ATI LPN
Chapter 15 The Gastrointestinal System Review Questions Questions
Question 1 of 5
All of the following are extraintestinal manifestations that are associated with ulcerative colitis except
Correct Answer: D
Rationale: The correct answer is D: Perianal fistula formation. Ulcerative colitis primarily affects the colon and rectum, leading to inflammation and ulceration of the intestinal lining. Perianal fistula formation is more commonly associated with Crohn's disease, not ulcerative colitis. Rationale: A: Arthritis - Extraintestinal manifestation commonly seen in ulcerative colitis due to immune system involvement. B: Sclerosing cholangitis - Liver complication associated with ulcerative colitis. C: Autoimmune hemolytic anemia - Blood disorder linked to ulcerative colitis due to immune system dysregulation. D: Perianal fistula formation - More characteristic of Crohn's disease, not ulcerative colitis.
Question 2 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 3 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 4 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.
Question 5 of 5
What is the action of histamine-2 receptor antagonists (H2RAs) in the treatment of PUD?
Correct Answer: B
Rationale: The correct answer is B because histamine-2 receptor antagonists (H2RAs) work by blocking the action of histamine on the H2 receptors of the stomach, which then leads to a decrease in gastric acid secretion. This helps in reducing the acidity level in the stomach, promoting ulcer healing in peptic ulcer disease (PUD). A: Neutralizing gastric acid is the action of antacids, not H2RAs. C: Coating the stomach lining is the mechanism of action of cytoprotective agents like sucralfate, not H2RAs. D: Eradicating H. pylori is a treatment approach for PUD caused by this bacterium, but H2RAs do not directly target H. pylori.