ✔✔3. A vestibular neurectomy.
Treatment for achalasia may include: 1. Balloon dilation of the lower esophageal
sphincter. 2. Beta blockers. 3. A fundoplication. 4. An esophagogastrectomy. - ✔✔1.
Balloon dilation of the LES Which oral medication might be used to treat a client with
chronic cholelithiasis who is a poor candidate for surgery? 1.Ursodiol (Actigall).
2.Ibuprofen (Advil). 3.Prednisone (Deltasone). 4.Surgery is the only answer. - ✔✔1.
Ursodiol (Actigall) 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). - ✔✔3.Antidopaminergic and cholinergic agents, such as metoclopramide
(Reglan). 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. - ✔✔4. IBS Which is the most common
presenting symptom of gastric cancer? 1.Weight loss. 2.Dysphagia. 3.Hematemesis.
4.Gastrointestinal bleeding. - ✔✔1. Weight loss The metabolism of which drug is not
affected in Marsha, age 74? 1.Alcohol. 2.Anticonvulsants. 3.Psychotropics. 4.Oral
anticoagulants. - ✔✔1. Alcohol Nausea is difficult to discern in a young child. What
question might you ask to determine if a child has nausea? 1."Are you sick to your tummy?"
2."Are you hungry?" 3."Are you eating the way you normally eat?" 4."Are you nauseous?" -
✔✔2. "Are you hungry?" Zena just had a hemorrhoidectomy. You know she has not
understood your teaching when she tells you she will: 1.Take a sitz bath after each bowel
movement for 1 to 2 weeks after surgery. 2.Drink at least 2000 mL of fluids per day.
3.Decrease her dietary fiber for 1 month. 4.Take stool softeners as prescribed. -
✔✔3.Decrease her dietary fiber for 1 month. Stacy, a nursing student, is to begin her series
of hepatitis B vaccinations. You test her for a serological marker, and the results show
hepatitis B surface antibodies (HBsAb). You tell Stacy that she: 1.Needs to begin the
hepatitis B series as soon as possible. 2.Needs to be tested again because one reading is
not indicative of immunity. 3.Is permanently immune to hepatitis B. 4.Has an acute
hepatitis B infection. - ✔✔3. Is permanently immune to hepatitis B. Margie, age 52, has an
,extremely stressful job and was just given a diagnosis of gastric ulcer. She tells you she is
sure it is going to be malignant. How do you respond? 1."Don't worry. Gastric ulcers are not
cancerous." 2."About 95% of gastric ulcers are benign." 3."You have about a 50% chance
of having gastric cancer from your ulcer." 4."Even if it is cancer, surgery is 100%
successful." - ✔✔2."About 95% of gastric ulcers are benign." 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. - ✔✔2.Foods containing whey. Susan, age 59, has no
specific complaints when she comes in for her annual examination. She does, however,
have type 2 diabetes mellitus (DM), slight hypertension, dyslipidemia, and central obesity.
How would you diagnose her? 1.As a healthy adult with several problems. 2.As having a
glycemic event. 3.As having metabolic syndrome. 4.As having multiple organ dysfunction -
✔✔3. As having metabolic syndrome. Tom has just been diagnosed with celiac disease.
Which of the following might you tell him? 1.There is a new pharmaceutical cure for celiac
disease. 2.A strict gluten-free diet is the only treatment for celiac disease. 3.Your children
will not be at a higher risk for developing this disease. 4.The presence of celiac disease is
decreasing dramatically in the United States. - ✔✔2.A strict gluten-free diet is the only
treatment for celiac disease. 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." - ✔✔4. "There is no
such thing as a 'normal' pattern of defecation." Matt, age 26, recently returned from a
camping trip and has gastroenteritis. He says that he has been eating only canned food.
Which of the following pathogens do you suspect? 1.Campylobacter jejuni. 2.Clostridium
botulinum. 3.Clostridium perfringens. 4.Staphylococcus. - ✔✔2. Clostridium botulinum.
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. - ✔✔2. 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. - ✔✔1. Cheese
Martina, age 34, has AIDS and currently suffers from diarrhea. You suspect she has which
protozoal infection of the bowel? 1.Giardiasis. 2.Amebiasis. 3.Cryptosporidiosis.
4.Escherichia coli. - ✔✔3. Cryptosporidiosis. Anson tells you he thinks his antacids are
causing his diarrhea. You respond: 1."Antacids contain fructose, which may not be totally
absorbed, resulting in fluid being drawn into the bowel." 2."Antacids contain sorbitol or
mannitol, which are sugars that aren't absorbed and can cause fluid to be drawn into the
bowel." 3."Antacids contain caffeine, which decreases bowel transit time." 4."Antacids
, may contain magnesium, which decreases bowel transit time and may contain poorly
absorbed salts that draw fluid into the bowel." - ✔✔4."Antacids may contain magnesium,
which decreases bowel transit time and may contain poorly absorbed salts that draw fluid
into the bowel." 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." - ✔✔4. "Abstain from sex during
your period." Marcie just returned from Central America with traveler's diarrhea. Which is
the best treatment? 1.Metronidazole (Flagyl). 2.Supportive care. 3.Quinolone antibiotics.
4.Gastric lavage. - ✔✔2. Supportive care. 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." - ✔✔4. "The infectious
agent invaded the stomach lining and is affecting the balance of water and nutrients."
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. - ✔✔3. Icteric. When
Sammy asks you what he can do to help his wife, who has dumping syndrome, what do you
suggest he encourage her to do? 1.Eat foods higher in carbohydrates. 2.Eat 3 large meals
plus 3 snacks per day. 3.Eat foods with a moderate fat and protein content. 4.Drink fluids
with each meal. - ✔✔3.Eat foods with a moderate fat and protein content. Cydney has
been given a diagnosis of ascariasis. Which symptoms would you expect to see? 1.Low-
grade fever, productive cough with blood-tinged sputum, wheezing, and dyspnea.
2.Nocturnal perianal and perineal pruritus. 3.Diarrhea, cramps, and malaise. 4.Ascites and
facial and extremity edema. - ✔✔1.Low-grade fever, productive cough with blood-tinged
sputum, wheezing, and dyspnea. 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. - ✔✔2. Nonsteroidal
anti-inflammatory drugs (NSAIDs). Ellie, age 42, has a seizure disorder and has been taking
phenytoin (Dilantin) for years. Which supplement should she also be taking if no other
problems exist? 1.Vitamin B12. 2.Iron. 3.Folic acid. 4.Calcium. - ✔✔3. Folic acid.
Samantha, age 28, is 100 lb overweight and wants to have a gastroplasty performed. In
discussing this with her, you explain that by having this procedure she may: 1.Develop
