Page 1 of 146
NEW MODIFIED NR 511 MIDTERM EXAM
WITH STUDY GUIDE QUESTIONS AND
ANSWERS WITH RATIONALE TESTED AND
APPROVED!!!
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) --CORRECT ANSWER--
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.
, Page 2 of 146
4.Irritable bowel syndrome. --CORRECT ANSWER--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. --CORRECT ANSWER--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." --CORRECT ANSWER--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,
, Page 3 of 146
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. --CORRECT ANSWER--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. --CORRECT ANSWER--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."
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3."There is no possibility of transmission through razors or toothbrushes."
4."Abstain from sex during your period." --CORRECT ANSWER--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." --CORRECT ANSWER--"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 is rapidly followed
by water along the osmotic gradient, resulting in watery stools.
Sandy, age 52, presents with jaundice, dark urine, and light-colored stools, stating that she is
slightly improved over last week's symptoms. Which stage of viral hepatitis do you suspect?
1.Incubation.
2.Prodromal.
3.Icteric.
NEW MODIFIED NR 511 MIDTERM EXAM
WITH STUDY GUIDE QUESTIONS AND
ANSWERS WITH RATIONALE TESTED AND
APPROVED!!!
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) --CORRECT ANSWER--
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.
, Page 2 of 146
4.Irritable bowel syndrome. --CORRECT ANSWER--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. --CORRECT ANSWER--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." --CORRECT ANSWER--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,
, Page 3 of 146
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. --CORRECT ANSWER--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. --CORRECT ANSWER--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."
, Page 4 of 146
3."There is no possibility of transmission through razors or toothbrushes."
4."Abstain from sex during your period." --CORRECT ANSWER--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." --CORRECT ANSWER--"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 is rapidly followed
by water along the osmotic gradient, resulting in watery stools.
Sandy, age 52, presents with jaundice, dark urine, and light-colored stools, stating that she is
slightly improved over last week's symptoms. Which stage of viral hepatitis do you suspect?
1.Incubation.
2.Prodromal.
3.Icteric.
