NR 511 Midterm
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1. 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): 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
2. 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.
4.Irritable bowel syndrome.: IBS
rationale: IBS does not produce a friction rub
3. 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.: 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,
, NR 511 Midterm
Study online at https://quizlet.com/_8eor6u
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.
4. 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.": 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, 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.
5. 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.: Colorectal cancer
rationale: A middle-aged or older client with an abrupt change in defecation pattern must be evaluated for colorectal
cancer
6. 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.: Cheese
rationale: Cheese, bread, pasta, rice, pretzels, and yogurt all help to thicken stools.
, NR 511 Midterm
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7. 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."
3."There is no possibility of transmission through razors or toothbrushes."
4."Abstain from sex during your period.": 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.
8. Your client's 2-month-old daughter is admitted with gastroenteritis and dehy-
dration 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 sys-
tem."
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.": "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.
9. 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.
, NR 511 Midterm
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4.Convalescent.: Icteric
rationale: In the icteric stage of viral hepatitis, there is jaundice, dark urine, and light-colored stools. There are continued
prodromal complaints, with gradual improvement.
10. Rose, a client with gastroesophageal reflux disease (GERD), has many other
concurrent conditions. In teaching Rose about medications to avoid, what do
you recommend she refrain from using?
1.Antibiotics.
2.Nonsteroidal anti-inflammatory drugs (NSAIDs).
3.Oral contraceptives.
4.Antifungals.: NSAIDS
rationale: Clients with GERD should avoid taking NSAIDs because they tend to aggravate the already irritated gastric
mucosa.
11. Lucy, age 49, has pain in both the left and right lower quadrants. What might
you suspect?
1.A gastric ulcer.
2.Gastritis.
3.Pelvic inflammatory disease.
4.Pancreatitis.: PID
rationale: The pain associated with pelvic inflammatory disease can be palpated in both the right and left lower
quadrants.
12. In a 2-month-old infant with vomiting and diarrhea, the most effective way
of determining a fluid deficit is to check for:
1.Decreased peripheral perfusion.
2.Hyperventilation.
3.Irritability.
4. Hyperthermia.: Decreased peripheral perfusion
rationale: In a 2-month-old infant with vomiting and diarrhea, the most effective way of determining a fluid deficit is to
check for decreased peripheral perfusion, dry oral mucous membranes, and sunken fontanels. The body compensates
Study online at https://quizlet.com/_8eor6u
1. 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): 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
2. 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.
4.Irritable bowel syndrome.: IBS
rationale: IBS does not produce a friction rub
3. 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.: 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,
, NR 511 Midterm
Study online at https://quizlet.com/_8eor6u
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.
4. 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.": 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, 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.
5. 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.: Colorectal cancer
rationale: A middle-aged or older client with an abrupt change in defecation pattern must be evaluated for colorectal
cancer
6. 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.: Cheese
rationale: Cheese, bread, pasta, rice, pretzels, and yogurt all help to thicken stools.
, NR 511 Midterm
Study online at https://quizlet.com/_8eor6u
7. 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."
3."There is no possibility of transmission through razors or toothbrushes."
4."Abstain from sex during your period.": 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.
8. Your client's 2-month-old daughter is admitted with gastroenteritis and dehy-
dration 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 sys-
tem."
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.": "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.
9. 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.
, NR 511 Midterm
Study online at https://quizlet.com/_8eor6u
4.Convalescent.: Icteric
rationale: In the icteric stage of viral hepatitis, there is jaundice, dark urine, and light-colored stools. There are continued
prodromal complaints, with gradual improvement.
10. Rose, a client with gastroesophageal reflux disease (GERD), has many other
concurrent conditions. In teaching Rose about medications to avoid, what do
you recommend she refrain from using?
1.Antibiotics.
2.Nonsteroidal anti-inflammatory drugs (NSAIDs).
3.Oral contraceptives.
4.Antifungals.: NSAIDS
rationale: Clients with GERD should avoid taking NSAIDs because they tend to aggravate the already irritated gastric
mucosa.
11. Lucy, age 49, has pain in both the left and right lower quadrants. What might
you suspect?
1.A gastric ulcer.
2.Gastritis.
3.Pelvic inflammatory disease.
4.Pancreatitis.: PID
rationale: The pain associated with pelvic inflammatory disease can be palpated in both the right and left lower
quadrants.
12. In a 2-month-old infant with vomiting and diarrhea, the most effective way
of determining a fluid deficit is to check for:
1.Decreased peripheral perfusion.
2.Hyperventilation.
3.Irritability.
4. Hyperthermia.: Decreased peripheral perfusion
rationale: In a 2-month-old infant with vomiting and diarrhea, the most effective way of determining a fluid deficit is to
check for decreased peripheral perfusion, dry oral mucous membranes, and sunken fontanels. The body compensates
