ATI LPN
Gastrointestinal System Nursing Exam Questions Questions
Question 1 of 5
Which of the following best describes a risk factor for a life-threatening episode of asthma?
Correct Answer: C
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
Question 2 of 5
An 80-year-old woman with background history of Type 2 Diabetes, hypertension and mild renal impairment is admitted with symptoms of haemoptysis and pleuritic chest pain. She is suspected to have a pulmonary embolism and a CT pulmonary angiogram is booked. She normally takes Metformin 500 mg TDS. What advice would you give her regarding metformin?
Correct Answer: D
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
Question 3 of 5
A patient has a history of chronic iron deficiency anemia requiring a recent blood transfusion. She has undergone an extensive GI work-up including upper endoscopy, colonoscopy, capsule enteroscopy, and abdominal CT scan. Her only medications are ferrous sulfate, baby aspirin, COX II inhibitor, and HCTZ. Which statement is true?
Correct Answer: B
Rationale: Dedicated small bowel series is typically of low yield in the diagnostic evaluation of chronic iron deficiency anemia. Provocative arteriograms have been performed in patients with gastrointestinal hemorrhage of obscure origin, but only a small series of cases have been reported, and it remains to be determined if this therapy can truly be done safely with a significant diagnostic yield. Hormonal therapy has been given to patients with arteriovenous malformations, but a randomized controlled trial published in 2001 showed no benefit using ethinyl estradiol and norethisterone in reducing recurrent bleeding in patients with angiodysplasia. It is important to recognize that even a baby aspirin a day can decrease the benefit in mucosal protection gained from using a COX II selective inhibitor.
Question 4 of 5
Which statement is true regarding Barrett's esophagus?
Correct Answer: D
Rationale: Treatment with PPIs should be directed at control of GERD symptoms and not with the expectation that Barrett's epithelium will regress, as this has yet to be proven. The presence of high-grade dysplasia is an indication for esophagectomy or endoscopic ablation by photodynamic therapy because there is high likelihood that adenocarcinoma is present by the time high-grade dysplasia is identified. Although patients with Barrett's esophagus with intestinal metaplasia are at higher risk of developing adenocarcinoma compared to the general population, the reality is that the vast majority of patients will never develop adenocarcinoma. Endoscopic surveillance at periodic intervals is generally recommended in those patients with Barrett's esophagus and intestinal metaplasia.
Question 5 of 5
A 62-year-old woman presents to the emergency room complaining of abdominal pain. The patient had a laparoscopic cholecystectomy for multiple small gallbladder stones eight months ago. She did not have any symptoms after the surgery until last week, when she suddenly developed pain in the right upper quadrant. The painful episode lasted 15 minutes. The next day, the pain returned and became constant. The intensity of pain gradually increased. Today she started to have nausea and vomiting, and her daughter brought her to the emergency room. The patient is febrile (her temperature is 38.6°C) and is jaundiced. Physical examination revealed localized tenderness in the right upper quadrant without a palpable mass. Her blood work showed white blood cell count 16.4/ L, total bilirubin 6.3 mg/dL, alkaline phosphatase 347 IU/L, amylase 53 U/L, and lipase 32 U/L. Which of the following would you order next for this patient?
Correct Answer: C
Rationale: The patient presents with obstructive jaundice and cholangitis. The most likely cause is a retained gallstone or a stricture that developed postcholecystectomy. An HIDA scan, viral hepatitis screening, and liver biopsy are not indicated in this patient with obvious bile duct obstruction. An ERCP may identify the cause of obstruction. Endoscopic sphincterotomy with removal of the stone, or dilatation and stenting of the biliary stricture, will restore patency of the biliary system to cure cholangitis and obstructive jaundice. If ERCP is not successful, the patient will need percutaneous transhepatic drainage of the biliary ducts or laparotomy with the common bile duct exploration.