NSG 533 ADVANCED PHARMACOLOGY – CHAPTER
20 NAUSEA AND VOMITING, EXAM 1
COMPREHENSIVE NURSING STUDY GUIDE 2026/2027
LATEST WITH Q&A
What are therapy or toxin induced causes of N/V? - ✔✔✔ANSWER-
1. Antibiotics
2. Antiarrhythmics
3. Aspirin
4. Cancer chemotherapy
5. Digoxin
6. Iron
7. Lead
8. Marijuana
9. Oral anti-diabetics
10. Oral contraceptives
11. Opioids
12. Anticonvulsants
1 | Pa g e
,13. Radiation therapy
14. Ethanol
Hyperemesis Gravidarum - ✔✔✔ANSWER-Potentially life- threatening
conditions of prolonged nausea, vomiting, and resultant malnutrition.
Define Nausea and Vomiting - ✔✔✔ANSWER-Nausea is the
subjective feeling of the need to vomit. Autonomic symptoms of
pallor, tachycardia, diaphoresis and salivation often accompany
nausea.
Vomiting (emesis) is a forceful oral expulsion of upper GI contents due to
sustained contractions in the abdominal and thoracic musculature.
Describe the pathophysiologic mechanisms of nausea and vomiting
- ✔✔✔ANSWER-Specific areas in the central nervous system and GI
tract are stimulated when the body is exposed to noxious stimuli or GI
irritants: the chemoreceptor trigger zone (CTZ) in the area postrema of
the fourth ventricle of the brain, the vestibular apparatus, visceral
afferents from the GI tract, and cerebral cortex. These in turn stimulate
regions of the reticular areas of the medulla within the brainstem. This
area is the central vomiting center, which coordinates the impulses sent
2 | Pa g e
, to the salivation and respiratory centers, and the pharyngeal, GI, and
abdominal muscles that lead to vomiting.
Explain the Chemoreceptor Trigger Zone (CTZ) -✔✔✔ANSWER-The
CTZ, located outside the blood-brain barrier, is exposed to cerebrospinal
fluid and blood. Therefore, it is easily stimulated by uremia, acidosis, and
circulating toxins such as chemotherapeutic agents. The CTZ has many 5
HTP (serotonin) type 3 (5-HT3), neurokin-1 (NK1) and dopamine (D2)
receptors. They respond to GI distention, mucosal irritation and infection.
What are endocrine/metabolic causes of N/V? - ✔✔✔ANSWER-1.
Pregnancy (NVP or hyperemesis gravidarum)
2. Uremia
3. Diabetic keto acidosis
4. Hyperthyroidism
5. Parathyroid disease
6. Addison disease
Post-operative N/V risk factors - ✔✔✔ANSWER-*Occurs in 30% of
surgical patients overall and up to 70% of high-risk patients
3 | Pa g e
20 NAUSEA AND VOMITING, EXAM 1
COMPREHENSIVE NURSING STUDY GUIDE 2026/2027
LATEST WITH Q&A
What are therapy or toxin induced causes of N/V? - ✔✔✔ANSWER-
1. Antibiotics
2. Antiarrhythmics
3. Aspirin
4. Cancer chemotherapy
5. Digoxin
6. Iron
7. Lead
8. Marijuana
9. Oral anti-diabetics
10. Oral contraceptives
11. Opioids
12. Anticonvulsants
1 | Pa g e
,13. Radiation therapy
14. Ethanol
Hyperemesis Gravidarum - ✔✔✔ANSWER-Potentially life- threatening
conditions of prolonged nausea, vomiting, and resultant malnutrition.
Define Nausea and Vomiting - ✔✔✔ANSWER-Nausea is the
subjective feeling of the need to vomit. Autonomic symptoms of
pallor, tachycardia, diaphoresis and salivation often accompany
nausea.
Vomiting (emesis) is a forceful oral expulsion of upper GI contents due to
sustained contractions in the abdominal and thoracic musculature.
Describe the pathophysiologic mechanisms of nausea and vomiting
- ✔✔✔ANSWER-Specific areas in the central nervous system and GI
tract are stimulated when the body is exposed to noxious stimuli or GI
irritants: the chemoreceptor trigger zone (CTZ) in the area postrema of
the fourth ventricle of the brain, the vestibular apparatus, visceral
afferents from the GI tract, and cerebral cortex. These in turn stimulate
regions of the reticular areas of the medulla within the brainstem. This
area is the central vomiting center, which coordinates the impulses sent
2 | Pa g e
, to the salivation and respiratory centers, and the pharyngeal, GI, and
abdominal muscles that lead to vomiting.
Explain the Chemoreceptor Trigger Zone (CTZ) -✔✔✔ANSWER-The
CTZ, located outside the blood-brain barrier, is exposed to cerebrospinal
fluid and blood. Therefore, it is easily stimulated by uremia, acidosis, and
circulating toxins such as chemotherapeutic agents. The CTZ has many 5
HTP (serotonin) type 3 (5-HT3), neurokin-1 (NK1) and dopamine (D2)
receptors. They respond to GI distention, mucosal irritation and infection.
What are endocrine/metabolic causes of N/V? - ✔✔✔ANSWER-1.
Pregnancy (NVP or hyperemesis gravidarum)
2. Uremia
3. Diabetic keto acidosis
4. Hyperthyroidism
5. Parathyroid disease
6. Addison disease
Post-operative N/V risk factors - ✔✔✔ANSWER-*Occurs in 30% of
surgical patients overall and up to 70% of high-risk patients
3 | Pa g e
