Chamberlain NR 511 Midterm UPDATED
ACTUAL Questions and CORRECT
Answers
What are common causes of N/V associated with gastritis? - CORRECT ANSWER -
Alcohol, NSAIDs, ASA, ABX, and illicit substances
What is the most common cause of nausea and vomiting? - CORRECT ANSWER -Acute
Gastroenteritis (AGE)
What are some manifestations of AGE? - CORRECT ANSWER -Nausea, vomiting, and
diarrhea, fever, abdominal pain. May also include fatigue, malaise, anorexia, tenesmus and
borborygmus.
How is the severity of AGE gauged? - CORRECT 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? - CORRECT
ANSWER -Travel, dining locations, ABX history..
What happens to the pH of the stomach when antacids are taken and how does this affect
bacteria? - CORRECT 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? - CORRECT 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? - CORRECT
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? - CORRECT
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? - CORRECT ANSWER -
Incubation periods greater than 14 hours and the initial symptom of vomiting.
If a patient presents with AGE and reports bloody stools, what can be understood about the
reason for blood in the stool/ - CORRECT ANSWER -Mucosal damage and inflammatory
process secondary to invasive pathogens.
What do frothy stools and flatus suggest? - CORRECT ANSWER -Malabsorption
problem.
Patients with prolonged AGE illness who are malnourished may present with edema. What is the
reason? - CORRECT ANSWER -Hypoalbuminemia
T or F: Chronic diarrhea usually has a noninfectious etiology. - CORRECT ANSWER -
True
T or F: Acute diarrhea usually is caused by infectious agents or toxins - CORRECT
ANSWER -True
What is the most common viral pathogen causing AGE in adults? - CORRECT
ANSWER -Norovirus
What is the most common viral pathogen causing AGE in pediatrics? - CORRECT
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 -
CORRECT ANSWER -False
,T or F: A CBC will help distinguish between viral and bacterial AGE - CORRECT
ANSWER -False
When are stool studies warranted? - CORRECT 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? - CORRECT ANSWER -
Shigella, Campylobacter, and E. coli.
What should the clinician do if the patient develops diarrhea after initiation of completion of
antibiotic therapy? - CORRECT ANSWER -Test for C. diff.
What are some DDx of AGE, particularly in patients with persistent or chronic diarrhea and
severe abdominal pain? - CORRECT 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? - CORRECT
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? - CORRECT ANSWER -Only supportive
treatment is initiated since AGE is usually self-limiting and resolves within 1 week after onset of
symptoms.
How such patients with evidence of dehydration be treated initially? - CORRECT
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? - CORRECT
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. - CORRECT ANSWER -True. Bactrim, Ciprofloxacin,
Norfloxacin, Floxacin.
T or F: Antibiotic prophylaxis for patients traveling to high-risk areas is appropriate. -
CORRECT ANSWER -True
How effective is antibiotic prophylaxis for patients traveling to high-risk areas? - CORRECT
ANSWER -90% effective
What does antibiotic prophylaxis treatment consist of? - CORRECT ANSWER -Bactrim,
Ciprofloxacin, Norfloxacin, or Floxacin given once daily until 2 days after returning home.
What is an appropriate symptomatic treatment for patients < 65 years or age with moderate to
severe diarrhea? - CORRECT ANSWER -Two-day course of Loperamide (Imodium)
What is an appropriate symptomatic treatment for patients < 65 years or age with significant
vomiting? - CORRECT ANSWER -Two-day course of Zofran or Phenergan.
What is the best way to prevent AGE? - CORRECT ANSWER -Hand washing.
T or F: Kids can attend daycare with infectious diarrhea as long as they're separated from other
children. - CORRECT ANSWER -False! Not until the diarrhea has stopped.
If pain is present in the right lower quadrant, what might be the etiology related to bowel
disorders? - CORRECT ANSWER -IBD, IBS, Infectious Colitis, and Constipation
ACTUAL Questions and CORRECT
Answers
What are common causes of N/V associated with gastritis? - CORRECT ANSWER -
Alcohol, NSAIDs, ASA, ABX, and illicit substances
What is the most common cause of nausea and vomiting? - CORRECT ANSWER -Acute
Gastroenteritis (AGE)
What are some manifestations of AGE? - CORRECT ANSWER -Nausea, vomiting, and
diarrhea, fever, abdominal pain. May also include fatigue, malaise, anorexia, tenesmus and
borborygmus.
How is the severity of AGE gauged? - CORRECT 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? - CORRECT
ANSWER -Travel, dining locations, ABX history..
What happens to the pH of the stomach when antacids are taken and how does this affect
bacteria? - CORRECT 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? - CORRECT 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? - CORRECT
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? - CORRECT
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? - CORRECT ANSWER -
Incubation periods greater than 14 hours and the initial symptom of vomiting.
If a patient presents with AGE and reports bloody stools, what can be understood about the
reason for blood in the stool/ - CORRECT ANSWER -Mucosal damage and inflammatory
process secondary to invasive pathogens.
What do frothy stools and flatus suggest? - CORRECT ANSWER -Malabsorption
problem.
Patients with prolonged AGE illness who are malnourished may present with edema. What is the
reason? - CORRECT ANSWER -Hypoalbuminemia
T or F: Chronic diarrhea usually has a noninfectious etiology. - CORRECT ANSWER -
True
T or F: Acute diarrhea usually is caused by infectious agents or toxins - CORRECT
ANSWER -True
What is the most common viral pathogen causing AGE in adults? - CORRECT
ANSWER -Norovirus
What is the most common viral pathogen causing AGE in pediatrics? - CORRECT
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 -
CORRECT ANSWER -False
,T or F: A CBC will help distinguish between viral and bacterial AGE - CORRECT
ANSWER -False
When are stool studies warranted? - CORRECT 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? - CORRECT ANSWER -
Shigella, Campylobacter, and E. coli.
What should the clinician do if the patient develops diarrhea after initiation of completion of
antibiotic therapy? - CORRECT ANSWER -Test for C. diff.
What are some DDx of AGE, particularly in patients with persistent or chronic diarrhea and
severe abdominal pain? - CORRECT 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? - CORRECT
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? - CORRECT ANSWER -Only supportive
treatment is initiated since AGE is usually self-limiting and resolves within 1 week after onset of
symptoms.
How such patients with evidence of dehydration be treated initially? - CORRECT
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? - CORRECT
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. - CORRECT ANSWER -True. Bactrim, Ciprofloxacin,
Norfloxacin, Floxacin.
T or F: Antibiotic prophylaxis for patients traveling to high-risk areas is appropriate. -
CORRECT ANSWER -True
How effective is antibiotic prophylaxis for patients traveling to high-risk areas? - CORRECT
ANSWER -90% effective
What does antibiotic prophylaxis treatment consist of? - CORRECT ANSWER -Bactrim,
Ciprofloxacin, Norfloxacin, or Floxacin given once daily until 2 days after returning home.
What is an appropriate symptomatic treatment for patients < 65 years or age with moderate to
severe diarrhea? - CORRECT ANSWER -Two-day course of Loperamide (Imodium)
What is an appropriate symptomatic treatment for patients < 65 years or age with significant
vomiting? - CORRECT ANSWER -Two-day course of Zofran or Phenergan.
What is the best way to prevent AGE? - CORRECT ANSWER -Hand washing.
T or F: Kids can attend daycare with infectious diarrhea as long as they're separated from other
children. - CORRECT ANSWER -False! Not until the diarrhea has stopped.
If pain is present in the right lower quadrant, what might be the etiology related to bowel
disorders? - CORRECT ANSWER -IBD, IBS, Infectious Colitis, and Constipation
