Quiz for Exam2

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Question 1
Multiple-choice

Which of the following interventions has been found to retard the advancement of chronic kidney disease?
a. Calcium supplementation
b. Erythropoietin
c. Insulin
d. ACE inhibitors or A-II receptor blockers

Select the best answer

d. ACE inhibitors or A-II receptor blockers

b. remove the usual stimuli for pancreatic secretion.

b. being treated with high-dose oral glucocorticoids.

Absence of peristalsis in a portion of the esophagus

Question 2
Multiple-choice

Candidates for the use of sibutramine (Meridia) who have no other risk factors should have a BMI of at least
a. 25.
b. 27.
c. 30.
d. 35.

Select the best answer

Functional obstructions are due to conditions that inhibit peristalsis, such as narcotics, anesthesia, surgical manipulation, peritonitis, hypokalemia, and spinal cord injuries. Functional obstructions are characterized by the absence of bowel sounds.

ANS: C
Vitamin A is needed for dark adaptation; night blindness often is the first indication of deficiency.
Easy bruising is a sign of clotting abnormalities and would be related to a deficiency of vitamin K.
Sore tongue is a sign of niacin deficiency.
Sore, bleeding gums are a sign of vitamin C deficiency.

ANS: C 30

In the absence of other risk factors, candidates for the use of sibutramine should have a BMI of 30 or higher.
If other risk factors are present, such as hypertension, diabetes, or hyperlipidemia, candidates for the use of sibutramine should have a BMI of 27 or higher.

ANS: d. Chronic renal failure

Magnesium can accumulate to toxic levels in patients with renal dysfunction. The nurse should withhold the medication.
Magnesium hydroxide is not contraindicated for patients with hemorrhoids, prostatitis, or cirrhosis.

Question 3
Multiple-choice

At his most recent clinic visit, a patient with end-stage renal disease is noted to have edema, congestive signs in the pulmonary system, and a pericardial friction rub. Appropriate therapy at this time would include
a. initiation of dialysis.
b. fluid restriction.
c. antibiotics.
d. phlebotomy.

Select the best answer

a. initiation of dialysis.

Herniations in the bowel wall

b. acute tubular necrosis.

a preneoplastic lesion

Question 4
Multiple-choice

A biliary cause of acute pancreatitis is suggested by which of the following laboratory results?
a. Elevated serum lipase
b. Elevated serum amylase
c. Elevated serum glucose
d. Elevated serum alkaline phosphatase

Select the best answer

Herniations in the bowel wall

Elevated serum alkaline phosphatase

c. insufficient active vitamin D.

The glomerular filtration rate (GFR)

Question 5
Multiple-choice

A patient has been taking phentermine (Adipex-P) for 12 weeks for weight loss. At a follow-up appointment, the patient reports that the medication is no longer causing appetite suppression. The nurse should advise the patient that the prescriber most likely will
a. switch to another agent in this class.
b. discontinue the drug.
c. increase the dosage.
d. continue the current dosage.

Select the best answer

ANS: D Lorazepam (Ativan)

One of the principal affects of lorazepam is its ability to suppress anticipatory nausea. It is used in combination regimens to suppress chemotherapy-induced nausea and vomiting (CINV).
Loperamide and ranitidine do not affect CINV.
Dronabinol is contraindicated in patients with a psychiatric illness.

ANS: b. discontinue the drug

Tolerance is common and may be seen in 6 to 12 weeks. The appropriate response is to discontinue the drug rather than increase the dosage.
Switching to another agent in this class will not be effective because of cross-tolerance.
Increasing the dosage is not indicated.
Continuing the medication when it is ineffective is unwise.

ANS: A “It creates a protective barrier against pepsin and acid.”

Sucralfate promotes ulcer healing by creating a protective barrier against acid and pepsin.
Sucralfate does not reduce gastric acid secretion.
Sucralfate does not inhibit the enzyme that generates gastric acid.
Sucralfate does not enhance prostaglandin synthesis.

ANS: b. these agents can effectively reduce abdominal pain.

The nurse should explain that these agents can effectively reduce abdominal pain. Depression is not associated with diarrhea.
TCAs do not relieve constipation.
Lifting depression does not alter the symptoms of IBS (ie, abdominal pain, constipation, and/or diarrhea).
TCAs do not alter dopaminergic effects in the GI tract.

Question 6
Multiple-choice

The nurse is caring for a psychiatric patient with breast cancer who is just about to receive chemotherapy. What antiemetic would be most appropriate for this patient, who is anticipating nausea?
a. Loperamide (Imodium)
b. Ranitidine (Zantac)
c. Dronabinol (Marinol)
d. Lorazepam (Ativan)

Select the best answer

ANS: a. Severe spasms of the tongue, face, and neck

The nurse should administer diphenhydramine for extrapyramidal reactions (ie, severe spasms of the tongue, neck, and face), which are caused by long-term use of metoclopramide.
IV diphenhydramine is not indicated for dry mouth, urinary retention, diarrhea, or constipation.

ANS: D Lorazepam (Ativan)

One of the principal affects of lorazepam is its ability to suppress anticipatory nausea. It is used in combination regimens to suppress chemotherapy-induced nausea and vomiting (CINV).
Loperamide and ranitidine do not affect CINV.
Dronabinol is contraindicated in patients with a psychiatric illness.

ANS: C
Scurvy is the result of a vitamin C deficiency; this statement indicates that further teaching is needed.
Vitamin A deficiency can cause night blindness; no further teaching is needed.
Vitamin E is know for its antioxidant effects; no further teaching is needed.
Folic acid deficiency may lead to birth defects; no further teaching is needed.

ANS: A, B, C
a. Oxycodone/acetaminophen (Percocet)
b. Aluminum hydroxide
c. Benztropine (Cogentin)

Drugs that most likely would contribute to constipation are the opioids (oxycodone/acetaminophen), anticholinergics (benztropine), and some antacids (aluminum hydroxide).
Ranitidine and diazepam are not associated with constipation.

Question 7
Multiple-choice

A patient with pancreatitis may experience muscle cramps and laryngospasm secondary to
a. alkalosis.
b. hyperglycemia.
c. hypocalcemia.
d. hypermagnesemia.

Select the best answer

stomach growling

Painful swallowing

c. hypocalcemia.

d. Bloody stools

Question 8
Multiple-choice

Renal artery stenosis, hypertension, and nephrosclerosis may all contribute to renal failure by causing
a. hydronephrosis.
b. renal ischemia.
c. nephrosis.
d. renal inflammation.

Select the best answer

Peptic Ulcer Disease

c. hypocalcemia.

a. bloody diarrhea.

b. renal ischemia.

Question 9
Multiple-choice

The nurse has admitted a patient to the unit who has been experiencing bowel problems. The patient is to receive a bowel preparation for a radiologic procedure. The nurse would anticipate administration of which of the following medications?
a. Psyllium (Metamucil)
b. Docusate sodium (Colace)
c. Castor oil
d. Bisacodyl (Dulcolax)

Select the best answer

ANS: B Vit B

Minimal storage of the B vitamins occurs in the body, therefore frequent ingestion is needed to replenish them.
Vitamins A, D, and E are fat soluble and are stored in the body.

ANS: C Castor oil is the only laxative listed that is indicated for bowel preparation for radiologic procedures.
Psyllium, docusate sodium, and bisacodyl are not indicated for bowel preparation for radiologic procedures.

Barrett esophagus

A complication of chronic gastroesophageal reflux disease that represents replacement of the normal squamous epithelium of the distal esophagus by columnar tissue. Considered to be a preneoplastic condition.

ANS: B
A deficiency of vitamin C can lead to scurvy.
A folic acid deficiency leads to neural tube defects in the fetus.
A nicotinic acid deficiency leads to pellagra.
A deficiency of riboflavin results in angular stomatitis and sore throat.

Question 10
Multiple-choice

A patient with gouty arthritis develops renal calculi. The composition of these calculi is most likely to be
a. calcium oxalate.
b. struvite.
c. cysteine.
d. uric acid crystals.

Select the best answer

b. Escherichia coli.

Peptic Ulcer Disease

c. Painless hematuria

d. uric acid crystals.

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