Nausea, Vomiting, Diarrhea, and Constipation (N/V/D/C) Questions PDF

**1.**\ **Question**: Which neurotransmitter is primarily involved in chemotherapy-induced nausea and vomiting (CINV)?\ **Choices**:\ A. Dopamine\ B. Serotonin\ C. Acetylcholine\ D. Norepinephrine\ **Correct Answer**: B\ **Explanation**: Serotonin (5-HT) plays a key role in CINV, particularly throug...

**1.**\ **Question**: Which neurotransmitter is primarily involved in chemotherapy-induced nausea and vomiting (CINV)?\ **Choices**:\ A. Dopamine\ B. Serotonin\ C. Acetylcholine\ D. Norepinephrine\ **Correct Answer**: B\ **Explanation**: Serotonin (5-HT) plays a key role in CINV, particularly through activation of 5-HT3 receptors in the chemoreceptor trigger zone (CTZ). **2.**\ **Question**: Which of the following is the most effective class of drugs for preventing motion sickness?\ **Choices**:\ A. Anticholinergics\ B. Antihistamines\ C. Serotonin antagonists\ D. Benzodiazepines\ **Correct Answer**: A\ **Explanation**: Anticholinergics, such as scopolamine, are highly effective in preventing motion sickness by blocking muscarinic receptors in the vestibular system. **3.**\ **Question**: A patient with CINV is prescribed ondansetron. What is the mechanism of action of this medication?\ **Choices**:\ A. Blocks dopamine receptors\ B. Inhibits acetylcholine release\ C. Antagonizes serotonin receptors\ D. Enhances GABA activity\ **Correct Answer**: C\ **Explanation**: Ondansetron is a 5-HT3 receptor antagonist, blocking serotonin in the chemoreceptor trigger zone and gastrointestinal tract to prevent nausea and vomiting. **4.**\ **Question**: What is a common adverse effect of ondansetron therapy?\ **Choices**:\ A. Hyperkalemia\ B. Constipation\ C. Hypotension\ D. Tinnitus\ **Correct Answer**: B\ **Explanation**: Constipation is a common side effect of ondansetron due to its effects on the GI tract. **5.**\ **Question**: Which of the following is most appropriate for treating hyperemesis gravidarum in pregnancy?\ **Choices**:\ A. Ondansetron\ B. Dexamethasone\ C. Meclizine\ D. Doxylamine/pyridoxine\ **Correct Answer**: D\ **Explanation**: Doxylamine/pyridoxine is the first-line treatment for hyperemesis gravidarum due to its safety and efficacy in pregnancy. **6.**\ **Question**: Which medication is contraindicated in children due to the risk of respiratory depression?\ **Choices**:\ A. Promethazine\ B. Ondansetron\ C. Metoclopramide\ D. Prochlorperazine\ **Correct Answer**: A\ **Explanation**: Promethazine is contraindicated in children under 2 years due to an increased risk of respiratory depression. **7.**\ **Question**: Which of the following medications is most effective for preventing postoperative nausea and vomiting (PONV)?\ **Choices**:\ A. Lorazepam\ B. Ondansetron\ C. Scopolamine\ D. Prochlorperazine\ **Correct Answer**: B\ **Explanation**: Ondansetron is widely used and highly effective for preventing and treating PONV. **8.**\ **Question**: Which of the following is an adverse effect of metoclopramide therapy?\ **Choices**:\ A. QT prolongation\ B. Parkinsonism\ C. Hyperglycemia\ D. Drowsiness\ **Correct Answer**: B\ **Explanation**: Metoclopramide can cause extrapyramidal symptoms, including Parkinsonism, due to dopamine receptor antagonism. **9.**\ **Question**: Which of the following medications is indicated for chemotherapy-induced nausea and vomiting but also increases appetite?\ **Choices**:\ A. Lorazepam\ B. Aprepitant\ C. Dronabinol\ D. Prochlorperazine\ **Correct Answer**: C\ **Explanation**: Dronabinol, a synthetic cannabinoid, is effective for CINV and stimulates appetite in patients with cancer or AIDS. **10.**\ **Question**: A patient is prescribed dexamethasone for delayed-phase CINV. What is a potential adverse effect of this medication?\ **Choices**:\ A. Hyperglycemia\ B. Hypotension\ C. Alopecia\ D. QT prolongation\ **Correct Answer**: A\ **Explanation**: Corticosteroids like dexamethasone can cause hyperglycemia, especially in patients with diabetes. **11.**\ **Question**: What is the mechanism of action of aprepitant?\ **Choices**:\ A. Blocks dopamine receptors\ B. Inhibits NK1 receptors\ C. Antagonizes serotonin receptors\ D. Enhances GABA activity\ **Correct Answer**: B\ **Explanation**: Aprepitant is a neurokinin-1 (NK1) receptor antagonist that prevents nausea and vomiting by inhibiting substance P. **12.**\ **Question**: Which medication is most appropriate for treating nausea caused by vertigo?\ **Choices**:\ A. Metoclopramide\ B. Meclizine\ C. Prochlorperazine\ D. Lorazepam\ **Correct Answer**: B\ **Explanation**: Meclizine is an antihistamine effective for nausea caused by vertigo due to its action on the vestibular system. **13.**\ **Question**: What is the primary neurotransmitter involved in motion sickness?\ **Choices**:\ A. Dopamine\ B. Acetylcholine\ C. Serotonin\ D. GABA\ **Correct Answer**: B\ **Explanation**: Acetylcholine is a key neurotransmitter in the vestibular system, which plays a significant role in motion sickness. **14.**\ **Question**: Which medication is contraindicated in patients with Parkinson\'s disease due to its dopamine antagonist effects?\ **Choices**:\ A. Lorazepam\ B. Ondansetron\ C. Prochlorperazine\ D. Dronabinol\ **Correct Answer**: C\ **Explanation**: Prochlorperazine is a dopamine antagonist that can worsen Parkinson's symptoms and should be avoided in these patients. **15.**\ **Question**: Which of the following medications should be avoided in patients with glaucoma due to its anticholinergic effects?\ **Choices**:\ A. Scopolamine\ B. Ondansetron\ C. Lorazepam\ D. Aprepitant\ **Correct Answer**: A\ **Explanation**: Scopolamine has strong anticholinergic properties, which can increase intraocular pressure and worsen glaucoma. **16.**\ **Question**: What is a common side effect of antihistamines like diphenhydramine when used for nausea?\ **Choices**:\ A. Sedation\ B. Diarrhea\ C. Hyperactivity\ D. Tachycardia\ **Correct Answer**: A\ **Explanation**: Antihistamines like diphenhydramine frequently cause sedation due to their effects on the central nervous system. **17.**\ **Question**: A patient undergoing chemotherapy is prescribed a combination of ondansetron and dexamethasone. What is the rationale for using this combination?\ **Choices**:\ A. To prevent breakthrough nausea\ B. To target multiple pathways of emesis\ C. To enhance appetite stimulation\ D. To reduce sedative effects\ **Correct Answer**: B\ **Explanation**: Combining ondansetron (5-HT3 antagonist) and dexamethasone (anti-inflammatory) targets different emetic pathways, improving efficacy for CINV. **18.**\ **Question**: Which of the following medications is most appropriate for opioid-induced nausea?\ **Choices**:\ A. Prochlorperazine\ B. Lorazepam\ C. Metoclopramide\ D. Ondansetron\ **Correct Answer**: C\ **Explanation**: Metoclopramide is effective for opioid-induced nausea as it enhances gastric motility and reduces dopamine-related nausea. **19.**\ **Question**: Which medication is recommended for the prevention of acute nausea and vomiting associated with highly emetogenic chemotherapy?\ **Choices**:\ A. Ondansetron\ B. Dronabinol\ C. Meclizine\ D. Aprepitant\ **Correct Answer**: A\ **Explanation**: Ondansetron is a first-line agent for preventing acute nausea and vomiting associated with highly emetogenic chemotherapy. **20.**\ **Question**: A patient is prescribed lorazepam as part of an antiemetic regimen. What is the primary reason for its use?\ **Choices**:\ A. Enhance gastric emptying\ B. Block serotonin receptors\ C. Treat anticipatory nausea\ D. Prevent vertigo-induced nausea\ **Correct Answer**: C\ **Explanation**: Lorazepam is a benzodiazepine that is particularly effective for anticipatory nausea and vomiting due to its anxiolytic effects. Would you like me to continue with the next 20 questions for this section? **You said:** next 20 **ChatGPT said:** ChatGPT **Nausea, Vomiting, Diarrhea, and Constipation (N/V/D/C) Part 1 PANCE-Style Questions (Continued)** **21.**\ **Question**: Which of the following medications is commonly used to prevent postoperative nausea and vomiting (PONV)?\ **Choices**:\ A. Lorazepam\ B. Aprepitant\ C. Metoclopramide\ D. Ondansetron\ **Correct Answer**: D\ **Explanation**: Ondansetron, a 5-HT3 receptor antagonist, is a first-line agent for preventing and treating PONV. **22.**\ **Question**: A patient is experiencing nausea after taking opioids for postoperative pain. Which medication would be the most appropriate to address this side effect?\ **Choices**:\ A. Promethazine\ B. Ondansetron\ C. Metoclopramide\ D. Dronabinol\ **Correct Answer**: C\ **Explanation**: Metoclopramide is effective for nausea related to opioid use as it enhances gastric motility and reduces nausea via dopamine receptor antagonism. **23.**\ **Question**: A pregnant patient is experiencing mild nausea and vomiting. What is the safest initial pharmacologic treatment?\ **Choices**:\ A. Ondansetron\ B. Metoclopramide\ C. Doxylamine/pyridoxine\ D. Meclizine\ **Correct Answer**: C\ **Explanation**: Doxylamine/pyridoxine is the first-line therapy for nausea and vomiting during pregnancy due to its safety profile. **24.**\ **Question**: Which neurotransmitter is primarily targeted by scopolamine for the prevention of motion sickness?\ **Choices**:\ A. Dopamine\ B. Serotonin\ C. Acetylcholine\ D. Histamine\ **Correct Answer**: C\ **Explanation**: Scopolamine prevents motion sickness by blocking acetylcholine at muscarinic receptors in the vestibular system. **25.**\ **Question**: Which of the following is a common adverse effect of antihistamines used to treat motion sickness?\ **Choices**:\ A. Constipation\ B. Sedation\ C. Diarrhea\ D. Insomnia\ **Correct Answer**: B\ **Explanation**: Antihistamines, such as meclizine and dimenhydrinate, frequently cause sedation due to their central nervous system effects. **26.**\ **Question**: A patient undergoing chemotherapy is experiencing delayed nausea and vomiting. Which medication is most appropriate to address this phase of emesis?\ **Choices**:\ A. Ondansetron\ B. Aprepitant\ C. Lorazepam\ D. Meclizine\ **Correct Answer**: B\ **Explanation**: Aprepitant, an NK1 receptor antagonist, is particularly effective in managing delayed-phase chemotherapy-induced nausea and vomiting. **27.**\ **Question**: Which of the following medications is most appropriate for a patient with vestibular nausea due to vertigo?\ **Choices**:\ A. Meclizine\ B. Ondansetron\ C. Metoclopramide\ D. Dronabinol\ **Correct Answer**: A\ **Explanation**: Meclizine, an antihistamine, is effective for managing vestibular nausea caused by vertigo. **28.**\ **Question**: Which antiemetic is most associated with extrapyramidal symptoms as a side effect?\ **Choices**:\ A. Ondansetron\ B. Metoclopramide\ C. Scopolamine\ D. Dronabinol\ **Correct Answer**: B\ **Explanation**: Metoclopramide, a dopamine antagonist, can cause extrapyramidal symptoms such as dystonia and akathisia. **29.**\ **Question**: Which of the following is a key benefit of using a combination of dexamethasone and ondansetron for chemotherapy-induced nausea and vomiting (CINV)?\ **Choices**:\ A. Reduced risk of sedation\ B. Enhanced efficacy through multiple mechanisms\ C. Faster onset of action\ D. Lower cost of therapy\ **Correct Answer**: B\ **Explanation**: Combining dexamethasone (anti-inflammatory) and ondansetron (5-HT3 antagonist) targets different emetic pathways, improving control of CINV. **30.**\ **Question**: A patient undergoing surgery is given scopolamine for postoperative nausea and vomiting (PONV). What is a common side effect of this medication?\ **Choices**:\ A. Tachycardia\ B. Dry mouth\ C. Diarrhea\ D. Hypotension\ **Correct Answer**: B\ **Explanation**: Scopolamine often causes dry mouth due to its anticholinergic effects. **31.**\ **Question**: Which antiemetic is also effective for treating appetite loss in patients with cancer?\ **Choices**:\ A. Lorazepam\ B. Ondansetron\ C. Dronabinol\ D. Metoclopramide\ **Correct Answer**: C\ **Explanation**: Dronabinol, a synthetic cannabinoid, stimulates appetite and is used in patients with cancer or AIDS. **32.**\ **Question**: A patient with motion sickness is prescribed dimenhydrinate. What is the mechanism of action of this medication?\ **Choices**:\ A. Blocks dopamine receptors\ B. Antagonizes histamine H1 receptors\ C. Blocks serotonin receptors\ D. Inhibits muscarinic receptors\ **Correct Answer**: B\ **Explanation**: Dimenhydrinate is an antihistamine that reduces motion sickness by blocking histamine H1 receptors in the vestibular system. **33.**\ **Question**: Which medication is most appropriate for a patient with nausea and vomiting secondary to gastroparesis?\ **Choices**:\ A. Meclizine\ B. Ondansetron\ C. Metoclopramide\ D. Prochlorperazine\ **Correct Answer**: C\ **Explanation**: Metoclopramide enhances gastric motility and is the treatment of choice for nausea caused by gastroparesis. **34.**\ **Question**: Which antiemetic is effective for anticipatory nausea and vomiting in patients undergoing chemotherapy?\ **Choices**:\ A. Prochlorperazine\ B. Lorazepam\ C. Ondansetron\ D. Aprepitant\ **Correct Answer**: B\ **Explanation**: Lorazepam, a benzodiazepine, is effective for anticipatory nausea and vomiting due to its anxiolytic properties. **35.**\ **Question**: Which antiemetic can cause gynecomastia as a potential side effect with long-term use?\ **Choices**:\ A. Prochlorperazine\ B. Ondansetron\ C. Metoclopramide\ D. Scopolamine\ **Correct Answer**: C\ **Explanation**: Metoclopramide can cause gynecomastia due to its effects on prolactin levels. **36.**\ **Question**: Which medication is effective for preventing nausea caused by labyrinthine disorders?\ **Choices**:\ A. Meclizine\ B. Ondansetron\ C. Metoclopramide\ D. Dronabinol\ **Correct Answer**: A\ **Explanation**: Meclizine, an antihistamine, is particularly effective for nausea caused by labyrinthine disorders, such as vertigo. **37.**\ **Question**: Which antiemetic is contraindicated in children under 2 years of age?\ **Choices**:\ A. Promethazine\ B. Meclizine\ C. Ondansetron\ D. Aprepitant\ **Correct Answer**: A\ **Explanation**: Promethazine is contraindicated in children under 2 years due to the risk of severe respiratory depression. **38.**\ **Question**: What is the primary advantage of using aprepitant in combination with ondansetron and dexamethasone for CINV?\ **Choices**:\ A. Increased sedation\ B. Enhanced coverage of delayed nausea\ C. Reduced need for breakthrough medications\ D. Lower risk of constipation\ **Correct Answer**: B\ **Explanation**: Aprepitant targets delayed-phase nausea, complementing the actions of ondansetron and dexamethasone for comprehensive CINV control. **39.**\ **Question**: Which medication is a first-line treatment for nausea and vomiting caused by vestibular dysfunction?\ **Choices**:\ A. Scopolamine\ B. Metoclopramide\ C. Ondansetron\ D. Lorazepam\ **Correct Answer**: A\ **Explanation**: Scopolamine, an anticholinergic, is effective in managing nausea and vomiting due to vestibular dysfunction, such as motion sickness. **40.**\ **Question**: A patient with severe nausea and vomiting related to highly emetogenic chemotherapy is prescribed a combination of antiemetics. Which class is critical in this regimen?\ **Choices**:\ A. Antihistamines\ B. 5-HT3 receptor antagonists\ C. Cannabinoids\ D. Benzodiazepines\ **Correct Answer**: B\ **Explanation**: 5-HT3 receptor antagonists like ondansetron are critical in preventing nausea and vomiting associated with highly emetogenic chemotherapy.