Upper GI
Which patient is at highest risk for having a gastric ulcer?
A. 55 y.o. female, smoker, with nausea/vomiting
B. 45 y.o. female admitted for illicit drug detox
C. 37 y.o. male, smoker, who fell while looking for a job.
D. 27 y.o. male who is being divorced and has back pain.
A. 55 y.o. female, smoker, with nausea/vomiting
The patient has peritonitis, which is a major complication of appendicitis. What treatment will the nurse plan to include?
A. Peritoneal lavage
B. Peritoneal Dialysis
C. IV fluid replacement
D. Increased oral fluid intake
C. IV fluid replacement
The occurrence of acute liver failure is most common in which situation?
A. An individual with Hepatitis A
B. An individual with Hepatitis C
C. Antihypertensive medication use
D. Use of acetaminophen with alcohol abuse
D. Use of acetaminophen with alcohol abuse
A young patient with a fractured femur has a hip spica cast applied. While the cast is drying, what should the nurse do?
A. Elevate the legs above the level of the heart for 24 hours.
B. Turn the patient to both sides and prone/supine every 2 hours.
C. Cover the cast with a light blanket to avoid chilling from evaporation.
D. Assess the patient frequently for abdominal pain, nausea, vomiting.
D. Assess the patient frequently for abdominal pain, nausea, vomiting.
Patient is a 50 year old female who is complaining of her joints feeling very stiff in the morning, and it lasts for a couple of hours. This makes the nurse suspicious of what?
A. Osteoporosis
B. Rheumatoid Arthritis
C. Carpal tunnel syndrome
D. Osteoarthritis
B. Rheumatoid Arthritis
A. Alcohol
B. Root beer
C. Chocolate
D. Citrus Fruits
E. Fatty foods
F. Cola Sodas
ACEF
The nurse should teach the patient with chronic constipation that which food has the highest dietary fiber?
A. Peaches
B. Popcorn
C. Dried beans
D. Shredded wheat
C. Dried beans
The nurse identifies a need for further teaching when the patient with hepatitis B makes which statement?
A. I should avoid alcohol completely for as long as a year.
B. I must avoid all physical contact with my family until the jaundice is gone.
C. I should use a condom to prevent spread of the disease to my sexual partner.
D. I will need to rest several times a day, gradually increasing my activity as I tolerate it.
B. I must avoid all physical contact with my family until the jaundice is gone.
Following change of shift handoff, which patient should then nurse assess first?
A. A 58 y.o. male experiencing phantom pain and requesting analgesic
B. A 72 y.o. male being transferred to a skilled nursing unit following repair of a hip fracture
C. A 25 y.o. female in left leg skeletal traction asking for the weights to be lifted for a few minutes.
D. A 68 y.o. male with a new lower leg cast complaining that the cast is too tight and he cannot feel his toes.
D. A 68 y.o. male with a new lower leg cast complaining that the cast is too tight and he cannot feel his toes.
During treatment of the patient with an acute attack of gout, the nurse would expect to amdinister which drug?
A. Aspirin
B. Colchicine
C. Allopurinol
D. Probenecid
B. Colchicine
A patient with a history of peptic ulcer disease is hospitalized with symptoms of perforation. During the initial assessment, what should the nurse expect to report?
A. Vomiting of bright-red blood
B. Projectile vomiting of undigested food
C. Sudden, severe upper abdominal pain and back pain
D. Hyperactive stomach sounds and upper abdominal swelling
C. Sudden, severe upper abdominal pain and back pain
For the patient hospitalized with inflammatory bowel disease, which treatments would be used to rest the bowel? Select all that apply.
A. NPO
B. IV fluids
C. Bed rest
D. Sedatives
E. NG suction
ABE
Combined with clinical manifestations, what is the lab finding that is most commonly used to diagnose acute pancreatitis?
A. Increased serum calcium
B. Increased serum amylase
C. Increased serum hematocrit
D. Decreased serum glucose
B. Increased serum amylase
36 year old male patient is in the hospital with fractured pelvis. The nurse notices petechiae across his chest. What is this suspicious of?
A. Graves disease
B. Bell's Palsy
C. Fat embolism
D. Compartment syndrome
C. Fat embolism
What best describes the manifestations of OA?
A. Smaller joints are typically affected first
B. There is joint stiffness after periods of inactivity
C. Joint stiffness is accompanied by fatigue, anorexia, and weight loss.
D. Pain and immobility may be aggravated by falling barometric pressure.
D. Pain and immobility may be aggravated by falling barometric pressure.
A patient with gastric outlet obstruction has been treated with NG decompression. After the first 24 hours, the patient develops nausea and increased upper abdominal bowel sounds. What is the best action by the nurse?
A. Place the patient in a recumbent position
B. Check the patency of the NG tube
C. Encourage the patient to deep breathe and consciously relax
D. Assess the patient's vital signs and circulatory status.
B. Check the patency of the NG tube
What lab findings are expected in ulcerative colitis as a result of diarrhea and vomiting?
A. Increased albumin
B. Elevated WBCs
C. Decreased Na, K, Mg, Cl, and HCO3
D. Decreased Hemoglobin and Hematocrit
C. Decreased Na, K, Mg, Cl, and HCO3
A patient with an obstruction in the common bile duct has clay-colored fatty stools, among other manifestations. What is the patho that causes this clinical manifestation?
A. Soluble bilirubin in the blood is excreted into the urine
B. Absence of bile salts in the intestine/duodenum, preventing fat emulsion and digestion.
C. Contraction of the inflamed gallbladder and obstructed ducts, stimulated by cholecystokinin when fats enter the duodenum.
D. Obstruction of the common dict prevents bile drainage into the duodenum, resulting in congestion of bile in the liver.
B. Absence of bile salts in the intestine/duodenum, preventing fat emulsion and digestion.
55 year old male patient presents to the clinic complaining of sudden bowel and bladder incontinence. What should the nurse suspect is the cause?
A. Herniated disc
B. Cauda Equina
C. Osteoarthritis
D. Systemic Lupus
B. Cauda Equina
Lab findings that the nurse would expect to be present in the patient with RA include (Select all that apply)
A. Polycythemia
B. Increased immunoglobulin G (IgG)
C. Decreased white blood cell count
D. Positive Rheumatoid Factor/ACPA
E. Elevated C-Reactive Protein
D&E
Duodenal ulcers and gastric ulcers have similar as well as differentiating features. What are characteristics unique to duodenal ulcers? Select all that apply.
A. Pain is relieved by eating food
B. They have a high recurrence rate
C. Increased gastric secretion occurs
D. Associated with H. Pylori infection
E. Hemorrhage, perforation, and obstruction may result
F. There is burning and cramping in the midepigastric area.
A, C, F
Duodenal ulcers and gastric ulcers have similar as well as differentiating features. What are characteristics unique to duodenal ulcers? Select all that apply.
A. Pain is relieved by eating food
B. They have a high recurrence rate
C. Increased gastric secretion occurs
D. Associated with H. Pylori infection
E. Hemorrhage, perforation, and obstruction may result
F. There is burning and cramping in the midepigastric area.
A 20 year old patient with a history of Crohn's disease comes to the clinic with persistent diarrhea. What are characteristics of Crohn's disease? Select all that apply
A. Weight loss
B. Rectal bleeding
C. Abdominal pain
D. Toxic megacolon
E. Involves the entire thickness of the bowel wall
ACE
Of the following characteristics, identify those that are most commonly associated with cholelithiasis. Select all that apply.
A. Obesity
B. Age over 40
C. Multiparous female
D. History of excesive alcohol intake
E. Family history of gallbladder disease
F. Use of estrogen or oral contraceptives
ABCEF
What are characteristics of Paget's disease? Select all that apply.
A. Results from vitamin D deficiency
B. Loss of total bone mass and substance
C. Abnormal remodeling and resorption of bone
D. Most common in bones of spine, hips, and wrists.
E. Generalized bone decalcification with bone deformity
F. Replacement of normal marrow with vascular connective tissue.
C & F
What are characteristics of Paget's disease? Select all that apply.
A. Results from vitamin D deficiency
B. Loss of total bone mass and substance
C. Abnormal remodeling and resorption of bone
D. Most common in bones of spine, hips, and wrists.
E. Generalized bone decalcification with bone deformity
F. Replacement of normal marrow with vascular connective tissue.
Which of female patients are at risk for developing osteoporosis? Select all that apply.
A. 60 y.o. white aerobics instructor
B. 55 y.o. Asian American who smokes cigarettes
C. 62 y.o. African American on estrogen therapy
D. 68 y.o. white who is underweight and inactive
E. 58 y.o. Native American who started menopause prematurely.
B, D, E
Which of female patients are at risk for developing osteoporosis? Select all that apply.
A. 60 y.o. white aerobics instructor
B. 55 y.o. Asian American who smokes cigarettes
C. 62 y.o. African American on estrogen therapy
D. 68 y.o. white who is underweight and inactive
E. 58 y.o. Native American who started menopause prematurely.