NUR 611 AP1 25 FL2 Adult Health at St. Thomas University

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Free NUR 611 AP1 25 FL2 Adult Health at St. Thomas University Questions

1.

Which of the following causes of gastrointestinal bleeding is found in the lower gastrointestinal tract?

  • Meckel’s diverticulum​

  • Duodenal ulcer​

  • Erosive esophagitis​

  • Gastric ulcer

Explanation

Explanation
Meckel’s diverticulum is a congenital anomaly located in the distal ileum, making it a lower gastrointestinal (GI) source of bleeding. It results from a remnant of the vitelline duct and may contain ectopic gastric mucosa that secretes acid, leading to ulceration and bleeding in adjacent intestinal tissue. It is a classic cause of painless lower GI bleeding, especially in children and young adults.
2.

Which of the following is an appropriate strategy to manage constipation?

  • Immediately begin pharmacologic treatment.​

  • Five timed minutes on the toilet in which to defecate.​

  • Drink at least 48 ounces of fluids daily.​

  • Mildly exercise after breakfast.

Explanation

Explanation
Mild exercise after breakfast helps stimulate intestinal motility through activation of the gastrocolic reflex, promoting natural bowel movement and reducing constipation. Walking or light stretching encourages peristalsis and is a first-line nonpharmacologic intervention. This approach, combined with increased fiber and adequate hydration, is preferred before using laxatives or stool softeners. Lifestyle measures are safe, sustainable, and effective for maintaining regular bowel habits.
3.

When administered at the beginning of an attack, oxygen therapy may help this kind of headache?

  • Stress​

  • Cluster​

  • Migraine​

  • Tension

Explanation

Explanation
Cluster headaches are severe, unilateral headaches often centered around one eye, accompanied by tearing, nasal congestion, and restlessness. Administering 100% oxygen via a non-rebreather mask at 7–10 L/min for 15–20 minutes at the onset of an attack can effectively abort or greatly reduce pain in most patients. Oxygen therapy works by causing cerebral vasoconstriction and decreasing trigeminal nerve activation. It is considered first-line acute treatment for cluster headaches.
4.

Rachel is a patient complaining of a pruritic erythematous rash on her face and hands that became apparent this morning. Which of the following questions would help determine whether she has contact dermatitis?

  • "Do you have a history of rosacea?"​

  • "Do you have any food allergies?"​

  • "Do you have a history of itchy rashes?"​

  • "Have you used any new face wash or soap?"

Explanation

Explanation
Contact dermatitis is an inflammatory skin reaction triggered by direct exposure to an irritant or allergen, such as soaps, detergents, cosmetics, or metals. Asking whether the patient has recently used a new face wash, soap, lotion, or detergent helps identify potential external triggers responsible for the rash. This question is crucial for distinguishing contact dermatitis from other dermatologic conditions and guides management, which includes removing the offending agent and using topical corticosteroids for inflammation.
5.

After typical groin hernia surgery, the patient should be instructed to:

  • Avoid heavy lifting for 4 to 6 weeks.​

  • Stay in the hospital for 2 weeks.​

  • Return to normal activities after 1 month.​

  • Avoid work for 3 weeks.

Explanation

Explanation
After inguinal (groin) hernia repair, patients are advised to avoid heavy lifting or straining for 4 to 6 weeks to allow the surgical site to heal and prevent recurrence. Normal light activities and walking can usually resume within a few days, but lifting objects heavier than 10–15 pounds should be avoided during this period. Adherence to this restriction reduces tension on the repair and supports optimal recovery.
6.

Which of the following is a condition that results in colicky abdominal pain?

  • Gallstones​

  • Glisson’s capsule around the liver​

  • Peptic ulcers​

  • Peritoneum irritation

Explanation

Explanation
Gallstones (cholelithiasis or biliary colic) cause colicky abdominal pain due to intermittent obstruction of the cystic or common bile duct by a stone. The pain is typically severe, cramp-like, and located in the right upper quadrant or epigastrium, often radiating to the right shoulder or back. It usually follows a fatty meal and occurs as the gallbladder contracts against the obstruction. Pain subsides when the stone moves and the duct clears.
7.

A patient is presenting with chorea (dance-like movements). Which of the following diseases might the patient have?

  • Dementia​

  • Huntington's disease​

  • Parkinson's disease​

  • Wilson's disease

Explanation

Explanation
Huntington’s disease is a hereditary neurodegenerative disorder caused by an autosomal dominant mutation in the HTT gene. It leads to progressive neuronal loss in the basal ganglia and cerebral cortex, resulting in chorea, which are rapid, involuntary, dance-like movements. Other features include cognitive decline, psychiatric symptoms, and gradual loss of motor control. Symptoms typically appear between ages 30–50, and diagnosis is confirmed by genetic testing.
8.

A blood pressure (BP) of 150/90 is considered:

  • Hypertensive​

  • Acceptable if the patient has diabetes mellitus (DM)​

  • Stage 2 hypertension​

  • Normal in healthy older adults

Explanation

Explanation
A blood pressure of 150/90 mm Hg falls within the hypertensive range according to the American College of Cardiology/American Heart Association (ACC/AHA) guidelines. Normal BP is below 120/80 mm Hg, and hypertension is diagnosed when BP is ≥130/80 mm Hg on at least two separate occasions. Although 150/90 does not meet Stage 2 criteria, it clearly exceeds normal and Stage 1 thresholds and requires lifestyle modification and evaluation for secondary causes.
9.

The patient with type 1 diabetes is exhibiting Kussmaul respirations, anorexia, fatigue, and increased thirst. Which condition should the clinician manage?

  • Hyperosmolar hyperglycemic syndrome​

  • Hypoglycemia​

  • Somogyi effect​

  • Diabetic ketoacidosis

Explanation

Explanation
Diabetic ketoacidosis (DKA) is an acute, life-threatening complication primarily seen in type 1 diabetes mellitus. It results from insulin deficiency, causing the body to break down fats for energy, leading to ketone accumulation and metabolic acidosis. The hallmark features include Kussmaul respirations (deep, rapid breathing to compensate for acidosis), anorexia, fatigue, and polydipsia (increased thirst). Immediate management includes IV insulin therapy, fluid replacement, and electrolyte correction, particularly potassium.
10.

Which patient is most likely to have myasthenia gravis (MG)?

  • A 55-year-old African American male​

  • A 31-year-old Hispanic woman​

  • A 75-year-old Caucasian woman​

  • A 10-year-old Middle Eastern male

Explanation

Explanation
Myasthenia gravis (MG) is an autoimmune neuromuscular disorder characterized by fluctuating muscle weakness that worsens with activity and improves with rest. It results from autoantibodies against acetylcholine receptors at the neuromuscular junction. MG most commonly affects younger women (ages 20–40) and older men (ages 60–80). Therefore, a 31-year-old woman fits the classic demographic profile for early-onset autoimmune MG.

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