NURS 5432- Final Disease, Non Pharm tx, Pharm tx Final Actual Exam Newest With Complete
Questions And Correct Detailed Answers| Brand New Version!
Question 1
A 4-year-old patient presents with gastroenteritis and is estimated to have 4% dehydration (mild).
Which non-pharmacologic intervention is most appropriate?
A) IV Bolus of Normal Saline at 20 mL/kg.
B) Oral rehydration with 50 mL/kg over 4 hours.
C) Oral rehydration with 100 mL/kg over 4 hours.
D) Clear liquid diet (apple juice and soda) for 24 hours.
E) Admitting the patient for nasogastric hydration.
Correct Answer: B) Oral rehydration with 50 mL/kg over 4 hours.
Rationale: For mild dehydration (typically defined as 3-5% weight loss), oral rehydration
therapy (ORT) is the gold standard. The recommended volume is 50 mL/kg administered
slowly over 4 hours. Option C is reserved for moderate dehydration (6-9%).
Question 2
A patient’s stool culture is positive for Giardia lamblia. Which of the following is the standard
pharmacologic treatment?
A) Vancomycin 125 mg PO QID.
B) Metronidazole 250 mg PO TID for 5-7 days.
C) Ciprofloxacin 500 mg PO BID for 7 days.
D) Azithromycin 500 mg once.
E) Bactrim DS BID for 3 days.
Correct Answer: B) Metronidazole 250 mg PO TID for 5-7 days.
Rationale: Metronidazole is the first-line treatment for Giardiasis. While higher doses are
used for other infections, 250 mg three times daily is the standard regimen for Giardia.
Question 3
Which of the following is the recommended dose of Vancomycin for a patient with a
confirmed C. difficile infection?
A) 125 mg IV every 6 hours.
B) 250 mg PO twice daily.
C) 125 mg PO four times daily.
D) 500 mg PO three times daily.
E) 1 gram PO once daily.
Correct Answer: C) Vancomycin 125 mg PO four times daily.
Rationale: Oral Vancomycin 125 mg QID is the preferred treatment for C. diff. It must be
given orally because IV vancomycin does not reach therapeutic concentrations in the gut
lumen to treat C. diff.
Question 4
A patient presents with inflammatory diarrhea. Culture reveals Shigella. Which antibiotic is most
, 2
appropriate?
A) Metronidazole.
B) Erythromycin.
C) Bactrim twice daily for 3-5 days.
D) Amoxicillin.
E) Fluconazole.
Correct Answer: C) Bactrim twice daily for 3-5 days.
Rationale: While many cases of Shigellosis are self-limiting, if treatment is indicated,
Trimethoprim-Sulfamethoxazole (Bactrim) is frequently used, though resistance patterns
should be monitored.
Question 5
A patient is diagnosed with Campylobacter enteritis. Which antibiotic treatment is
recommended?
A) Vancomycin 125 mg QID.
B) Metronidazole 500 mg TID.
C) Erythromycin four times daily for 5 days.
D) Doxycycline 100 mg BID.
E) Penicillin V 500 mg QID.
Correct Answer: C) Erythromycin four times daily for 5 days.
Rationale: Erythromycin (or Azithromycin) is the treatment of choice for Campylobacter.
Alternatively, Ciprofloxacin can be used, but Erythromycin is the traditional first-line
choice provided in the curriculum.
Question 6
A 25-year-old female experiences severe nausea with her viral gastroenteritis. What is the
appropriate adult dose of Promethazine?
A) 4 mg every 4 hours.
B) 8 mg every 8 hours.
C) 12.5-25 mg every 4-6 hours.
D) 0.5 mg/kg every 4-6 hours.
E) 50 mg every 2 hours.
Correct Answer: C) 12.5-25 mg every 4-6 hours.
Rationale: Promethazine (Phenergan) is an antihistamine/antiemetic. The standard adult
dose is 12.5 to 25 mg. Option D represents the pediatric weight-based dosing.
Question 7
What is a critical non-pharmacologic education point for a patient struggling with chronic
constipation?
A) Drink 0.5 liters of fluid daily.
B) Limit fiber intake to less than 10 grams daily.
, 3
C) Aim for 20-35 grams of fiber daily and 1.5-2 liters of fluid.
D) Use a stimulant laxative every morning.
E) Avoid regular exercise to prevent bowel irritation.
Correct Answer: C) 20-35 grams fiber daily, 1.5-2 liters fluid daily, regular toileting, exercise.
Rationale: Constipation management starts with lifestyle. Increasing fiber (to 20-35g) and
fluids (1.5-2L) provides bulk and hydration to the stool, while exercise and a routine
toileting schedule stimulate the natural urge to defecate.
Question 8
Which of the following classes is considered first-line pharmacologic therapy for chronic
constipation?
A) Opioid antagonists.
B) Bulking agents like psyllium.
C) Antibiotics like Rifaximin.
D) Antispasmodics like Dicyclomine.
E) Proton Pump Inhibitors.
Correct Answer: B) Bulking agents (psyllium), stool softeners (docusate), osmotic laxatives
(PEG).
Rationale: Bulking agents, stool softeners, and osmotic laxatives are considered the safest
and most effective first-line pharmacological treatments before moving to stimulant
laxatives.
Question 9
What is the standard adult dose for Ondansetron (Zofran) when treating acute nausea?
A) 2 mg every 12 hours.
B) 4 mg every 4 hours.
C) 8 mg every 8 hours.
D) 25 mg every 6 hours.
E) 10 mg four times daily.
Correct Answer: C) 8 mg every 8 hours.
Rationale: Ondansetron is a 5-HT3 receptor antagonist. The standard adult dose for general
nausea/vomiting is 8 mg every 8 hours. 4 mg is the standard pediatric dose for children
ages 4-11.
Question 10
A patient is going on a cruise and asks for motion sickness prevention. How should Scopolamine
be administered?
A) 10 mg PO once daily.
B) One patch applied behind the ear.
C) 12.5 mg IM injection.
) 1 drop in each eye.
, 4
E) 1 spray in each nostril.
Correct Answer: B) Apply one patch behind the ear.
Rationale: Scopolamine is an anticholinergic administered via a transdermal patch for
motion sickness. It should be applied at least 4 hours before the effect is needed.
Question 11
In the Step-Up approach for GERD, what is the first-line pharmacologic therapy for mild,
intermittent symptoms?
A) Daily PPI.
) H2 blockers given twice daily (e.g., famotidine).
C) Sucralfate before every meal.
D) Metoclopramide 10 mg TID.
E) Quadruple antibiotic therapy.
Correct Answer: B) H2 blockers given twice daily (famotidine, cimetidine).
Rationale: H2 receptor antagonists (H2RAs) are considered first-line for mild GERD. If
symptoms are severe or erosive esophagitis is suspected, the patient is stepped up to a PPI.
Question 12
To maximize the efficacy of Proton Pump Inhibitors (PPIs) in GERD management, when should
the patient be instructed to take them?
A) Right before bed.
B) 30-60 minutes before meals.
C) Immediately after a large meal.
D) Only when they feel heartburn.
E) With a glass of milk.
Correct Answer: B) 30-60 minutes before meals (except dexlansoprazole).
Rationale: PPIs inhibit the proton pump in the parietal cells. They are most effective when
taken 30-60 minutes before the first meal of the day because the pumps are most active
during mealtime.
Question 13
What is the recommended duration of PPI therapy for a patient diagnosed with erosive
esophagitis?
A) 2 weeks.
B) 4 weeks.
C) 8 weeks.
D) 6 months.
E) Lifelong.
Correct Answer: C) 8 weeks.
Rationale: Evidence-based guidelines suggest a standard 8-week course of PPIs to allow for
the healing of esophageal erosions.
Questions And Correct Detailed Answers| Brand New Version!
Question 1
A 4-year-old patient presents with gastroenteritis and is estimated to have 4% dehydration (mild).
Which non-pharmacologic intervention is most appropriate?
A) IV Bolus of Normal Saline at 20 mL/kg.
B) Oral rehydration with 50 mL/kg over 4 hours.
C) Oral rehydration with 100 mL/kg over 4 hours.
D) Clear liquid diet (apple juice and soda) for 24 hours.
E) Admitting the patient for nasogastric hydration.
Correct Answer: B) Oral rehydration with 50 mL/kg over 4 hours.
Rationale: For mild dehydration (typically defined as 3-5% weight loss), oral rehydration
therapy (ORT) is the gold standard. The recommended volume is 50 mL/kg administered
slowly over 4 hours. Option C is reserved for moderate dehydration (6-9%).
Question 2
A patient’s stool culture is positive for Giardia lamblia. Which of the following is the standard
pharmacologic treatment?
A) Vancomycin 125 mg PO QID.
B) Metronidazole 250 mg PO TID for 5-7 days.
C) Ciprofloxacin 500 mg PO BID for 7 days.
D) Azithromycin 500 mg once.
E) Bactrim DS BID for 3 days.
Correct Answer: B) Metronidazole 250 mg PO TID for 5-7 days.
Rationale: Metronidazole is the first-line treatment for Giardiasis. While higher doses are
used for other infections, 250 mg three times daily is the standard regimen for Giardia.
Question 3
Which of the following is the recommended dose of Vancomycin for a patient with a
confirmed C. difficile infection?
A) 125 mg IV every 6 hours.
B) 250 mg PO twice daily.
C) 125 mg PO four times daily.
D) 500 mg PO three times daily.
E) 1 gram PO once daily.
Correct Answer: C) Vancomycin 125 mg PO four times daily.
Rationale: Oral Vancomycin 125 mg QID is the preferred treatment for C. diff. It must be
given orally because IV vancomycin does not reach therapeutic concentrations in the gut
lumen to treat C. diff.
Question 4
A patient presents with inflammatory diarrhea. Culture reveals Shigella. Which antibiotic is most
, 2
appropriate?
A) Metronidazole.
B) Erythromycin.
C) Bactrim twice daily for 3-5 days.
D) Amoxicillin.
E) Fluconazole.
Correct Answer: C) Bactrim twice daily for 3-5 days.
Rationale: While many cases of Shigellosis are self-limiting, if treatment is indicated,
Trimethoprim-Sulfamethoxazole (Bactrim) is frequently used, though resistance patterns
should be monitored.
Question 5
A patient is diagnosed with Campylobacter enteritis. Which antibiotic treatment is
recommended?
A) Vancomycin 125 mg QID.
B) Metronidazole 500 mg TID.
C) Erythromycin four times daily for 5 days.
D) Doxycycline 100 mg BID.
E) Penicillin V 500 mg QID.
Correct Answer: C) Erythromycin four times daily for 5 days.
Rationale: Erythromycin (or Azithromycin) is the treatment of choice for Campylobacter.
Alternatively, Ciprofloxacin can be used, but Erythromycin is the traditional first-line
choice provided in the curriculum.
Question 6
A 25-year-old female experiences severe nausea with her viral gastroenteritis. What is the
appropriate adult dose of Promethazine?
A) 4 mg every 4 hours.
B) 8 mg every 8 hours.
C) 12.5-25 mg every 4-6 hours.
D) 0.5 mg/kg every 4-6 hours.
E) 50 mg every 2 hours.
Correct Answer: C) 12.5-25 mg every 4-6 hours.
Rationale: Promethazine (Phenergan) is an antihistamine/antiemetic. The standard adult
dose is 12.5 to 25 mg. Option D represents the pediatric weight-based dosing.
Question 7
What is a critical non-pharmacologic education point for a patient struggling with chronic
constipation?
A) Drink 0.5 liters of fluid daily.
B) Limit fiber intake to less than 10 grams daily.
, 3
C) Aim for 20-35 grams of fiber daily and 1.5-2 liters of fluid.
D) Use a stimulant laxative every morning.
E) Avoid regular exercise to prevent bowel irritation.
Correct Answer: C) 20-35 grams fiber daily, 1.5-2 liters fluid daily, regular toileting, exercise.
Rationale: Constipation management starts with lifestyle. Increasing fiber (to 20-35g) and
fluids (1.5-2L) provides bulk and hydration to the stool, while exercise and a routine
toileting schedule stimulate the natural urge to defecate.
Question 8
Which of the following classes is considered first-line pharmacologic therapy for chronic
constipation?
A) Opioid antagonists.
B) Bulking agents like psyllium.
C) Antibiotics like Rifaximin.
D) Antispasmodics like Dicyclomine.
E) Proton Pump Inhibitors.
Correct Answer: B) Bulking agents (psyllium), stool softeners (docusate), osmotic laxatives
(PEG).
Rationale: Bulking agents, stool softeners, and osmotic laxatives are considered the safest
and most effective first-line pharmacological treatments before moving to stimulant
laxatives.
Question 9
What is the standard adult dose for Ondansetron (Zofran) when treating acute nausea?
A) 2 mg every 12 hours.
B) 4 mg every 4 hours.
C) 8 mg every 8 hours.
D) 25 mg every 6 hours.
E) 10 mg four times daily.
Correct Answer: C) 8 mg every 8 hours.
Rationale: Ondansetron is a 5-HT3 receptor antagonist. The standard adult dose for general
nausea/vomiting is 8 mg every 8 hours. 4 mg is the standard pediatric dose for children
ages 4-11.
Question 10
A patient is going on a cruise and asks for motion sickness prevention. How should Scopolamine
be administered?
A) 10 mg PO once daily.
B) One patch applied behind the ear.
C) 12.5 mg IM injection.
) 1 drop in each eye.
, 4
E) 1 spray in each nostril.
Correct Answer: B) Apply one patch behind the ear.
Rationale: Scopolamine is an anticholinergic administered via a transdermal patch for
motion sickness. It should be applied at least 4 hours before the effect is needed.
Question 11
In the Step-Up approach for GERD, what is the first-line pharmacologic therapy for mild,
intermittent symptoms?
A) Daily PPI.
) H2 blockers given twice daily (e.g., famotidine).
C) Sucralfate before every meal.
D) Metoclopramide 10 mg TID.
E) Quadruple antibiotic therapy.
Correct Answer: B) H2 blockers given twice daily (famotidine, cimetidine).
Rationale: H2 receptor antagonists (H2RAs) are considered first-line for mild GERD. If
symptoms are severe or erosive esophagitis is suspected, the patient is stepped up to a PPI.
Question 12
To maximize the efficacy of Proton Pump Inhibitors (PPIs) in GERD management, when should
the patient be instructed to take them?
A) Right before bed.
B) 30-60 minutes before meals.
C) Immediately after a large meal.
D) Only when they feel heartburn.
E) With a glass of milk.
Correct Answer: B) 30-60 minutes before meals (except dexlansoprazole).
Rationale: PPIs inhibit the proton pump in the parietal cells. They are most effective when
taken 30-60 minutes before the first meal of the day because the pumps are most active
during mealtime.
Question 13
What is the recommended duration of PPI therapy for a patient diagnosed with erosive
esophagitis?
A) 2 weeks.
B) 4 weeks.
C) 8 weeks.
D) 6 months.
E) Lifelong.
Correct Answer: C) 8 weeks.
Rationale: Evidence-based guidelines suggest a standard 8-week course of PPIs to allow for
the healing of esophageal erosions.
