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NR 511 / NR511 Midterm Exam Review (2021) Chamberlain
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NR 511 / NR511 Midterm Exam Review
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NR 511 Midterm Exam1. 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, 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.
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 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."
- "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.
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?
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