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NR 511 LATEST ACTUAL EXAM 2025 [NEWEST]
If a patient presents with AGE and reports bloody stools, what can be understood
about the reason for blood in the stool/ - ANSWER-Mucosal damage and
inflammatory process secondary to invasive pathogens.
What do frothy stools and flatus suggest? - ANSWER-Malabsorption problem.
Patients with prolonged AGE illness who are malnourished may present with
edema. What is the reason? - ANSWER-Hypoalbuminemia
T or F: Chronic diarrhea usually has a noninfectious etiology. - ANSWER-True
T or F: Acute diarrhea usually is caused by infectious agents or toxins - ANSWER-
True
What is the most common viral pathogen causing AGE in adults? - ANSWER-
Norovirus
What is the most common viral pathogen causing AGE in pediatrics? - ANSWER-
Rotavirus. This has been greatly reduced since the introduction of the rotavirus
vaccine.
,T or F: Stool studies are indicated in the absence of bloody diarrhea or systemic
disease - ANSWER-False
T or F: A CBC will help distinguish between viral and bacterial AGE - ANSWER-
False
When are stool studies warranted? - ANSWER-Severe or prolonged diarrhea, a
fever > 38.5ºC, bloody stools or stools that test positive for leukocytes or occult
blood.
What are common pathogens involved in Traveler's Diarrhea? - ANSWER-
Shigella, Campylobacter, and E. coli.
What should the clinician do if the patient develops diarrhea after initiation of
completion of antibiotic therapy? - ANSWER-Test for C. diff.
What are some DDx of AGE, particularly in patients with persistent or chronic
diarrhea and severe abdominal pain? - ANSWER-IBS, IBD, ischemic bowel
disease, partial bowel obstruction, small bowel diverticulosis.
What are some red flag symptoms that may indicate the need for hospitalization? -
ANSWER-Hypovolemia, dehydration, abnormal electrolytes, decreased renal
function, bloody stool/rectal bleeding, weight loss, severe abdominal pain,
prolonged symptoms greater than 1 week, pregnancy, advanced age, history of
hospitalization or antibiotic use in the last 3-6 months.
,What is the usual course of treatment for AGE? - ANSWER-Only supportive
treatment is initiated since AGE is usually self-limiting and resolves within 1 week
after onset of symptoms.
What are common causes of N/V associated with gastritis? - ANSWER-Alcohol,
NSAIDs, ASA, ABX, and illicit substances
What is the most common cause of nausea and vomiting? - ANSWER-Acute
Gastroenteritis (AGE)
What are some manifestations of AGE? - ANSWER-Nausea, vomiting, and
diarrhea, fever, abdominal pain. May also include fatigue, malaise, anorexia,
tenesmus and borborygmus.
How is the severity of AGE gauged? - ANSWER-Dehydration secondary to
profuse watery diarrhea, fever greater than 101ºF (38.3ºC), vomiting, or dysentery.
What are important parts of a patient's history when AGE is suspected? -
ANSWER-Travel, dining locations, ABX history..
What happens to the pH of the stomach when antacids are taken and how does this
affect bacteria? - ANSWER-High pH can make it easier for bacteria to survive and
cause and infection.
How does motility of the GI tract affect bacteria colonization? - ANSWER-Small
bowel stasis as a result of obstruction, diverticulitis, or blind loop syndrome
frequently develop an overgrowth of bacteria within the stagnant segment.
, Which immunoglobulin may protect the GI tract against invading organisms? -
ANSWER-IgA...may also help protect against a future attack by the same
pathogen.
Onset of N/V begin within 6 hours after exposure. Is this bacterial or viral? -
ANSWER-Bacterial: time frame suggests food poisoning resulting from the
ingestion of a preformed toxin such as that of Bacillus cereus.
What two indications are highly suggestive of viral AGE? - ANSWER-Incubation
periods greater than 14 hours and the initial symptom of vomiting.
How such patients with evidence of dehydration be treated initially? - ANSWER-
Fluid repletion and nutrition. Sports drinks aren't as effective as specific electrolyte
replenishing drinks.
At what point should a patient be referred to the hospital for dehydration? -
ANSWER-Signs of hypovolemia such as hypotension, tachycardia, pallor, and
poor skin turgor.
T of F: Empiric antimicrobial therapy is recommended for patients with severe
diarrhea suspected form traveling. - ANSWER-True. Bactrim, Ciprofloxacin,
Norfloxacin, Floxacin.
T or F: Antibiotic prophylaxis for patients traveling to high-risk areas is
appropriate. - ANSWER-True
How effective is antibiotic prophylaxis for patients traveling to high-risk areas? -
ANSWER-90% effective