NUR 372 - EXAM 2 QUESTIONS AND ANSWERS LATEST UPDATE 2025-2026
Causes of Diarrhea - Answers 1. Primary cause is infectious organisms (viral, e.coli, parasites,
C.diff)
2. Osmotic diarrhea from lactose intolerance or drugs (PPI, ABX)
3. Malabsorption Problems (Celiac disease, short bowel syndrome, Crohn's disease)
4. Inflammatory Disrders (Crohn's/Inflammatory Bowel Disease)
5. Immunocopromised (enteric feedings)
Primary Assessment of Pt with N/V/D - Answers -History of food intake
-Current medications
-Travel to foreign countries
-Interpersonal contacts, HX of diarrhea
-Labs (look for signs of dehydration, elevated WBCs, deficiencies in iron and folate -- anemia)
-Electrolyte abnormalities
-Stool C & S
Assessing N/V - Answers - Is it do to regurgitation?
- Is it projectile?
- Look at color of emesis
- fecal odor in emesis
- Abdominal pain
- s/s of dehydration
Assessing Diarrhea - Answers - Stool exam (blood, mucus, WBCs, parasites
cultures to ID infectious organisms)
- Abdominal pain
- s/s of dehydration
Nursing Care for N/V/D - Answers - Symptom relief with medications or non-drug therapy
(peppermint oil, ginger, positioning/breathing, cool room temp, icepacks/cool rags)
,- Initiate appropriate isolation protocols
- Keep NPO at first a progress slowly to low residue diet (broth, crackers, toast)
- N/G tube use if necessary
- Give IV fluids with electrolytes and glucose
- Replace electrolytes: Gatorade (careful of NaCl overload)
- Prevent skin breakdown
T or F ? Contact precautions should be taken on all cases of diarrhea until it is diagnosed -
Answers TRUE
C.diff Isolation - Answers contact precaution with gloves/gowns, proper cleaned equipment, and
10% bleach solution
Complications of N/V/D - Answers dehydration, electrolyte imbalances, aspiration (look for gag
relfex; alcohol can impair), Mallory Weiss tears (between stomach and esophagus), dental
caries, and skin breakdown
WDL Electrolytes - Answers -Na: 135 to 145
-K: 3.5 to 5.0
-Mg: 1.5 - 2.5
GERD (acid reflux) - Answers - Causes/RF: incompetent esophageal sphincter, hiatal hernia,
obesity, smoking, pregancy
- Symptoms: heartburn, dyspepsia, hypersalivation, non-cardiac chest pain, wheezing/coughing,
dyspnea, hoarseness, sore throat, lump in throat, choking, regurgitation
- Dx: H&P, upper GI endoscopy with bx, barium swallow, motility studies, pH monitoring,
radionucleotide studies
- Complications: scar tissue from inflamm, dysphagia, Barrett's esophagus, cancer
Heartburn - Answers -Most common clinical manifestation of GERD
-Burning, tight sensation felt beneath the lower sternum and spreading upward to throat or jaw
-Felt intermittently
-Relieved by milk, alkaline substances, or water
Regurgitation - Answers -Effortless return of food or gastric contents from stomach into
esophagus or mouth
, -Described as hot, bitter, or sour liquid coming into the mouth or throat
GERD-related chest pain - Answers can mimic angina; described as burning or squeezing and
can radiate to the back, neck, jaw, or arms; unlike angina, GERD-related chest pain is relieved
with antacids.
Nutritional therapy for GERD - Answers -Decrease high-fat foods
-Take fluids between rather than with meals
-Avoid milk products at night
-Avoid late-night snacking or meals
-Avoid chocolate, peppermint, caffeine, and fatty foods (these decrease LES pressure)
-Avoid foods that irritate the esophagus (tomatoes, orange juice, red wine, cola)
-Weight reduction therapy-if indicated
Lifestyle Modifications for GERD - Answers - stop smoking
- no or decreased alcohol consumption
- eat small, frequent meals
- avoid late night meals or snacks
- avoid lying down for 3 hours after eating
- elevate HOB with 4-6 inch blocks (30 degrees)
- avoid tight clothing
- chew gum
Magnesium vs Aluminum Antacids - Answers magnesium antacids can cause diarrhea while
aluminum antacids can cause constipation
PPIs (-prazoles) - Answers used for GERD or PUD and inhibits H+, K+, and ATPase (the enzyme
that generates gastric acid); most common SE is a H/A; take before first meal of day
H2 Blockers (-tidine) - Answers used for GERD or PUD; H2 receptor in parietal cells which
secrete gastric acid are suppressed; has very few SE
Surgical therapy for GERD is necessary if... - Answers -Conservative therapy fails
-Medication intolerance
Causes of Diarrhea - Answers 1. Primary cause is infectious organisms (viral, e.coli, parasites,
C.diff)
2. Osmotic diarrhea from lactose intolerance or drugs (PPI, ABX)
3. Malabsorption Problems (Celiac disease, short bowel syndrome, Crohn's disease)
4. Inflammatory Disrders (Crohn's/Inflammatory Bowel Disease)
5. Immunocopromised (enteric feedings)
Primary Assessment of Pt with N/V/D - Answers -History of food intake
-Current medications
-Travel to foreign countries
-Interpersonal contacts, HX of diarrhea
-Labs (look for signs of dehydration, elevated WBCs, deficiencies in iron and folate -- anemia)
-Electrolyte abnormalities
-Stool C & S
Assessing N/V - Answers - Is it do to regurgitation?
- Is it projectile?
- Look at color of emesis
- fecal odor in emesis
- Abdominal pain
- s/s of dehydration
Assessing Diarrhea - Answers - Stool exam (blood, mucus, WBCs, parasites
cultures to ID infectious organisms)
- Abdominal pain
- s/s of dehydration
Nursing Care for N/V/D - Answers - Symptom relief with medications or non-drug therapy
(peppermint oil, ginger, positioning/breathing, cool room temp, icepacks/cool rags)
,- Initiate appropriate isolation protocols
- Keep NPO at first a progress slowly to low residue diet (broth, crackers, toast)
- N/G tube use if necessary
- Give IV fluids with electrolytes and glucose
- Replace electrolytes: Gatorade (careful of NaCl overload)
- Prevent skin breakdown
T or F ? Contact precautions should be taken on all cases of diarrhea until it is diagnosed -
Answers TRUE
C.diff Isolation - Answers contact precaution with gloves/gowns, proper cleaned equipment, and
10% bleach solution
Complications of N/V/D - Answers dehydration, electrolyte imbalances, aspiration (look for gag
relfex; alcohol can impair), Mallory Weiss tears (between stomach and esophagus), dental
caries, and skin breakdown
WDL Electrolytes - Answers -Na: 135 to 145
-K: 3.5 to 5.0
-Mg: 1.5 - 2.5
GERD (acid reflux) - Answers - Causes/RF: incompetent esophageal sphincter, hiatal hernia,
obesity, smoking, pregancy
- Symptoms: heartburn, dyspepsia, hypersalivation, non-cardiac chest pain, wheezing/coughing,
dyspnea, hoarseness, sore throat, lump in throat, choking, regurgitation
- Dx: H&P, upper GI endoscopy with bx, barium swallow, motility studies, pH monitoring,
radionucleotide studies
- Complications: scar tissue from inflamm, dysphagia, Barrett's esophagus, cancer
Heartburn - Answers -Most common clinical manifestation of GERD
-Burning, tight sensation felt beneath the lower sternum and spreading upward to throat or jaw
-Felt intermittently
-Relieved by milk, alkaline substances, or water
Regurgitation - Answers -Effortless return of food or gastric contents from stomach into
esophagus or mouth
, -Described as hot, bitter, or sour liquid coming into the mouth or throat
GERD-related chest pain - Answers can mimic angina; described as burning or squeezing and
can radiate to the back, neck, jaw, or arms; unlike angina, GERD-related chest pain is relieved
with antacids.
Nutritional therapy for GERD - Answers -Decrease high-fat foods
-Take fluids between rather than with meals
-Avoid milk products at night
-Avoid late-night snacking or meals
-Avoid chocolate, peppermint, caffeine, and fatty foods (these decrease LES pressure)
-Avoid foods that irritate the esophagus (tomatoes, orange juice, red wine, cola)
-Weight reduction therapy-if indicated
Lifestyle Modifications for GERD - Answers - stop smoking
- no or decreased alcohol consumption
- eat small, frequent meals
- avoid late night meals or snacks
- avoid lying down for 3 hours after eating
- elevate HOB with 4-6 inch blocks (30 degrees)
- avoid tight clothing
- chew gum
Magnesium vs Aluminum Antacids - Answers magnesium antacids can cause diarrhea while
aluminum antacids can cause constipation
PPIs (-prazoles) - Answers used for GERD or PUD and inhibits H+, K+, and ATPase (the enzyme
that generates gastric acid); most common SE is a H/A; take before first meal of day
H2 Blockers (-tidine) - Answers used for GERD or PUD; H2 receptor in parietal cells which
secrete gastric acid are suppressed; has very few SE
Surgical therapy for GERD is necessary if... - Answers -Conservative therapy fails
-Medication intolerance
