ATI LPN
Chapter 15 The Gastrointestinal System Review Questions Questions
Question 1 of 5
In a patient with chronic obstructive pulmonary disease, what is cor pulmonale?
Correct Answer: A
Rationale: The correct answer is A: Right-sided heart failure secondary to lung disease. In cor pulmonale, chronic lung disease such as COPD leads to pulmonary hypertension, which in turn causes the right side of the heart to work harder and eventually fail. This is because the right side of the heart pumps blood to the lungs to pick up oxygen, and when the lungs are diseased, the heart has to pump harder to maintain adequate blood flow. Choices B, C, and D are incorrect because they do not accurately describe cor pulmonale. Left-sided heart failure (choice B) is not directly related to lung disease, whereas lung disease secondary to left-sided heart failure (choice C) and lung disease secondary to right-sided heart failure (choice D) are not accurate descriptions of cor pulmonale.
Question 2 of 5
A 56-year-old woman with rheumatoid arthritis has severe joint pain and swelling in her hands. She has a history of peptic ulcer disease five years ago but presently has no GI symptoms. You elect to start her on an NSAID. Which of the following is correct?
Correct Answer: B
Rationale: The correct answer is B: Misoprostol is superior to an H2-blocker in prophylaxis against NSAID-related GI toxicity. Misoprostol, a prostaglandin analog, helps protect the gastric mucosa by increasing mucus production and decreasing acid secretion. This makes it more effective than H2-blockers, which only reduce acid production. Choice A is incorrect because proton-pump inhibitors are more effective than H2-blockers in preventing NSAID-related GI toxicity. Choice C is incorrect as sucralfate is not recommended for prophylaxis against NSAID-related GI toxicity. Choice D is incorrect because H. pylori infection significantly increases the risk of NSAID-induced ulcers.
Question 3 of 5
A 45-year-old woman with occasional indigestion has had episodes of chest pain and dysphagia to both solids and liquids. An upper GI series and EGD fail to disclose any structural abnormalities. What is the most appropriate initial therapy?
Correct Answer: B
Rationale: The correct answer is B: Proton-pump inhibitor. The patient's symptoms of chest pain and dysphagia are suggestive of gastroesophageal reflux disease (GERD). Proton-pump inhibitors (PPIs) are the first-line therapy for GERD as they reduce gastric acid secretion, alleviating symptoms and promoting healing of esophageal mucosa. Sucralfate is not effective for GERD symptoms. Prokinetic agents are used for motility disorders, not GERD. Benzodiazepines are not indicated for GERD and may even exacerbate symptoms. Therefore, the most appropriate initial therapy for this patient is a proton-pump inhibitor.
Question 4 of 5
A 56-year-old Brazilian woman with a history of idiopathic cardiomyopathy presents complaining of weight loss, dysphagia, and regurgitation. A chest x-ray is done that reveals an air-fluid level at the level of the esophagus. No gastric bubble is appreciated. A barium swallow reveals a dilated esophagus that tapers at the lower esophageal sphincter. Which of the following is appropriate in this patient's evaluation/treatment?
Correct Answer: D
Rationale: The correct answer is D: Obtain serologic studies for antibodies to Trypanosoma cruzi. The patient's presentation of dysphagia, regurgitation, and dilated esophagus suggests Chagas disease, caused by Trypanosoma cruzi. Serologic studies are necessary for definitive diagnosis. Choice A is incorrect because esophagectomy is not warranted without confirming the diagnosis. Choice B is incorrect as there are no indications of parasitic infection. Choice C is incorrect as proton pump inhibitors are not appropriate for Chagas disease.
Question 5 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 because performing an urgent ERCP is not indicated in the management of acute pancreatitis with necrosis. ERCP is typically not recommended in the acute phase of severe pancreatitis due to the risk of exacerbating pancreatitis. - B: Antibiotic therapy with imipenem may be initiated to address potential infection in necrotizing pancreatitis. - C: A CT-guided needle aspirate of the pancreas may be performed to guide antimicrobial therapy. - D: Surgical debridement may be considered if there is evidence of infection based on gram stain and cultures from a pancreatic aspirate.