NR 511 Midterm exam NR511 MIDTERM EXAM
200+ QUESTIONS AND CORRECT
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): 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
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.: IBS
rationale: IBS does not produce a friction rub
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.: 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.
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.": 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.
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.: Colorectal cancer
rationale: A middle-aged or older client with an abrupt change in defecation pattern
must be evaluated for colorectal cancer
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.: Cheese
rationale: Cheese, bread, pasta, rice, pretzels, and yogurt all help to thicken stools.
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.": 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.
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.": "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.
9. Sandy, age 52, presents with jaundice, dark urine, and light-colored
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.: 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.
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.: NSAIDS
rationale: Clients with GERD should avoid taking NSAIDs because they tend to
aggravate the already irritated gastric mucosa.
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.:
PID
rationale: The pain associated with pelvic inflammatory disease can be palpated in
both the right and left lower quadrants.
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.: Decreased peripheral perfusion
200+ QUESTIONS AND CORRECT
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): 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
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.: IBS
rationale: IBS does not produce a friction rub
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.: 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.
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.": 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.
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.: Colorectal cancer
rationale: A middle-aged or older client with an abrupt change in defecation pattern
must be evaluated for colorectal cancer
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.: Cheese
rationale: Cheese, bread, pasta, rice, pretzels, and yogurt all help to thicken stools.
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.": 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.
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.": "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.
9. Sandy, age 52, presents with jaundice, dark urine, and light-colored
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.: 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.
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.: NSAIDS
rationale: Clients with GERD should avoid taking NSAIDs because they tend to
aggravate the already irritated gastric mucosa.
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.:
PID
rationale: The pain associated with pelvic inflammatory disease can be palpated in
both the right and left lower quadrants.
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.: Decreased peripheral perfusion
