NU 160 Exam 4 Spring 2025

Correct Answer A: Furosemide

Explanation:

A. Furosemide

Furosemide is a loop diuretic and is often prescribed to clients with Menière’s disease. The purpose is to reduce fluid volume within the body, which may help lower the fluid pressure in the inner ear. By doing so, it helps decrease the frequency and severity of vertigo episodes, one of the main symptoms of Menière’s disease.

Why the Other Options Are Incorrect:

B. Oxybutynin

Oxybutynin is an anticholinergic medication used to treat urinary incontinence and overactive bladder. It has no effect on the inner ear or vertigo and is not appropriate for Menière’s disease.

C. Warfarin

Warfarin is an anticoagulant used to prevent blood clots. It has no therapeutic benefit in treating Menière’s disease and is not part of the treatment protocol for this condition.

D. Pantoprazole

Pantoprazole is a proton pump inhibitor used to manage acid-related gastrointestinal disorders such as GERD. It is not used in the treatment of inner ear conditions like Menière’s disease.

Correct Answers:

A. Grape juice

B. Lemon gelatin

D. Broth

Explanation:

Clear liquid diets are typically prescribed after surgery to provide hydration and maintain electrolyte balance while minimizing the workload on the digestive system. Clear liquids are transparent and can be easily absorbed by the stomach. The items listed below are appropriate for a clear liquid diet:

A. Grape juice

Grape juice is a clear liquid that does not contain any solids, making it suitable for a clear liquid diet. However, it should be strained to ensure that there are no pulp particles, which would make it unsuitable.

B. Lemon gelatin

Lemon gelatin is considered a clear liquid since it dissolves into a liquid form, making it appropriate for a clear liquid diet. The key here is that gelatin should not contain any solid particles or dairy components, which lemon gelatin does not.

D. Broth

Broth is a common item on a clear liquid diet. It is clear, contains no solid food particles, and provides hydration and electrolytes, which are essential after surgery.

Why the Other Options Are Incorrect:

C. Custard

Custard is not suitable for a clear liquid diet because it contains dairy and has a thicker consistency. A clear liquid diet is intended to consist of liquids that do not contain solid food particles or dairy products, so custard would not meet the criteria.

E. Nonfat milk

Nonfat milk is not considered a clear liquid because it is a dairy product with a thicker consistency that is not easily absorbed by the digestive system following surgery. It should be avoided during the clear liquid phase of the diet.

Correct Answer B: Oral herpes simplex virus type 1

Explanation:

B. Oral herpes simplex virus type 1

The description of the lesion, particularly its yellow-grey base and painful nature, suggests a herpes simplex virus (HSV) type 1 infection. HSV-1 is a common cause of cold sores or fever blisters, which can present as painful, erythematous lesions with a yellow-grey center on the buccal mucosa or lips. These lesions are typically associated with a primary or recurrent infection of the virus, and the pain and appearance are characteristic of this condition.

Why the Other Options Are Incorrect:

A. Oral cancer

Oral cancer typically presents as persistent, non-healing ulcers or lumps in the mouth that may not have a yellow-grey base. These lesions usually do not resolve on their own and may be painless initially. The lesion described in the question is painful, which is more consistent with an infectious cause like HSV-1. Oral cancer also tends to present in other areas of the mouth, such as the tongue or floor of the mouth, and is generally not localized to the buccal mucosa with the specific characteristics described here.

C. Oral aphthous ulcer

An oral aphthous ulcer (canker sore) is also a common cause of painful lesions in the mouth. However, these ulcers typically have a white or yellow center with a red border rather than a yellow-grey base. Additionally, aphthous ulcers are usually not as erythematous as the lesion described and are not typically associated with viral infections. They often occur in individuals without other systemic infections or conditions.

D. Crohn's disease

While Crohn’s disease can cause oral lesions (such as cobblestone mucosa or deep ulcers in the mouth), these lesions are often part of a more systemic inflammatory condition. Crohn's-related mouth ulcers are generally larger, deeper, and more chronic than the acute, painful, and erythematous lesion described here. The lesion described in the question is more characteristic of a viral infection, such as HSV-1, rather than an inflammatory disease like Crohn’s.

Correct Answer D: Prolonged exposure to loud noises

Explanation:

D. Prolonged exposure to loud noises

Prolonged or repeated exposure to loud noises is a well-established risk factor for noise-induced hearing loss (NIHL). This type of hearing damage occurs when the delicate hair cells in the cochlea are damaged due to sustained high-decibel environments, such as construction sites, loud music venues, military settings, or industrial workplaces. NIHL is often permanent and preventable with proper use of hearing protection like earplugs or earmuffs.

Why the Other Options Are Incorrect:

A. Alcohol use disorder

While chronic alcohol use can lead to various neurological issues, it is not a primary or direct cause of hearing loss. Some studies suggest a potential association with auditory processing issues, but it is not recognized as a leading cause of hearing damage.

B. Exposure to environmental toxins

Certain ototoxic chemicals, such as heavy metals (like lead or mercury) or industrial solvents, can contribute to hearing loss. However, this option is too vague ("environmental toxins") and less directly associated than the clear and commonly known cause of noise exposure.

C. Contact with excessive heat

Heat exposure does not contribute to hearing loss. While heat stroke or burns can have serious health consequences, they are unrelated to auditory function unless there is direct trauma to the ear.

Correct Answers:

A. Stress

C. NSAIDs

E. Tobacco

Explanation:

A. Stress

Stress does not directly cause Crohn’s disease, but it can trigger or worsen symptoms. Emotional stress can lead to immune and hormonal responses that exacerbate intestinal inflammation, contributing to flare-ups.

C. NSAIDs

Nonsteroidal anti-inflammatory drugs (such as ibuprofen and naproxen) can irritate the gastrointestinal lining and are known to aggravate inflammatory bowel diseases like Crohn's. Their use is associated with increased risk of disease exacerbation.

E. Tobacco

Smoking is a well-established risk factor for both the development and worsening of Crohn’s disease. Tobacco use can increase the severity and frequency of flares, reduce the effectiveness of treatment, and lead to more complications.

Why the Other Options Are Incorrect:

B. Vitamin supplements

Vitamin supplements are generally beneficial in Crohn’s disease, as patients are often at risk of nutrient deficiencies due to malabsorption. They do not contribute to exacerbations and may help maintain remission.

D. Exercise

Exercise is usually encouraged in patients with Crohn’s disease. Regular physical activity can help reduce stress, improve mood, and support overall health. It is not known to trigger disease flares.

Correct Answer C: My contact lenses just don't fit like they used to.

Explanation:

C. My contact lenses just don't fit like they used to.

This statement suggests that the client may be experiencing vision changes related to cataracts. Cataracts occur when the lens of the eye becomes cloudy, which can cause blurry or distorted vision. As the lens becomes more clouded, it may affect the fit of contact lenses, which are designed to fit against a clear cornea and lens. Cataracts can change the way the lens works, leading to discomfort or difficulty with contact lenses.

Why the Other Options Are Incorrect:

A. My vision is almost gone from the center part of my eye.

This statement is more indicative of macular degeneration, a condition that affects the central part of the retina, leading to central vision loss. Cataracts typically cause blurred or cloudy vision across the entire field of vision, not specifically in the central part.

B. I can't see anything from the sides of my eyes.

This statement is suggestive of glaucoma, which leads to peripheral vision loss due to damage to the optic nerve. Cataracts do not typically cause loss of peripheral vision; they cause overall blurry or cloudy vision due to the clouding of the lens.

D. I keep seeing flashes of lights moving around in my eye.

This description is more consistent with retinal detachment or vitreous detachment rather than cataracts. Flashes of light (known as photopsia) are often associated with retinal issues and should be evaluated by an eye specialist. Cataracts do not typically cause flashes of light in the vision, though they can cause blurry vision or halos around lights.

Correct Answer A: Avoid drinking alcohol.

Explanation:

A. Avoid drinking alcohol.

Alcohol can irritate the stomach lining and increase the risk of further damage during an acute episode of gastritis. It can also exacerbate the symptoms and delay healing. Therefore, it is essential to advise clients to avoid alcohol to prevent worsening of gastritis.

Why the Other Options Are Incorrect:

B. Limit drinking milk.

While milk might temporarily soothe the stomach, it can actually stimulate acid production in the stomach after a short period of time, potentially worsening the symptoms of gastritis. Thus, it's generally advised to avoid excessive milk consumption during an acute gastritis episode.

C. Limit strenuous exercise.

Strenuous exercise is not directly related to the treatment of gastritis. However, it is important to rest and avoid activities that can cause stress on the body, especially when experiencing acute gastritis. This statement isn't as relevant to gastritis management as avoiding alcohol or milk.

D. Take NSAIDs for pain.

NSAIDs (nonsteroidal anti-inflammatory drugs) should be avoided in the case of gastritis because they can irritate the stomach lining and worsen symptoms. NSAIDs are known to increase the risk of gastrointestinal bleeding and ulcer formation, which is particularly problematic for clients with gastritis.

Correct Answer B: H. pylori infection

Explanation:

The most common cause of peptic ulcer disease (PUD) is an infection with Helicobacter pylori (H. pylori). This bacterium damages the mucosal lining of the stomach and duodenum, leading to ulcers. H. pylori infection is the leading cause of gastric and duodenal ulcers, and it is usually treated with antibiotics and proton pump inhibitors (PPIs).

Why the Other Options Are Incorrect:

A. Chronic stress:

While stress can exacerbate existing ulcers or lead to increased stomach acid production, it is not considered a direct cause of peptic ulcer disease. The primary cause remains H. pylori infection or the use of nonsteroidal anti-inflammatory drugs (NSAIDs).

C. Consuming spicy foods:

Spicy foods do not cause peptic ulcers. While they may irritate an existing ulcer or cause discomfort, they are not a causative factor for the development of ulcers. The primary culprits are H. pylori infection and the overuse of NSAIDs.

D. Excessive caffeine consumption:

Excessive caffeine can increase stomach acid production, which may aggravate symptoms of peptic ulcers, but it is not a primary cause of the condition. It can contribute to the irritation of existing ulcers but does not directly cause them.

Correct Answer A: Severe nearsightedness

Explanation:

A. Severe nearsightedness (Myopia)

Severe nearsightedness (myopia) is a recognized risk factor for developing glaucoma, especially open-angle glaucoma. Individuals with myopia have a higher risk of optic nerve damage, which is a hallmark of glaucoma. The longer the eyeball (as in myopia), the higher the risk of increased intraocular pressure and potential damage to the optic nerve.

Why the Other Options Are Incorrect:

B. Light skin pigmentation

Light skin pigmentation does not directly increase the risk for developing glaucoma. While people with light-colored eyes (blue, green, or gray) have been found to be at a slightly higher risk for some eye diseases like macular degeneration, glaucoma risk is not significantly linked to skin or eye color. Dark eye pigmentation may even offer some protective effects.

C. Exposure to environmental toxins

Exposure to environmental toxins is generally not a known or direct risk factor for glaucoma. While some toxins can affect overall eye health, they are not primary contributors to the development of glaucoma.

D. Overexposure to UV rays

Overexposure to UV rays can lead to other eye problems, such as cataracts or macular degeneration, but it is not considered a significant risk factor for glaucoma. UV exposure can increase the risk of damage to the lens and retina, but glaucoma is primarily associated with factors like increased intraocular pressure, family history, and conditions like myopia.