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MCA1 Exam 3 questions with well explained answers 2025.

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MCA1 Exam 3 questions with well explained answers 2025.

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MCA1 Exam 3 questions with well
explained answers 2025.




A patient with a history of peptic ulcer disease has presented to the emergency
department with severe abdominal pain and a rigid, boardlike abdomen. The health care
provider suspects a perforated ulcer. Which interventions should the nurse anticipate?

Providing IV fluids and inserting a nasogastric (NG) tube

Administering oral bicarbonate and testing the patient's gastric pH level

Performing a fecal occult blood test and administering IV calcium gluconate

Starting parenteral nutrition and placing the patient in a high-Fowler's position -
ANSWER: Providing IV fluids and inserting a nasogastric (NG) tube

A perforated peptic ulcer requires IV replacement of fluid losses and continued gastric
aspiration by NG tube. Nothing is given by mouth, and gastric pH testing is not a
priority. Calcium gluconate is not a medication directly relevant to the patient's
suspected diagnosis, and parenteral nutrition is not a priority in the short term.

After administration of a dose of metoclopramide, which patient assessment finding
would show the medication was effective?

Decreased blood pressure

Absence of muscle tremors

Relief of nausea and vomiting

,No further episodes of diarrhea - ANSWER: Relief of nausea and vomiting

Metoclopramide is classified as a prokinetic and antiemetic medication. If it is effective,
the patient's nausea and vomiting should resolve. Metoclopramide does not affect blood
pressure, muscle tremors, or diarrhea.

The nurse determines a patient has experienced the beneficial effects of therapy with
famotidine when which symptom is relieved?

Nausea

Belching

Epigastric pain

Difficulty swallowing - ANSWER: Epigastric pain

Famotidine is an H2-receptor antagonist that inhibits parietal cell output of HCl acid and
minimizes damage to gastric mucosa related to hyperacidity, thus relieving epigastric
pain. It is not indicated for nausea, belching, and dysphagia.

The nurse is teaching a group of college students how to prevent food poisoning. Which
comment shows an understanding of foodborne illness protection?

"Eating raw cookie dough from the package is a great snack when you do not have time
to bake."

"Since we only have one cutting board, we can cut up chicken and salad vegetables at
the same time."

"To save refrigerator space, leftover food can be kept on the counter if it is in sealed
containers."

"When the cafeteria gave me a pink hamburger, I sent it back and asked for a new bun
and clean plate." - ANSWER: When the cafeteria gave me a pink hamburger, I sent it
back and asked for a new bun and clean plate."

The student who did not accept the pink hamburger and asked for a new bun and clean
plate understood that the pink meat may not have reached 160°F and could be
contaminated with bacteria. Improperly storing cooked foods, eating raw cookie dough
from a refrigerated package, and only using one cutting board without washing it with

,hot soapy water between the chicken and salad vegetables could all lead to food
poisoning from contamination.

The nurse is caring for a patient treated with IV fluid therapy for severe vomiting. As the
patient recovers and begins to tolerate oral intake, which food choice would be most
appropriate?

Iced tea

Dry toast

Hot coffee

Plain yogurt - ANSWER: Dry toast

Dry toast or crackers may alleviate the feeling of nausea and prevent further vomiting.
Water is the initial fluid of choice. Extremely hot or cold liquids and fatty foods are
generally not well tolerated.

The nurse teaches senior citizens at a community center how to prevent food poisoning
at social events. Which community member statement reflects accurate understanding?

"Pasteurized juices and milk are safe to drink."

"Alfalfa sprouts are safe if rinsed before eating."

"Fresh fruits do not need to be washed before eating."

"Ground beef is safe to eat if cooked until it is brown." - ANSWER: "Pasteurized juices
and milk are safe to drink."

Drink only pasteurized milk, juice, or cider. Ground beef should be cooked thoroughly.
Browned meat can still harbor live bacteria. Cook ground beef until a thermometer
reads at least 160° F. If a thermometer is unavailable, decrease the risk of illness by
cooking the ground beef until there is no pink color in the middle. Fruits and vegetables
should be washed thoroughly, especially those that will not be cooked. Persons who are
immunocompromised or older should avoid eating alfalfa sprouts until the safety of the
sprouts can be ensured.

A patient complaining of nausea receives a dose of metoclopramide. Which potential
adverse effect should the nurse tell the patient to report?

, Tremors

Constipation

Double vision

Numbness in fingers and toes - ANSWER: Tremors

Extrapyramidal side effects, including tremors and tardive dyskinesias, may occur with
metoclopramide administration. Constipation, double vision, and numbness in fingers
and toes are not adverse effects of metoclopramide.

The patient receiving chemotherapy rings the call bell and reports the onset of nausea.
The nurse should prepare an as-needed dose of which medication?

Zolpidem

Ondansetron

Dexamethasone

Morphine sulfate - ANSWER: Ondansetron is a 5-HT3 receptor antagonist antiemetic
that is especially effective in reducing cancer chemotherapy-induced nausea and
vomiting. Morphine sulfate may cause nausea and vomiting. Zolpidem does not relieve
nausea and vomiting. Dexamethasone is usually used in combination with ondansetron
for acute and chemotherapy-induced emesis.

The nurse is caring for a patient who complains of abdominal pain and hematemesis.
Which new assessment finding(s) would indicate the patient is experiencing a decline in
condition?

Pallor and diaphoresis

Ecchymotic peripheral IV site

Guaiac-positive diarrhea stools

Heart rate 90, respiratory rate 20, BP 110/60 - ANSWER: Pallor and diaphoresis
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