ATI LPN
Gastrointestinal System NCLEX Questions Questions
Question 1 of 5
Which of the following radiographic changes represents stage 1 of pulmonary sarcoidosis?
Correct Answer: D
Rationale: Stage 1 sarcoidosis is characterized by bilateral hilar lymphadenopathy without parenchymal involvement, making D the correct answer.
Question 2 of 5
Which regimen is most effective to treat H. pylori?
Correct Answer: C
Rationale: Regimen A fails to include an H2-blocker or proton-pump inhibitor. Regimen B uses only two drugs, and two drugs are not as effective as three- or four-drug regimens for eradicating H. pylori. Regimen D treats only for 7 days, when 10 to 14 days regimens have been shown to have greater efficacy. Regimen C is recommended by the FDA for the eradication of H. pylori. Answer E is not a regimen that has been tested.
Question 3 of 5
A 26-year-old woman has been using a PPI every morning to control moderate GERD symptoms. She reports awakening at night with a nonproductive cough several times per week. Correct statements include all except
Correct Answer: B
Rationale: Patients with nocturnal GERD symptoms most likely have nonerosive esophagitis, thus deep ulcerations are not likely to be found.
Question 4 of 5
A 25-year-old man with a history of AIDS presents to the emergency room with severe abdominal pain and episodic nausea and vomiting. He describes the pain as constant; it is located in the epigastric area and radiates to the back. The pain started 12 hours ago and is becoming more intense. His current medications include dideoxyinosine (ddI), ganciclovir, and pentamidine. Physical examination reveals a low-grade fever and tenderness in the epigastric area without guarding or rebound. Blood tests demonstrate white blood cells of 6900/ L, amylase of 362 U/L, lipase of 428 U/L, and total bilirubin of 1.1 mg/dL. What is/are the possible cause(s) of this patient's problem?
Correct Answer: D
Rationale: This patient has acute pancreatitis as evidenced by his symptoms and elevated amylase and lipase. Cytomegalovirus is the most commonly reported viral infection that can involve the pancreas. HIV and many AIDS-related infections can affect the pancreas (e.g., cryptococcus, Mycobacterium tuberculosis, candida, and Toxoplasma gondii). Numerous medications may also cause acute pancreatitis (e.g., ddI, pentamidine, trimethoprim/sulfamethoxazole, and metronidazole).
Question 5 of 5
A 66-year-old woman, a recently retired social worker who cares for her disabled husband, has been experiencing left lower quadrant discomfort. For the past few months, she has been having bowel movements every other day, which is a change from her usual once or twice per day. She has a long history of noninsulin-dependent diabetes mellitus, arthritis, hypothyroidism, and hypertension. Medications are glyburide $5 \mathrm{mg}$, levothyroxine $0.1 \mathrm{mg}$, and diltiazem (extended release) $240 \mathrm{mg}$ four times a day (previously managed on propranolol but changed on her last visit to diltiazem because of depressed mood), and ibuprofen as needed. She is very worried about colon cancer although she had a normal colonoscopy last year. What is the best plan for her?
Correct Answer: D
Rationale: New onset of constipation will most often have a nonfunctional cause. In this case, the most likely cause is the change of antihypertensives to a calcium channel-blocker. These medications are more often associated with constipation than are $\alpha$-blockers. New-onset constipation can sometimes be a symptom of colon cancer (Answer A), but this would be less likely in a patient that had a recent negative colonoscopy. One could consider a repeat colonoscopy should the constipation be persistent after addressing more likely causes. Constipation may also be secondary to hypothyroidism (Answer B), and one should be suspicious of hypothyroidism (especially in females and elderly patients). However, the calcium channel-blocker is a more likely cause than is noncompliance with a reasonable dose of thyroid medication in this social worker that cares for her disabled husband. Similarly, stress may play a role in her constipation, but the correlation between medications and the constipation should be addressed first and is more likely to be helpful.