NR 511 Midterm Exam Questions with Verified Answers (Correct
Update)
Question 1: 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
Question 2: 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
Question 3: 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 lactoserich 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.
Question 4: 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.
Page 1
,Question 5: 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
Question 6: 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.
Question 7: 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.
Question 8: 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.
Question 9: Sandy, age 52, presents with jaundice, dark urine, and lightcolored 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 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.
Page 2
, Question 10: 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.
Answer: NSAIDS rationale: Clients with GERD should avoid taking NSAIDs because they tend to
aggravate the already irritated gastric mucosa.
Question 11: Lucy, age 49, has pain in both the left and right lower quadrants. What might you
suspect? 1.A gastric ulcer. 2.Gastritis. 3.Pelvic inflammatory disease. 4.Pancreatitis.
Answer: PID rationale: The pain associated with pelvic inflammatory disease can be palpated in both the
right and left lower quadrants.
Question 12: In a 2-month-old infant with vomiting and diarrhea, the most effective way of
determining a fluid deficit is to check for: 1.Decreased peripheral perfusion. 2.Hyperventilation.
3.Irritability. 4. Hyperthermia.
Answer: Decreased peripheral perfusion rationale: In a 2-month-old infant with vomiting and diarrhea,
the most effective way of determining a fluid deficit is to check for decreased peripheral perfusion, dry
oral mucous membranes, and sunken fontanels. The body compensates for loss of fluid by shifting the
interstitial fluid into the intravascular space, thereby maintaining perfusion of vital organs. If the fluid
loss continues, circulating volume is diminished and vasoconstriction occurs in the peripheral vessels,
resulting in decreased perfusion
Question 13: You suspect that Harry has a peptic ulcer and tell him that it has been found to be
strongly associated with: 1.Anxiety and panic attacks. 2.Long-term use of nonsteroidal
antiinflammatory drugs (NSAIDs). 3.Infection by Helicobacter pylori. 4.A family history of
peptic ulcers.
Answer: Infection by H. Pylori rationale: About 90% of cases of peptic ulcers have been found to be
caused by infection with the bacteria H pylori
Question 14: You suspect that Nikki has a gastroduodenal ulcer caused by Helicobacter pylori
and plan to treat her empirically. What medications should you order? 1.A proton pump
inhibitor (omeprazole), tetracycline or amoxicillin, and metronidazole (Flagyl). 2.Bismuth
subsalicylate (Pepto- Bismol) and omeprazole (Prilosec). 3.Amoxicillin (Amoxil) and omeprazole
(Prilosec). 4.Clarithromycin (Biaxin) and metronidazole (Flagyl)
Answer: Amoxicillin (Amoxil) and omeprazole (Prilosec) rationale: Both drugs listed are used in the
eradication of H pylori, but do not complete the regimen.
Page 3
Update)
Question 1: 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
Question 2: 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
Question 3: 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 lactoserich 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.
Question 4: 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.
Page 1
,Question 5: 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
Question 6: 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.
Question 7: 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.
Question 8: 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.
Question 9: Sandy, age 52, presents with jaundice, dark urine, and lightcolored 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 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.
Page 2
, Question 10: 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.
Answer: NSAIDS rationale: Clients with GERD should avoid taking NSAIDs because they tend to
aggravate the already irritated gastric mucosa.
Question 11: Lucy, age 49, has pain in both the left and right lower quadrants. What might you
suspect? 1.A gastric ulcer. 2.Gastritis. 3.Pelvic inflammatory disease. 4.Pancreatitis.
Answer: PID rationale: The pain associated with pelvic inflammatory disease can be palpated in both the
right and left lower quadrants.
Question 12: In a 2-month-old infant with vomiting and diarrhea, the most effective way of
determining a fluid deficit is to check for: 1.Decreased peripheral perfusion. 2.Hyperventilation.
3.Irritability. 4. Hyperthermia.
Answer: Decreased peripheral perfusion rationale: In a 2-month-old infant with vomiting and diarrhea,
the most effective way of determining a fluid deficit is to check for decreased peripheral perfusion, dry
oral mucous membranes, and sunken fontanels. The body compensates for loss of fluid by shifting the
interstitial fluid into the intravascular space, thereby maintaining perfusion of vital organs. If the fluid
loss continues, circulating volume is diminished and vasoconstriction occurs in the peripheral vessels,
resulting in decreased perfusion
Question 13: You suspect that Harry has a peptic ulcer and tell him that it has been found to be
strongly associated with: 1.Anxiety and panic attacks. 2.Long-term use of nonsteroidal
antiinflammatory drugs (NSAIDs). 3.Infection by Helicobacter pylori. 4.A family history of
peptic ulcers.
Answer: Infection by H. Pylori rationale: About 90% of cases of peptic ulcers have been found to be
caused by infection with the bacteria H pylori
Question 14: You suspect that Nikki has a gastroduodenal ulcer caused by Helicobacter pylori
and plan to treat her empirically. What medications should you order? 1.A proton pump
inhibitor (omeprazole), tetracycline or amoxicillin, and metronidazole (Flagyl). 2.Bismuth
subsalicylate (Pepto- Bismol) and omeprazole (Prilosec). 3.Amoxicillin (Amoxil) and omeprazole
(Prilosec). 4.Clarithromycin (Biaxin) and metronidazole (Flagyl)
Answer: Amoxicillin (Amoxil) and omeprazole (Prilosec) rationale: Both drugs listed are used in the
eradication of H pylori, but do not complete the regimen.
Page 3
