ATI LPN
Gastrointestinal System Quiz Questions Questions
Question 1 of 5
Which of the following statements regarding pancreatic cancer is correct?
Correct Answer: C
Rationale: Although serum CA 19-9 is not a useful screening tool in asymptomatic patients, it is quite sensitive and specific in patients with symptoms of the disease. Tumors arising from the tail or body of the pancreas are usually associated with a poorer prognosis and these patients are rarely resectable. A palpable gallbladder (Courvoisier's sign) has been described as being suggestive of a tumor at the head of the pancreas but not the tail. This sign lacks specificity, however.
Question 2 of 5
A 28-year-old woman at 34 weeks of gestation presents with elevated liver enzymes and pruritus. Labs reveal total bilirubin to be 4.2 mg/dL, AST 480 U/L, ALT 640 U/L, and alkaline phosphatase 232 U/L. Viral hepatitis serologies and ANA are negative. On physical examination, she is jaundiced, but has a normal blood pressure, no edema, and a soft abdomen. The fetus is in no distress. Which of the following is true?
Correct Answer: B
Rationale: The likely diagnosis is intrahepatic cholestasis of pregnancy, which resolves after delivery. Prompt delivery is indicated only for fetal distress. Intrahepatic cholestasis tends to recur with subsequent pregnancies and can be treated with cholestyramine and ursodeoxycholic acid. LCHAD deficiency is associated with acute fatty liver of pregnancy and HELLP syndrome.
Question 3 of 5
A 50-year-old man with a history of alcoholic cirrhosis presents with new-onset ascites, fever, chills, and abdominal pain. His ascitic fluid is sampled and reveals a white blood cell count of 750/mL with $50 \%$ neutrophils. Gram stain of the fluid shows white blood cells but no organisms. Which of the following statements is correct regarding this patient's care?
Correct Answer: C
Rationale: This patient has more than 250 neutrophils in his ascitic fluid and presents with symptoms typical of bacterial peritonitis. He should be treated with antibiotics regardless of the Gram stain and culture results because they can often be negative. Empiric therapy usually consists of a broad-spectrum agent such as cefotaxime. Recurrent episodes are common, with $70 \%$ of patients experiencing a second episode within one year. Prophylactic therapy is indicated for patients with recurrent infections but not after the first infection. Clindamycin or ampicillin would be poor antibiotic choices; better coverage against enteric gram-negatives would be warranted (e.g., norfloxacin).
Question 4 of 5
When educating a patient with PUD about lifestyle changes, which habit is most important to avoid?
Correct Answer: B
Rationale: Smoking impairs mucosal healing, increases acid production, and delays recovery, making it the most critical habit to avoid in PUD.
Question 5 of 5
A patient is scheduled for a gastroscopy. Which pre-procedure instruction should the nurse provide?
Correct Answer: B
Rationale: Fasting for 6-8 hours ensures an empty stomach, allowing clear visualization during gastroscopy and reducing aspiration risk.