GI

Question 1

You are caring for a patient with a severe duodenal ulcer who suddenly complains of severe pain spreading over the abdomen, likely due to a perforation. What should be the most immediate intervention by the nurse?

Answer 1

Insertion of an NG tube

Question 2

What is the most common cause of peptic ulcers?

Answer 2

H. Pylori

Question 3

What hormone (that stimulates gastric acid secretion) is released by distention of the stomach?

Answer 3

Gastrin

Question 4

What is Xerostomia?

Answer 4

Decreased saliva production in the elderly population

Question 5

What is the characteristic sign of Peritoneal inflammation?

Answer 5

rebound tenderness

Question 6

A patient with Gastritis from H. Pylori is generally put on which meds?

Answer 6

Antibiotic(s), proton pump inhibitor, and bismuth (Pepto Bismol)

Question 7

What is tenesmus?

Answer 7

the sensation of incomplete bowel evacuation (associated with ulcerative colitis)

Question 8

What is the “classic sign” of perforation of an ulcer?

Answer 8

Sudden “board-like” abdominal rigidity

Question 9

What class of drugs can be a causative factor in GERD?

Answer 9

Anticholinergic drugs; because they may relax the esophageal sphincter

Question 10

What genre of enzymes are secreted in the pancreas?

Answer 10

Pancreatic enzymes all end in “ayse”

Question 11

What amount of blood flow is directed towards the GI system?

Answer 11

25-30%

Question 12

What is the medical word for chewing?

Answer 12

Mastication

Question 13

What is the medical word for swallowing?

Answer 13

Degluttition

Question 14

What is the word for the “mixing” that takes place in the GI tract?

Answer 14

Segmentation

Question 15

What is the word for the “propulsion” that takes place in the GI tract?

Answer 15

Peristalsis

Question 16

What does Pepto-Bismol do?

Answer 16

Decreases secretions and has weak antibacterial effect. Used to prevent travelers diarrhea.

Question 17

What does Mitrolan do?

Answer 17

Bulk-forming agent that absorbs excessive fluid from diarrhea to form a gel. Used when intestinal mucosa cannot absorb fluid.

Question 18

What does Loperamide (Imodium) do?

Answer 18

Inhibits peristalsis, delays transit, and increases absorption of fluid from stool

Question 19

What does Lomotil do?

Answer 19

Opiod and anticholinergic; decreases peristalsis

Question 20

What is the action of Sandostatin?

Answer 20

Suppresses serotonin secretion; stimulates fluid absorption from GI tract and slows intestinal motility

Question 21

What is a possible severe side effect of using antidirrheal meds too long?

Answer 21

Toxic megacolon

Question 22

What is the definition of toxic megacolon?

Answer 22

Colon dilated greater than 5cm

Question 23

When in the gastrocolic reflex (urge to poo) strongest?

Answer 23

Right after breakfast

Question 24

What disease are patients with IBD at risk for?

Answer 24

Osteoporosis

Question 25

What is the term to describe the normal portions of bowel between lesions in a patient with Crohn's disease?

Answer 25

"skip lesions"

Question 26

What is ERCP?

Answer 26

Endoscopic Retrograde Cholangiopancreatography; it is a procedure that combines upper GI endoscopy and x-rays to treat problems of the bile and pancreatic ducts.

Question 27

Patients with which blood type develop duodenal ulcers more often than normal?

Answer 27

blood type O

Question 28

What does borborygmi mean and how is it spelled?

Answer 28

stomach growling; B-O-R-B-O-R-Y-G-M-I

Question 29

What does a pulsation felt between the umbilicus and the pubis indicate?

Answer 29

Abdominal aortic aneurysm

Question 30

What does elevated white blood count and right lower quadrant pain possibly indicate?

Answer 30

Appendicitis and possible rupture

Question 31

What is a "gallbladder series"?

Answer 31

Also called a "cholecystography"; it's a series of xrays taken of the gallbladder to detect gallstones

Question 32

What are "Grey's Turner spots"?

Answer 32

Areas of bluish eccymotic areas (bruises) on the flanks associated with pancreatitis

Question 33

What is "Cullen's sign"?

Answer 33

Bluish periumbilical eccymotic discoloration associated with pancreatitis

Question 34

What is a T-Tube Cholangiogram?

Answer 34

When the gallbladder is removed, a special tube known as a T-tube is inserted into the duct that connects your liver to your small intestine. The T-tube cholangiogram is an x-ray examination of this passage.

Question 35

Patients with chronic gastritis may have a deficiency in which vitamin?

Answer 35

Vitamin B12

Question 36

What is amylase?

Answer 36

Amylase is made in the pancreas to break down carbohydrates in food into simple sugars.

Question 37

What is lipase?

Answer 37

Lipase is produced by the pancreas to digest fats into fatty acids.

Question 38

What will the nurse find on physical exam of the patient with chronic liver cirrhosis?

Answer 38

Hard, enlarged liver

Question 39

What is a normal amalyse level?

Answer 39

Normal blood amylase level is 30-122

Question 40

What is the normal lipase level?

Answer 40

A normal lipase level is 31-186

Question 41

What amalyse and lipase levels indicate pancreatic damage?

Answer 41

Blood levels more than four times normal levels of amylase (>450 U/L) and lipase (>400 U/L), likely indicate pancreatic damage or pancreatitis.

Question 42

What is a Choledocholithotomy?

Answer 42

Opening into common bile duct for | removal of stones

Question 43

What does an elevated alpha fetoprotein level indicate?

Answer 43

hepatocellular carcinoma (liver cancer)

Question 44

What is the normal level of alpha fetaprotein?

Answer 44

less than 10

Question 45

What is a "virtual colonosopy"?

Answer 45

A lower abdominal CT scan

Question 46

What is a necessary dietary requirement for a patient with Crohn's disease?

Answer 46

An intake of 2-3 liters of water daily

Question 47

What are the 2 primary roles of the small intestine?

Answer 47

Digestion and absorption

Question 48

The kneading action of the circular muscles in the large intestine is technically termed what?

Answer 48

Haustral churning

Question 49

What is the role of Kupffer cells in the liver?

Answer 49

They carry out phagocytic activity; removal of bacteria and toxins from the blood

Question 50

What is billirubin?

Answer 50

It is a pigment derived from the breakdown of hemoglobin (by the Kupffer cells)

Question 51

What is the difference in conjugated and unconjugated billirubin?

Answer 51

Unconjugated is not soluble and must be transported to the liver by albumin; conjugated has been processed by the liver and is soluble

Question 52

What is Cheilosis?

Answer 52

Softening, fissuring and cracking of the lips at the angles of the mouth

Question 53

What is Pyorrhea?

Answer 53

Recessed gums with purulent pockets

Question 54

What is the "cardinal sign" of Appendicitis?

Answer 54

Pain at McBurney's point

Question 55

Where is McBurney's point?

Answer 55

Right lower quadrant

Question 56

A patient presents with severe abdominal pain. What lab value would be used to confirm a diagnosis of acute appendicitis?

Answer 56

Serum amalyase

Question 57

To palpate the patient's liver, where should the nurse palpate the patient's abdomen?

Answer 57

Right upper quadrant

Question 58

Colicky pain in the epigastric area and chest pain after eating fatty foods are signs of what disease?

Answer 58

Cholecystitis (inflammation of the gallbladder)

Question 59

Rebound tenderness is indicative of what disease?

Answer 59

Peritoneal inflammation

Question 60

A jaundiced patient with elevated LFT's indicates what?

Answer 60

Cirrhosis

Question 61

A low Calcium level is found in what GI disease?

Answer 61

Pancreatitis

Question 62

What is normal ALT range?

Answer 62

Normal ALT range is 7--56

Question 63

What is normal AST range?

Answer 63

normal AST range is 5--40

Question 64

Which clinical manifestation of pain does the nurse expect to identify in a patient who has cholecystitis?

Answer 64

Right upper quadrant pain radiating to the patient's back