ATI LPN
NCLEX Questions Gastrointestinal System Questions
Question 1 of 5
Which of the following features is most consistent with a diagnosis of chronic obstructive pulmonary disease (COPD)?
Correct Answer: A
Rationale: Step-by-step rationale for choice A: 1. A chronic productive cough is a key symptom of COPD due to excess mucus production. 2. This cough is persistent and lasts for a prolonged period, reflecting airway inflammation. 3. Productive cough is often associated with sputum production in COPD patients. 4. The presence of a chronic productive cough aligns with the pathophysiology of COPD. Summary of why other choices are incorrect: B: A nocturnal cough may be seen in conditions like asthma but is not specific to COPD. C: A wheeze is more common in asthma and may occur in COPD exacerbations, but not a consistent feature. D: COPD typically develops after years of exposure to risk factors, so onset at 25 years old is unlikely.
Question 2 of 5
A patient presents to you with an exacerbation of asthma. Which of the following would make you categorise this as a SEVERE exacerbation?
Correct Answer: C
Rationale: The correct answer is C: Peak flow <33% of normal. This indicates severe airflow obstruction. A: Hypotension is a sign of severe asthma but not specific enough to categorize it as severe. B: Peak flow <50% indicates moderate exacerbation. D: Bradycardia is not typically associated with asthma exacerbation. Therefore, C is the most appropriate choice because it directly reflects the severity of the patient's condition.
Question 3 of 5
All of the following statements about Helicobacter pylori (H. pylori) are true except
Correct Answer: C
Rationale: The correct answer is C. Eradication of H. pylori prevents adenocarcinoma of the stomach. This statement is incorrect because eradication of H. pylori has been shown to decrease the risk of gastric cancer but does not completely prevent it. A: H. pylori can invade the gastric epithelium, leading to inflammation. B: H. pylori actually reduces gastric acid secretion to help it survive in the stomach. D: H. pylori does produce urease, which helps it survive in the acidic stomach environment by neutralizing urea into ammonia and CO2.
Question 4 of 5
A 65-year-old white female with a history of arthritis, congestive heart failure, and osteoporosis complains of odynophagia for two weeks. A barium swallow shows a moderate-sized crater just above the gastroesophageal junction. What is the least likely contributor to this condition?
Correct Answer: D
Rationale: The correct answer is D: Calcium channel-blocker. The crater above the gastroesophageal junction is likely due to a peptic ulcer, which can be caused by NSAIDs and alendronate due to their potential to irritate the gastric mucosa. Iron sulfate can also contribute to gastrointestinal irritation but is less common compared to NSAIDs and alendronate in causing ulcers. Calcium channel-blockers, on the other hand, do not have a direct irritant effect on the gastrointestinal mucosa and are not associated with peptic ulcers. Therefore, calcium channel-blockers are the least likely contributor to the formation of the crater in this scenario.
Question 5 of 5
A 42-year-old accountant is referred to your office for evaluation of progressive weight loss. He has lost 20 pounds over the last 6 months. He has a long history (16 years) of insulin-dependent diabetes mellitus. He denies alcohol abuse but admits to heavy smoking (2 packs of cigarettes per day for 20 years). Three days ago he noticed that his urine became dark and that his skin started to itch. He had a CT scan of the abdomen last week that revealed fullness in the head of the pancreas with dilatation of intra- and extrahepatic biliary ducts. The CT scan did not demonstrate a discrete mass in the pancreas or liver, gallstones, or pancreatitis. His physical examination is normal except for obvious jaundice. His blood work reveals WBC count 6.4, total bilirubin 5.7 mg/dL, alkaline phosphatase 340 U/L, amylase 64 U/L, and lipase 47 U/L. Which of the following tests would you order next?
Correct Answer: C
Rationale: The correct answer is C: Endoscopic retrograde cholangiopancreatography (ERCP). ERCP is the next appropriate step for this patient due to the presence of jaundice, dark urine, and dilatation of the biliary ducts on CT scan, which indicate a likely biliary obstruction. ERCP allows direct visualization of the biliary tree and pancreatic duct, as well as therapeutic interventions such as stent placement or stone removal. This procedure can help identify the cause of the jaundice and guide further management. Choice A (Hepatobiliary scintigraphy) is used to evaluate gallbladder function but is not the most appropriate test in this scenario where biliary obstruction is suspected. Choice B (Abdominal ultrasound) can help identify biliary dilatation but does not provide direct visualization or therapeutic options like ERCP. Choice D (Transcutaneous transhepatic cholangiography) is an invasive test that is typically reserved