NURS-172 Exam 2 UPDATED ACTUAL
QUESTIONS AND CORRECT ANSWERS
Which of the following would contribute to a client's excessive weight gain? (Select all that
apply.)(There are 3 correct answers)
1. A hypothalamus lesion
2. Hyperthyroidism
3. High levels of serotonin
4. Cushing's disease
5. Diabetes mellitus - CORRECT ANSWER 1. A hypothalamus lesion
4. Cushing's disease
5. Diabetes mellitus
Lesions in the appetite and satiety centers in the hypothalamus may contribute to overeating
and lead to obesity. Hypothyroidism, not hyperthyroidism, is a problem that interferes with
basal metabolism and may lead to weight gain. Weight gain can also occur in response to the
decreased insulin production of diabetes mellitus and the increased cortisone production of
Cushing's disease. New evidence also exists to indicate that low levels of the neurotransmitter
serotonin may play a role in compulsive eating.
A nurse should identify topiramate (Topamax) as the drug of choice for which of the
following conditions? (Select all that apply.)(There are 2 correct answers)
1. Bingeing and purging with a diagnosis of bulimia nervosa
2. Weight loss with a diagnosis of anorexia nervosa
3. Amenorrhea with a diagnosis of anorexia nervosa
4. Emaciation with a diagnosis of bulimia nervosa
5. Binge eating with a diagnosis of obesity - CORRECT ANSWER 1. Bingeing and
purging with a diagnosis of bulimia nervosa
5. Binge eating with a diagnosis of obesity
,The nurse should identify that topiramate is the drug of choice when treating binge eating
with a diagnosis of obesity or bingeing and purging with a diagnosis of bulimia nervosa.
Topiramate is an anticonvulsant that produces a significant decline in binge frequency and
reduction in body weight.
A nursing instructor is teaching about the DSM-5 criteria for the diagnosis of binge-eating
disorder. Which of the following student statements indicates that further instruction is
needed? (Select all that apply.)(There are 3 correct answers)
1. "In this disorder, distress regarding binge eating is absent."
2. "In this disorder, binge eating occurs exclusively during the course of bulimia nervosa."
3. "In this disorder, binge eating occurs, on average, at least once a week for three months."
4. "In this disorder, binge eating occurs, on average, at least two days a week for six months."
5. "In this disorder, distress regarding binge eating is present." - CORRECT
ANSWER 1. "In this disorder, distress regarding binge eating is absent."
2. "In this disorder, binge eating occurs exclusively during the course of bulimia nervosa."
4. "In this disorder, binge eating occurs, on average, at least two days a week for six months."
According to the DSM-5 criteria for the diagnosis of binge-eating disorder, binge eating
should not occur exclusively during the course of anorexia nervosa or bulimia nervosa. The
new time frame criteria in the DSM-5 states that binge eating must occur, on average, at least
once a week for three months not two days a week for six months. The DSM-5 criteria states
that distress regarding binge eating would be present.
Anorexia nervosa deals with issues of control and a struggle between dependence and
independence.
True
False - CORRECT ANSWER True. Anorexia nervosa deals with issues of control and a
struggle between dependence and independence. It is often associated with parent-child
conflicts about dependency issues. Children often feel as though their bodies and weight are
their only areas of control. It occurs primarily in adolescents and young adults. It is more
common in females than males.
,Bulimia deals with loss of control (binge eating) and guilt (purging).
True
False - CORRECT ANSWER True. Bulimia deals with loss of control (binge eating)
and guilt (purging). Bulimia is characterized by eating excessive amounts of food followed
by self-induced purging by vomiting, misuse of laxatives, diuretics or other medications,
fasting, and/or excessive exercise.
Fatty foods are the common food intolerances for clients with cholelithiasis.
True
False - CORRECT ANSWER True. Fatty foods are the common food intolerances for
clients with cholelithiasis.
Teaching in relation to home management following a laparoscopic cholecystectomy should
include
a. reporting any bile-colored drainage or pus from any incision.
b. keeping the bandages on the puncture sites for 48 hours.
c. using over-the-counter antiemetics if nausea and vomiting occur.
d. emptying and measuring the contents of the bile bag from the T tube every day. -
CORRECT ANSWER a. reporting any bile-colored drainage or pus from any incision.
The following discharge instructions are taught to the patient and caregiver after a
laparoscopic cholecystectomy. First, remove the bandages on the puncture site the day after
surgery and shower. Second, notify the surgeon if any of the following signs and symptoms
occur: redness, swelling, bile-colored drainage or pus from any incision; and severe
abdominal pain, nausea, vomiting, fever, or chills. Third, gradually resume normal activities.
Fourth, return to work within 1 week of surgery. Fifth, resume a usual diet, but a low-fat diet
is usually better tolerated for several weeks after surgery. T tube is not inserted when a
lap.chole. is performed.
, The nursing management of the client with cholecystitis associated with cholelithiasis is
based on the knowledge that
a. laparoscopic cholecystectomy is the treatment of choice in most clients who are
symptomatic.
b. shock-wave therapy sould be tried initially.
c. once gallstones are removed, they tend not to recur.
d. the disorder can be successfully treated with oral bile salts that dissolve gallstones. -
CORRECT ANSWER a. laparoscopic cholecystectomy is the treatment of choice in
most clients who are symptomatic.
Laparoscopic cholecystectomy is the treatment of choice for symptomatic cholelithiasis
because of its success. Approximately 90% of cholecystectomies are done laparoscopically.
Usually shock-wave therapy (ESWL) and oral dissolution therapy are used together.
Gallstones are not usually treated with drugs because gallstones may recur. Endoscopic
retrograde cholangiopancreatography (ERCP) is especially effective in removing common
bile duct stones.
To care for a T-tube in a client following an open/incisional cholecystectomy, the nurse
a. attaches the tube to low continuous suction.
b. keeps the tube supported and free of kinks.
c. clamps the tube when ambulating the client.
d. irrigates the tube with 10-mL sterile saline every 2 to 4 hours. - CORRECT
ANSWER b. keeps the tube supported and free of kinks.
The T-tube drains bile from the common bile duct until swelling from trauma has subsided
and bile can freely enter the duodenum. The tube is placed to gravity drainage and should be
kept open and free from kinks to prevent bile from backing up into the liver. The tube is not
normally irrigated. Drainage from the T-tube is initially bloody and then turns a greenish-
brown color. The drainage is measured as output. The amount of the expected drainage will
range from 500 to 1000 mL/day.
QUESTIONS AND CORRECT ANSWERS
Which of the following would contribute to a client's excessive weight gain? (Select all that
apply.)(There are 3 correct answers)
1. A hypothalamus lesion
2. Hyperthyroidism
3. High levels of serotonin
4. Cushing's disease
5. Diabetes mellitus - CORRECT ANSWER 1. A hypothalamus lesion
4. Cushing's disease
5. Diabetes mellitus
Lesions in the appetite and satiety centers in the hypothalamus may contribute to overeating
and lead to obesity. Hypothyroidism, not hyperthyroidism, is a problem that interferes with
basal metabolism and may lead to weight gain. Weight gain can also occur in response to the
decreased insulin production of diabetes mellitus and the increased cortisone production of
Cushing's disease. New evidence also exists to indicate that low levels of the neurotransmitter
serotonin may play a role in compulsive eating.
A nurse should identify topiramate (Topamax) as the drug of choice for which of the
following conditions? (Select all that apply.)(There are 2 correct answers)
1. Bingeing and purging with a diagnosis of bulimia nervosa
2. Weight loss with a diagnosis of anorexia nervosa
3. Amenorrhea with a diagnosis of anorexia nervosa
4. Emaciation with a diagnosis of bulimia nervosa
5. Binge eating with a diagnosis of obesity - CORRECT ANSWER 1. Bingeing and
purging with a diagnosis of bulimia nervosa
5. Binge eating with a diagnosis of obesity
,The nurse should identify that topiramate is the drug of choice when treating binge eating
with a diagnosis of obesity or bingeing and purging with a diagnosis of bulimia nervosa.
Topiramate is an anticonvulsant that produces a significant decline in binge frequency and
reduction in body weight.
A nursing instructor is teaching about the DSM-5 criteria for the diagnosis of binge-eating
disorder. Which of the following student statements indicates that further instruction is
needed? (Select all that apply.)(There are 3 correct answers)
1. "In this disorder, distress regarding binge eating is absent."
2. "In this disorder, binge eating occurs exclusively during the course of bulimia nervosa."
3. "In this disorder, binge eating occurs, on average, at least once a week for three months."
4. "In this disorder, binge eating occurs, on average, at least two days a week for six months."
5. "In this disorder, distress regarding binge eating is present." - CORRECT
ANSWER 1. "In this disorder, distress regarding binge eating is absent."
2. "In this disorder, binge eating occurs exclusively during the course of bulimia nervosa."
4. "In this disorder, binge eating occurs, on average, at least two days a week for six months."
According to the DSM-5 criteria for the diagnosis of binge-eating disorder, binge eating
should not occur exclusively during the course of anorexia nervosa or bulimia nervosa. The
new time frame criteria in the DSM-5 states that binge eating must occur, on average, at least
once a week for three months not two days a week for six months. The DSM-5 criteria states
that distress regarding binge eating would be present.
Anorexia nervosa deals with issues of control and a struggle between dependence and
independence.
True
False - CORRECT ANSWER True. Anorexia nervosa deals with issues of control and a
struggle between dependence and independence. It is often associated with parent-child
conflicts about dependency issues. Children often feel as though their bodies and weight are
their only areas of control. It occurs primarily in adolescents and young adults. It is more
common in females than males.
,Bulimia deals with loss of control (binge eating) and guilt (purging).
True
False - CORRECT ANSWER True. Bulimia deals with loss of control (binge eating)
and guilt (purging). Bulimia is characterized by eating excessive amounts of food followed
by self-induced purging by vomiting, misuse of laxatives, diuretics or other medications,
fasting, and/or excessive exercise.
Fatty foods are the common food intolerances for clients with cholelithiasis.
True
False - CORRECT ANSWER True. Fatty foods are the common food intolerances for
clients with cholelithiasis.
Teaching in relation to home management following a laparoscopic cholecystectomy should
include
a. reporting any bile-colored drainage or pus from any incision.
b. keeping the bandages on the puncture sites for 48 hours.
c. using over-the-counter antiemetics if nausea and vomiting occur.
d. emptying and measuring the contents of the bile bag from the T tube every day. -
CORRECT ANSWER a. reporting any bile-colored drainage or pus from any incision.
The following discharge instructions are taught to the patient and caregiver after a
laparoscopic cholecystectomy. First, remove the bandages on the puncture site the day after
surgery and shower. Second, notify the surgeon if any of the following signs and symptoms
occur: redness, swelling, bile-colored drainage or pus from any incision; and severe
abdominal pain, nausea, vomiting, fever, or chills. Third, gradually resume normal activities.
Fourth, return to work within 1 week of surgery. Fifth, resume a usual diet, but a low-fat diet
is usually better tolerated for several weeks after surgery. T tube is not inserted when a
lap.chole. is performed.
, The nursing management of the client with cholecystitis associated with cholelithiasis is
based on the knowledge that
a. laparoscopic cholecystectomy is the treatment of choice in most clients who are
symptomatic.
b. shock-wave therapy sould be tried initially.
c. once gallstones are removed, they tend not to recur.
d. the disorder can be successfully treated with oral bile salts that dissolve gallstones. -
CORRECT ANSWER a. laparoscopic cholecystectomy is the treatment of choice in
most clients who are symptomatic.
Laparoscopic cholecystectomy is the treatment of choice for symptomatic cholelithiasis
because of its success. Approximately 90% of cholecystectomies are done laparoscopically.
Usually shock-wave therapy (ESWL) and oral dissolution therapy are used together.
Gallstones are not usually treated with drugs because gallstones may recur. Endoscopic
retrograde cholangiopancreatography (ERCP) is especially effective in removing common
bile duct stones.
To care for a T-tube in a client following an open/incisional cholecystectomy, the nurse
a. attaches the tube to low continuous suction.
b. keeps the tube supported and free of kinks.
c. clamps the tube when ambulating the client.
d. irrigates the tube with 10-mL sterile saline every 2 to 4 hours. - CORRECT
ANSWER b. keeps the tube supported and free of kinks.
The T-tube drains bile from the common bile duct until swelling from trauma has subsided
and bile can freely enter the duodenum. The tube is placed to gravity drainage and should be
kept open and free from kinks to prevent bile from backing up into the liver. The tube is not
normally irrigated. Drainage from the T-tube is initially bloody and then turns a greenish-
brown color. The drainage is measured as output. The amount of the expected drainage will
range from 500 to 1000 mL/day.
