Mr. Johnson, 69 years of age, has had Meniere disease for several years. He has some
hearing loss but now has persistent vertigo. What treatment might be instituted to
relieve the vertigo?
1.A labyrinthectomy.
2.Pharmacological therapy.
3.A vestibular neurectomy.
4.Wearing an earplug in the ear that has the most hearing loss. - Answer 3.
A vestibular neurectomy.
Treatment for achalasia may include:
1. Balloon dilation of the lower esophageal sphincter.
2. Beta blockers.
3. A fundoplication.
4. An esophagogastrectomy. - Answer 1. Balloon dilation of the LES
Which oral medication might be used to treat a client with chronic cholelithiasis who is a
poor candidate for surgery?
1.Ursodiol (Actigall).
2.Ibuprofen (Advil).
3.Prednisone (Deltasone).
4.Surgery is the only answer. - Answer 1. Ursodiol (Actigall)
All of the following drugs are used in the management of nausea and vomiting. Which
drug acts to stimulate upper gastrointestinal motility, increasing lower esophageal
sphincter pressure through action on the chemoreceptor trigger zone?
,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). - Answer 3.Antidopaminergic
and cholinergic agents, such as metoclopramide (Reglan).
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. - Answer 4. IBS
Which is the most common presenting symptom of gastric cancer?
1.Weight loss.
2.Dysphagia.
3.Hematemesis.
4.Gastrointestinal bleeding. - Answer 1. Weight loss
The metabolism of which drug is not affected in Marsha, age 74?
1.Alcohol.
2.Anticonvulsants.
3.Psychotropics.
4.Oral anticoagulants. - Answer 1. Alcohol
Nausea is difficult to observe in a toddler. What would you ask to evaluate if a child is
nauseated?
1."Is your tummy sick?"
,2."Are you hungry?"
3."Are you eating as you normally do?"
4."Are you nauseous?" Answer 2.
"Are you hungry?"
Zena has just had a hemorrhoidectomy. You recognize she has not comprehended your
teaching when she says she will :
1. Soak the perineum in a sitz bath after each bowel movement for 1 to 2 weeks
postoperatively.
2. Drink at least 2000 mL of fluid daily.
3. Avoid dietary fiber for one month.
4. Take ordered stool softeners. Response Answer 3. Avoid dietary fiber for one month.
Stacy is a nursing student and must initiate her series of hepatitis B vaccinations. You
test her for a serological marker and the results indicate hepatitis B surface antibodies,
HBsAb. You tell Stacy that she:
1.Should initiate the hepatitis B series as soon as possible.
2.Should be retested because a single reading is not indicative of immunity.
3.Is immune to hepatitis B for life.
4. Has an acute hepatitis B infection. - Answer 3. Is permanently immune to hepatitis B.
Margie is a 52-year-old female who has a very stressful job and has just been diagnosed
with gastric ulcer. She states that she knows it is going to be malignant. What is your
response?
1."Don't worry. Gastric ulcers are not cancerous."
2."About 95% of gastric ulcers are benign."
3."You have about a 50% chance of having gastric cancer from your ulcer."
4."Even if it is cancer, surgery is 100% successful." - Answer 2."About 95% of gastric
ulcers are benign."
, 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. - Answer 2.Foods containing whey.
Susan, 59 years old, does not have any specific complaints on her annual examination.
However, she does have type 2 diabetes mellitus (DM), slight hypertension,
dyslipidemia, and central obesity. How would you diagnose her?
1. A healthy adult with several problems.
2. As having a glycemic event.
3. As having metabolic syndrome.
4. As having multiple organ dysfunction - Answer 3.
As having metabolic syndrome.
Tom has just been diagnosed with celiac disease. Which of the following might you tell
him?
1. There is a new pharmaceutical cure for celiac disease.
2. A strict gluten-free diet is the only treatment for celiac disease.
3. Your children will not be at a higher risk for developing this disease.
4. Celiac disease is much less common now in the United States than in the past. -
Answer 2. The only current treatment for celiac disease is a strict gluten-free diet.
Simon, 72 years old, states that he is worried because he only has a bowel movement
once every third day. You reinforce by stating:1.
"You should have two to three stools daily."
2."You should have one bowel movement daily."
3."You should have at least three bowel movements weekly."
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