Ch. 21 Flashcards
Which of the following is a function of the liver?
• Drug detoxification
• Production of enzymes for protein breakdown
• Production of insulin
• Storage of bile
Drug detoxification.
Icteric sclera and acholic stools are clinical manifestations of:
• cirrhosis.
• diverticulitis.
• colitis.
• pancreatitis.
Cirrhosis
A 38-year-old man presents with an acute onset of severe right upper quadrant abdominal pain, pain to his right shoulder, and nausea. He is conscious and alert, but is restless from the pain. His blood pressure is 150/86 mm Hg, pulse rate is 120 beats/min and strong, and respirations are 22 breaths/min and regular. You should:
• perform a comprehensive abdominal exam, start at least one large-bore IV line, infuse normal saline at 125 mL/hr, and consider giving him an antiemetic medication.
• establish vascular access with a large-bore catheter, administer a 500-mL normal saline bolus, and avoid analgesics due to the potential for intra-abdominal bleeding.
• start an IV with normal saline and set it to keep the vein open, place him in a position of comfort, and administer morphine and promethazine.
• encourage him to remain supine to relieve his pain, monitor his oxygen saturation level, and administer Nubain via the IM route.
start an IV with normal saline and set it to keep the vein open, place him in a position of comfort, and administer morphine and promethazine.
The presentation of Mallory-Weiss syndrome is caused by which of the following?
• Rupture of hollow organs with resultant peritoneal inflammation
• Tear at the junction between the esophagus and stomach
•Erosion of the lining of the gastrointestinal tract
•Rupture of esophageal veins due to portal hypertension
Tear at the junction between the esophagus and stomach
Bile is produced in which organ?
• Pancreas
• Liver
• Gallbladder
• Duodenum
Liver
Filtering of blood and recycling of dead red blood cells are functions of the:
• liver.
• pancreas.
• kidneys.
• spleen.
Spleen
Irritation or injury to abdominal tissue, causing activation of peripheral nerve tracts, would most likely result in which type of pain?
• Parietal
• Rebound
• Visceral
• Somatic
Somatic
An obese 52-year-old woman who presents with severe pain in the right upper quadrant of her abdomen and pain in her right shoulder is most likely experiencing:
• Crohn disease.
• Mallory-Weiss syndrome.
• cholecystitis.
• cute hepatitis.
cholecystitis
Which of the following behaviors place a person at risk for gastrointestinal disease?
• High-fiber diet
• Working 8-hour days
• Stress
• Consumption of fruits and vegetables
Stress
Which of the following assessment findings or techniques would be most useful when determining the extent of internal volume loss?
• Orthostatic vital signs
• Resting blood pressure
• Duration of the illness
• Temperature of the skin
Orthostatic vital signs
Blood that has been digested by stomach acids manifests as:
-gray-colored stool.
- hematochezia.
-bright red vomitus.
-coffee grounds emesis
Coffee grounds emesis
Esophageal varices are a direct result of:
- alcohol consumption.
- portal hypertension.
- cirrhosis of the liver.
- esophageal erosion.
Portal hypertension
Peristalsis is defined as:
- rhythmic contraction.
- the churning of food.
- turbulent blood flow.
- passive regurgitation.
Rhythmic contraction
Which of the following is a common sign or symptom of acute gastroenteritis?
- Hypertension
- Fever
- Chest pain
- Shortness of breath
Fever.
Clinical signs of hypokalemia include:
- muscle cramps and peaked T waves.
- convulsions and absent P waves.
- coma and severe peripheral edema.
- weakness and flattened T waves.
weakness and flattened T waves.
You are caring for a middle-aged man with severe abdominal pain and dark, tarry stools. He is conscious but very restless. His blood pressure is 78/52 mm Hg, pulse rate is 130 beats/min and weak, and respirations are 24 breaths/min and shallow. Further assessment reveals that his skin is cool and clammy, and his radial pulses are weakly present. You should:
- administer high-flow oxygen, start a large-bore IV line, administer a 20-mL/kg normal saline bolus, and give fentanyl for pain.
- administer high-flow oxygen, start two large-bore IV lines, and administer 20-mL/kg normal saline boluses until his radial pulses strengthen.
- apply supplemental oxygen, establish vascular access, and give isotonic crystalloid boluses until his systolic BP is at least 110 mm Hg.
- apply a nasal cannula in case he vomits, start at least one large-bore IV line, and administer up to 3 L of normal saline solution.
administer high-flow oxygen, start two large-bore IV lines, and administer 20-mL/kg normal saline boluses until his radial pulses strengthen.
Pain over the suprapubic region is suggestive of injury to the:
- iliac arteries.
- ureters.
- bladder.
- urethra.
Bladder
Which of the following statements regarding Grey Turner sign is correct?
- Grey Turner sign is characterized by bruising around the umbilicus.
- The presence of Grey Turner sign should make you suspicious for hepatitis.
- Grey Turner sign is the cessation of inspiration during abdominal palpation.
- Grey Turner sign is characterized by flank bruising and indicates internal bleeding.
Grey Turner sign is characterized by flank bruising and indicates internal bleeding.
Intestinal adhesions are the most common cause of:
- bowel obstruction.
- ulcerative colitis.
- diarrhea.
- gastroenteritis
Bowel obstruction.
Which of the following is a common sign of bleeding in the upper gastrointestinal tract?
- Hematochezia
- Gross bleeding
- Vomitus
- Melena
Melena
