ATI LPN
Chapter 15 The Gastrointestinal System Review Questions Questions
Question 1 of 5
A 46-year-old woman with a history of alcohol abuse is admitted for acute pancreatitis due to alcohol. She is treated with supportive care but continues to deteriorate over 72 hours. A CT scan is obtained that reveals extensive pancreatic inflammation with the suggestion of necrosis. All of the following statements are correct regarding this patient's management except
Correct Answer: A
Rationale: The correct answer is A: Endoscopic retrograde cholangiopancreatography (ERCP) should be performed urgently. ERCP is not indicated in the acute setting of pancreatitis unless there is evidence of biliary obstruction or cholangitis. The priority in this case would be to manage the acute pancreatitis and potential pancreatic necrosis. Antibiotic therapy (Choice B) may be considered in cases of infected necrosis. A CT-guided needle aspirate (Choice C) may be helpful for diagnosing infected necrosis but is not typically done urgently. Surgical debridement (Choice D) is indicated if there is evidence of infected pancreatic necrosis on culture results, but this should be done after appropriate medical management.
Question 2 of 5
Which of the following statements is true?
Correct Answer: D
Rationale: The correct answer is D because hepatitis A infection can have a relapsing course. This is due to the natural course of the infection, where patients can initially recover but then experience a recurrence of symptoms. This is different from hepatitis B or C, which typically do not have a relapsing course. A is incorrect because in alcoholic hepatitis, the AST/ALT ratio is usually greater than 2. B is incorrect because Alpha-1 Antitrypsin deficiency is associated with liver and lung diseases, not arteriovenous malformations of the brain. C is incorrect because although serum A1AT levels are used to diagnose A1AT deficiency, they are not solely diagnostic as genetic testing is also required for confirmation.
Question 3 of 5
A 48-year-old man with a history cirrhosis secondary to hepatitis C presents to the emergency room with confusion, altered mentation, and erratic behavior. He is afebrile. His examination is notable for grossly normal motor strength throughout, hyperreflexia, asterixis, bulging flanks, and shifting dullness. His total bilirubin is 6 mg/dL, his creatinine is 1.8 mg/dL, and his prothrombin time is elevated. His white blood cell count is 11,000/µL with $85 \%$ neutrophils. His ammonia level is 30 µg/dL (normal 15-45 µg/dL). Which of the following statements is correct?
Correct Answer: B
Rationale: The correct answer is B. Ascitic fluid sampling is crucial in ruling out bacterial peritonitis in patients with cirrhosis presenting with altered mental status. The presence of ascites, bulging flanks, and shifting dullness in the patient's examination indicates ascites, which increases the risk of spontaneous bacterial peritonitis (SBP). SBP can lead to hepatic encephalopathy, contributing to the patient's altered mental status. Sampling ascitic fluid allows for culture and analysis to identify bacterial infection. Choice A is incorrect because normal ammonia levels do not exclude hepatic encephalopathy, which can still be present due to other factors. Choice C is incorrect as aminoglycosides are not recommended for empiric antibiotic therapy in SBP. Choice D is incorrect as lactulose is indicated for hepatic encephalopathy but not for treating bacterial peritonitis.
Question 4 of 5
A patient with PUD is advised to avoid NSAIDs. What is the reason for this?
Correct Answer: C
Rationale: The correct answer is C: NSAIDs are known to irritate the gastric mucosa. NSAIDs can lead to gastric mucosal injury by inhibiting prostaglandin synthesis, which plays a protective role in maintaining the integrity of the gastric mucosa. This can result in the development or exacerbation of peptic ulcers. A: NSAIDs actually inhibit prostaglandin synthesis, leading to decreased gastric acid secretion. B: NSAIDs do not delay gastric emptying; rather, they can cause dyspepsia and increase the risk of ulcers. D: NSAIDs do not interfere with proton pump inhibitors; instead, they can reduce the efficacy of these drugs in treating ulcers.
Question 5 of 5
Which of the following is a common side effect of antacids in the management of PUD?
Correct Answer: B
Rationale: The correct answer is B: Constipation. Antacids containing aluminum or calcium can cause constipation due to their ability to slow down digestion. This is a common side effect observed in patients using antacids for peptic ulcer disease (PUD). Rationale: 1. Aluminum and calcium-based antacids can reduce bowel motility, leading to constipation. 2. Diarrhea is not a common side effect of antacids in the management of PUD. 3. Weight gain is not a direct side effect of antacids but may occur indirectly due to overeating to alleviate symptoms. 4. Dizziness is not a typical side effect of antacids in the management of PUD.