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, which can affect any part of the gastrointestinal tract. Choices A, B, and C are extraintestinal manifestations commonly seen in ulcerative colitis due to the systemic nature of the disease and immune system involvement. Arthritis can occur due to inflammation in joints, sclerosing cholangitis affects the bile ducts, and autoimmune hemolytic anemia involves the destruction of red blood cells.
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 because the patient's presentation with cirrhosis, altered mentation, and ascites is concerning for spontaneous bacterial peritonitis (SBP). Ascitic fluid should be sampled to confirm the diagnosis and guide appropriate antibiotic therapy. Choice A is incorrect because ammonia levels can fluctuate and do not rule out hepatic encephalopathy. Choice C is incorrect as aminoglycosides are not first-line for SBP. Choice D is incorrect because lactulose is used to treat hepatic encephalopathy, not SBP. Sampling ascitic fluid is crucial in this case to diagnose and treat SBP promptly and effectively.
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 cause direct damage to the stomach lining, increasing the risk of peptic ulcers and worsening existing peptic ulcers. This is due to the inhibition of prostaglandin synthesis, which plays a protective role in maintaining the integrity of the gastric mucosa. Explanation for incorrect choices: A: NSAIDs do not increase gastric acid secretion; they primarily affect the mucosal lining. B: NSAIDs do not delay gastric emptying; this is more commonly associated with other factors like certain medications or medical conditions. D: NSAIDs and proton pump inhibitors have different mechanisms of action and do not directly interfere with each other.
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 lead to constipation due to their ability to slow down gut motility. This can cause difficulty in passing stool. Diarrhea (choice A) is not a common side effect of antacids. Weight gain (choice C) and dizziness (choice D) are also not typical side effects of antacids. Constipation is a well-known side effect of antacids, making choice B the correct answer in managing 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. H2RAs block acid secretion by inhibiting histamine. Histamine stimulates acid production by binding to H2 receptors on parietal cells. By blocking these receptors, H2RAs reduce acid secretion, providing relief in peptic ulcer disease (PUD). Choice A is incorrect because H2RAs do not neutralize gastric acid directly. Choice C is incorrect as H2RAs do not coat the stomach lining. Choice D is incorrect as H2RAs do not eradicate H. pylori, the bacteria commonly associated with PUD.