Midterm Examination Study Material - Detailed Answer Review

Midterm Examination Study Material - Detailed Answer Review 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