NR 511 Midterm
Study online at https://quizlet.com/_8eor6u
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 postop-
erative 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.
, NR 511 Midterm
Study online at https://quizlet.com/_8eor6u
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
, NR 511 Midterm
Study online at https://quizlet.com/_8eor6u
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 bal-
ance 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 im-
provement.
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.
, NR 511 Midterm
Study online at https://quizlet.com/_8eor6u
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
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
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 anti-inflammatory drugs (NSAIDs).
3.Infection by Helicobacter pylori.
4.A family history of peptic ulcers.: 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
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): Amoxicillin (Amoxil) and
Study online at https://quizlet.com/_8eor6u
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 postop-
erative 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.
, NR 511 Midterm
Study online at https://quizlet.com/_8eor6u
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
, NR 511 Midterm
Study online at https://quizlet.com/_8eor6u
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 bal-
ance 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 im-
provement.
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.
, NR 511 Midterm
Study online at https://quizlet.com/_8eor6u
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
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
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 anti-inflammatory drugs (NSAIDs).
3.Infection by Helicobacter pylori.
4.A family history of peptic ulcers.: 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
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): Amoxicillin (Amoxil) and
