NR 511 Midterm Exam With Verified Solution
100% pass 2024-2025
All of the following medications are used in the management of nausea and vomiting.
Which of the medications below acts on the chemoreceptor trigger zone to induce
upper gastrointestinal motility, 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 indicated for diabetic gastroparesis and
postoperative nausea and vomiting. It acts on the chemoreceptor trigger zone,
stimulating upper GI motility and increasing lower esophageal sphincter pressure
You auscultate Julie's abdomen and elicit a peritoneal friction rub. Which condition can
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 cause a friction rub
You are teaching Lillian, a lactose intolerant client, about foods to avoid. You realize that
,she has misunderstood the teaching when she states she can have the following foods:
1. Yogurt
2.Foods containing whey
3.Prehydrolyzed milk
4.Oranges. - Answer Foods containing whey
Rationale: Advise lactose intolerant clients to avoid foods to which whey has been
added. Whey is a lactose containing additive used in selected foods. Lactose intolerant
clients should read labels for all foods. Dietary lactose can be minimized/restricted for
symptom management by using lactose-reduced and lactose-free dairy products or by
consuming lactose-containing foods in small portions or in combination with low lactose
or lactose-free foods.
Simon, age 72 years states that he is worried since he only has one bowel movement
every third day. You would 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, 68 years, informs you that he has experienced a change in his bowel
elimination pattern. You would evaluate this client for:
1.Constipation.
2.Colorectal cancer.
3.Irritable bowel syndrome.
,4.Acute appendicitis. - Answer Colorectal cancer
rationale: A middle-aged or older client who presents an sudden change in bowel
elimination pattern should be evaluated for colorectal cancer
Ruby has a colostomy and complains that her stools are too watery. What food(s) would
you instruct her to consume that will thicken the stools?
1.Cheese.
2.Leafy green vegetables.
3.Raw fruits and vegetables.
4. Dried beans. - Cheese
explanation: The following foods thickens the stool : Cheese, bread, pasta, rice,
pretzels, and yogurt.
Tina tiene una infección crónica de hepatitis C. 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.
Rationale: Since hepatitis C virus is shed into blood including menstrual periods, client
should avoid sex during menstruation. You may also want to genotype Tina's HCV to
determine is she is eligible for Harvoni or Epclusa.
Your client's 2-month-old daughter is admitted with gastroenteritis and dehydration
after 2 days of vomiting and diarrhea. If the father asks you what is causing the child's
diarrhea, how would 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 irritating the lining of the gastrointestinal lining, which results in
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."
reason: Virus accounts for gastroenteritis 80% of the time. Because of the viral
infection, there is a secretion-induced diarrhea where electrolytes are hypersecretized
in the intestine. Water quickly follows down the osmotic gradient resulting in watery
stools.
Sandy, a 52-year-old client, relates jaundice, dark urine, and palecolored stools and
states that she is a little better than she was one week ago. In what stage of viral
hepatitis do you think that Ms Sandy is exhibiting?
1.Incubation.
2.Prodromal.
3.Icteric.
4.Convalescent. - Answer Icteric
rationale: Viral hepatitis is characterized by jaundice, dark urine, and light-colored
stools during the icteric stage. The prodromal complaints continue but improve
somewhat.
Rose is a client with gastroesophageal reflux disease who has been experiencing many
comorbidities. While teaching Rose about medications that should be avoided, what
would you instruct her to avoid?
1. Antibiotics.
2. Nonsteroidal antiinflammatory drugs (NSAIDs).
3. Oral contraceptives.
4. Antifungals. - Answer NSAIDS
rationale: Patients with GERD should avoid NSAIDs as they irritate an already inflamed
100% pass 2024-2025
All of the following medications are used in the management of nausea and vomiting.
Which of the medications below acts on the chemoreceptor trigger zone to induce
upper gastrointestinal motility, 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 indicated for diabetic gastroparesis and
postoperative nausea and vomiting. It acts on the chemoreceptor trigger zone,
stimulating upper GI motility and increasing lower esophageal sphincter pressure
You auscultate Julie's abdomen and elicit a peritoneal friction rub. Which condition can
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 cause a friction rub
You are teaching Lillian, a lactose intolerant client, about foods to avoid. You realize that
,she has misunderstood the teaching when she states she can have the following foods:
1. Yogurt
2.Foods containing whey
3.Prehydrolyzed milk
4.Oranges. - Answer Foods containing whey
Rationale: Advise lactose intolerant clients to avoid foods to which whey has been
added. Whey is a lactose containing additive used in selected foods. Lactose intolerant
clients should read labels for all foods. Dietary lactose can be minimized/restricted for
symptom management by using lactose-reduced and lactose-free dairy products or by
consuming lactose-containing foods in small portions or in combination with low lactose
or lactose-free foods.
Simon, age 72 years states that he is worried since he only has one bowel movement
every third day. You would 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, 68 years, informs you that he has experienced a change in his bowel
elimination pattern. You would evaluate this client for:
1.Constipation.
2.Colorectal cancer.
3.Irritable bowel syndrome.
,4.Acute appendicitis. - Answer Colorectal cancer
rationale: A middle-aged or older client who presents an sudden change in bowel
elimination pattern should be evaluated for colorectal cancer
Ruby has a colostomy and complains that her stools are too watery. What food(s) would
you instruct her to consume that will thicken the stools?
1.Cheese.
2.Leafy green vegetables.
3.Raw fruits and vegetables.
4. Dried beans. - Cheese
explanation: The following foods thickens the stool : Cheese, bread, pasta, rice,
pretzels, and yogurt.
Tina tiene una infección crónica de hepatitis C. 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.
Rationale: Since hepatitis C virus is shed into blood including menstrual periods, client
should avoid sex during menstruation. You may also want to genotype Tina's HCV to
determine is she is eligible for Harvoni or Epclusa.
Your client's 2-month-old daughter is admitted with gastroenteritis and dehydration
after 2 days of vomiting and diarrhea. If the father asks you what is causing the child's
diarrhea, how would 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 irritating the lining of the gastrointestinal lining, which results in
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."
reason: Virus accounts for gastroenteritis 80% of the time. Because of the viral
infection, there is a secretion-induced diarrhea where electrolytes are hypersecretized
in the intestine. Water quickly follows down the osmotic gradient resulting in watery
stools.
Sandy, a 52-year-old client, relates jaundice, dark urine, and palecolored stools and
states that she is a little better than she was one week ago. In what stage of viral
hepatitis do you think that Ms Sandy is exhibiting?
1.Incubation.
2.Prodromal.
3.Icteric.
4.Convalescent. - Answer Icteric
rationale: Viral hepatitis is characterized by jaundice, dark urine, and light-colored
stools during the icteric stage. The prodromal complaints continue but improve
somewhat.
Rose is a client with gastroesophageal reflux disease who has been experiencing many
comorbidities. While teaching Rose about medications that should be avoided, what
would you instruct her to avoid?
1. Antibiotics.
2. Nonsteroidal antiinflammatory drugs (NSAIDs).
3. Oral contraceptives.
4. Antifungals. - Answer NSAIDS
rationale: Patients with GERD should avoid NSAIDs as they irritate an already inflamed
