NR-511 Differential Diagnosis & Primary Care Practicum
Exam Questions and Correct Answers 2024
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) -
(answers)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
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. - (answers)IBS
,rationale: IBS does not produce a friction rub
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. - (answers)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.
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." - (answers)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.
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. - (answers)Colorectal cancer
rationale: A middle-aged or older client with an abrupt change in defecation
pattern must be evaluated for colorectal cancer
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. - (answers)Cheese
rationale: Cheese, bread, pasta, rice, pretzels, and yogurt all help to thicken stools.
, 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." - (answers)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.
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." - (answers)"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
Exam Questions and Correct Answers 2024
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) -
(answers)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
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. - (answers)IBS
,rationale: IBS does not produce a friction rub
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. - (answers)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.
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." - (answers)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.
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. - (answers)Colorectal cancer
rationale: A middle-aged or older client with an abrupt change in defecation
pattern must be evaluated for colorectal cancer
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. - (answers)Cheese
rationale: Cheese, bread, pasta, rice, pretzels, and yogurt all help to thicken stools.
, 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." - (answers)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.
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." - (answers)"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
