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MARYVILLE NURS 623 EXAM 3 AND STUDY
GUIDE 2024 ACTUAL EXAM COMPLETE 200
QUESTIONS AND CORRE CT DETAILED
ANSWERS (VERIFIED ANSWERS )
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NURS 623 EXAM 3 MARYVILLE UNIVERSITY
How would you differentiate between a diagnosis of
gastroenteritis and irritable bowel syndrome? - ANSWER- IBS:
is chronic LLQ pain diarrhea, constipation, passing mucous and occurs 1 or more times a week over 3 months.
Gastroenteritis: (stomach bug) is caused by a bacteria, (no
constipation) diarrhea, N/V symptom limited to several days
How do you treat travelers diarrhea? - ANSWER- azithromycin 1000mg 1 one dose; or 500mg x 3 d Cipro 750 mg one dose Levofloxacin 500 mg 1-3 days
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differential diagnosis, for a patient presents with diarrhea -
ANSWER- Acute: Gastritis, medication induced, lactose
intolerant
Chronic: CRhons, IBS, IBD,
mode of transmission for Hepatitis A - ANSWER- fecal-oral
mode of transmission for Hepatitis B - ANSWER- direct contact with infected blood or blood products or by sexual contact
mode of transmission for Hepatitis C - ANSWER- blood, semen, maternal-neonate
Describe the clinical presentation of appendicitis? (Subjective and objective findings) - ANSWER- Vague symptoms first 24 hours, worse when walking or jumping, N/V, low grade temp, +Rovsings, Psoas, obturator, mcburneys
Describe the various maneuvers for diagnosing appendicitis? -
ANSWER- ROVSING'S: Deep Papation LLQ do sudden
unexpected release; Positive if causes Tenderness to RLQ.
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PSOAS: Pt on back and raise RT leg against pressure or on left
side extend RT leg at hip; Positive if increased pain
OBTURATOR: Pt on back with the right hip and knee flexed
the examiner slowly rotates the right leg internally; Positive if pain over RLQ
McBURNEY'S: pressure applied to McBurney's point (halfway
between the umbilicus and the anterior spine of the ilium); Positive if pain with pressure applied
Describe the clinical presentation for Gastroesophageal Reflux Disease (GERD)? - ANSWER- heartburn, regurgitation, water brash (reflex salivation), sour taste in morning, belching,
coughing, and hoarseness. Objective: only sign may be occult
blood in stool.
How is GERD diagnosed (when to refer to GI)? - ANSWER- With symptoms, sometimes with upper endo; refer if failed treatment of step 2- after 6 weeks of treatment
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Discuss the patient education regarding lifestyle changes for management of GERD. - ANSWER- lifestyle changes including diet weight loss, raising the head of their bed 6-8 inches, avoid nicotine products avoid recumbency or sleeping for 3 to 4 hours after a meal, avoid bedtime snacks, avoid fatty and late meals, foods such as chocolate, alcohol, peppermint, caffeine, onions, garlic, citrus, and tomatoes, wearing loose comfortable clothing, and starting a routine exercise and weight loss program
Describe medical management of GERD? - ANSWER- step-up:
LIFESTYLE changes, PRN OTC H2ra and antacid; PPI; referral
Step-down: starts with PPI then step down until Sx under control
46 year old male complains of dysphasia hoarseness and cough he states he wakes up with a sour taste in his mouth. What is the most likely cause of the patient symptoms? - ANSWER- GERD
Managment of peptic/gastric ulcer - ANSWER- *relieve pain, heal the ulcer, and prevent complications/reoccurrence *PHARMACOLOGICAL therapy is the foundation of management (H2Ra, PPI, antacids, antibx w/H-pylori)
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