Targeted M-S GI

Question 1

ID= 6507272

Answer 1

Pword= 63F5466T57

Question 2

Ax-ing p with Crohn’s disease. WOTF is expected?

a. fatty, diarrheal stools
b. hyperkalemia
c. wt gain
d. sharp epigastric pain

Answer 2

a. fatty, diarrheal stools or steatorrhea is a sign of Crohn’s disease along with wt loss, possible hypokalemia, and RLQ pain.

Question 3

P. w/ colorectal CA is receiving chemotherapy. P asks why blood is being drawn for a carcinoembryonic antigen (CEA) level?

a. CEA determines the current stage of colon CA
b. CEA determines the efficacy of your chemo
c. CEA determines if neutrophil count is below the expected reference range.
d. CEA determines if you are experiencing occult bleeding from the GI tract.

Answer 3

b. CEA determines the efficacy of chemotherapy

Question 4

P postop gastrectomy. WOTF indicate acute gastric dilation?

a. hiccups
b. elevated bp
c. bradycardia
d. LLQ pain

Answer 4

a. hiccups, hypotension, tachycardia and epigastric pain are all indicative of acute gastric dilation

Question 5

P w/ peritonitis. WOTF is an expected sign?

a. bloody diarrhea
b. board-like abdomen
c. periumbilical cyanosis
d. increased bowel sounds

Answer 5

b. a board like abdomen is a classic sign of peritonitis. This condition is a life-threatening infla of the visceral/parietal peritoneum and endothelial lining of the abd. cavity that leads to blocked peristalsis and major fluid accumulation. There is a high risk for septicemia. Other S&S= abd pain/distention, N/V, anorexia, decreased bowel sounds, rebound tenderness, inability to pass flatus or BMs, hiccups, tachy-c.

Question 6

periumbilical cyanosis is a sign of?

Answer 6

intraperitoneal hemorrhage

Question 7

Expected axmt finding for a p w/ acute hep B?

a. joint pain
b. obstipation
c. abdominal distention
d. periumbilical discoloration

Answer 7

a. joint pain

Question 8

(MM) Expected axmt findings for a p w/ appendicitis?

a. oral T 101.1 degrees
b. WBC 6000/mm3
c. bloody diarrhea
d. N/V
e. RLQ pain

Answer 8

a, d, and e: fever, n/v and RLQ pain are S&S of appendicitis (along with an increased WBC count)

Question 9

WOTF is the priority for the RN to report for a p w/ cirrhosis?

a. spider angiomas
b. peripheral edema
c. bloody stools
d. jaundice

Answer 9

c. bloody stools. The greatest risk to p’s with cirrhosis is hemorrhaging r/t esophageal varices. Cirrhosis causes increased pressure in the portal vein which leads to back up of bld and swollen/dilated vessels that can rupture

Question 10

POC for p w/ cirrhosis and ascites. Include WOTF?

a. measure abd girth daily
b. give warfarin at the same time each day
c. provide a daily intake of 4g of sodium
d. assess breath sounds q12h

Answer 10

a. mx abd girth daily

Question 11

WOTF should RN expect to find in a p w/ a duodenal ulcer?

a. p c/o of painful spasms in the RLQ
b. p describes the pain as pressure felt in the epigastrium
c. p states the pain occurs as soon as food enters the stomach
d. p states the pain occurs 1.5-3 hr pc and during the night.

Answer 11

d. duodenal ulcers cause pain hours pc and during the night, midline b/w xiphoid process and the umbilicus

Question 12

d/c teaching to a p w/ an ileostomy. WOTF should RN tell p to report?

a. intolerance to high fiber foods
b. liquid ileostomy output
c. dark purple stoma
d. sensation of burning during bowel elimination

Answer 12

c. a dark purple stoma indicates inadequate circulation

Question 13

Expected lab values for a p w/ colorectal CA?

a. negative fecal occult blood test
b. decreased serum CEA level
c. Hct 43%
d. hgb 9.1 g/dL

Answer 13

d. hgb 9.1. Hgb and hct are low in p’s with colorectal CA due to bleeding, while fecal occult bld tests are positive. Also, the CEA is increased

Question 14

d/c teaching for p w/ GERD. WOTF ind teaching effective?

a. I will decrease the amt of carbonated bvgs I drink
b. I will avoid liquids for 30 minutes after taking a chewable antacid tab
c. I will eat a snack before going to bed
d. I will lie down for at least 30 minutes after eating each meal

Answer 14

a. avoid carb bvgs to reduce GI acid. Also, p should take antacids with water, eat 4-6 small meals/day, sit up for 1-2 hours pc, and avoid eating before bedtime

Question 15

P. w/ cirrhosis and new rx for lactulose. Include in teaching?

a. notify the provider if bloating occurs
b. expect to have 2-3 soft stools/day
c. restrict carbohydrates in the diet
d. limit oral fluid intake to 1000 mL/day of clear liquids

Answer 15

b. lactulose is given to promote defecation (which excretes ammonium ions)

Question 16

Admitting p w/ acute pancreatitis. First action RN should take?

a. insert a NG tube
b. give ceftazidime
c. ID the p’s current level of pain
d. instruct the p to remain NPO

Answer 16

c. determines the p’s pain level, then have p remain NPO, later: give antibiotics and insert NG tube if necessary for gastric decompression

Question 17

Assessing a p after a paracentesis to tx ascites. WOTF ind. the procedure was effective?

a. presence of a fluid wave
b. increased HR
c. equal pre- and post-procedure weights
d. decreased SOB

Answer 17

d. decreased SOB

Question 18

Food recommendation for a p w/ a new colostomy that is worried about flatus/odor?

a. eggs
b. fish
c. yogurt
d. broccoli

Answer 18

c. yogurt

Question 19

D/c teaching for a p w/chronic Hep. C. WOTF indicates understanding?

a. I will avoid alcohol until im no longer contagious
b. I will avoid meds containing acetaminophen
c. I will decrease my intake of calories
d. I will need txmt for 3 months

Answer 19

b. I will avoid meds containing acetaminophen

Question 20

WOTF lab results of a p w/ hepatic cirrhosis should be reported to the HCP?

a. Albumin 4.0
b. INR 1.5
c. bilirubin 0.2mg/dL
d. ammonia 180 mcg/dL

Answer 20

d. normal ammonia levels are 10-80 mcg/dL

Question 21

Instructions to include in the POC to minimize further exacerbations of UC for a p who has experienced several? (MM)

a. use progressive relaxation techniques
b. increase dietary fiber intake
c. drink two 240 mL glasses of milk/day
d. arrange activities to allow for daily rest periods
e. restrict intake of carbonated bvgs

Answer 21

a d and e. Ps should be told to use relaxation techniques and allow for daily rest periods to reduce stress. Also, they should restrict carbonated bvgs, fiber, and dairy products in their diet.

Question 22

P w/ GERD has new rx for metoclopramide, RN plans to mon for WOTF AEs?

a. thrombocytopenia
b. hearing loss
c. hypotension
d. ataxia

Answer 22

d. ataxia, metoclopramide can cause EPS like symptoms bc it is a dopamine2 receptor antagonist

Question 23

Acute pancreatitis expected lab value?

a. BS 110
b. increased serum amylase
c. WBC 9000/mm3
d. decreased bilirubin

Answer 23

b. increased serum amylase

Question 24

D/C teaching for a p who has gastritis and a new rx for famotidine (Pepcid). WOTF statements ind effectiveness?

a. I should make sure the water I drink is filtered
b. I should expect immediate pain relief
c. I will drink iced tea with my meals and snacks
d. I will mon my BS level regularly while taking this med

Answer 24

a. make sure the water is filtered.

Question 25

Chronic cholecystitis food recommendations?

a. unsalted nuts
b. bologna
c. cheddar cheese
d. bananas

Answer 25

d. bananas- the p needs to consume low fat foods to prevent exacerbations

Question 26

Teaching r/t preparing for a colonoscopy should include?

a. begin drinking oral liquid prep for bowel cleansing the morning of the proc
b. drink full liquids for breakfast the day of the proc
c. drink clear liquids for 24 hr prior to the proc, then NPO for 6 before the procedure.
d. drink the oral liquid prep for bowel cleansing slowly

Answer 26

c.

Question 27

RN is assessing a p w/ an upper GI bleed. WOTF is expected?

a. hypoactive bowel sounds
b. epigastric pain
c. hypotension
d. pernicious anemia

Answer 27

c. hypotension

Question 28

P w/ hepatic encephalopathy. P asks for larger portion of beef for dinner, WOTF is the correct response?

a. beef is too high in fat, but I can request chicken
b. you need to increase your fluid intake, Would you like beef and noodle soup?
c. you should limit your animal protein intake, can I get you a veggie burger instead?
d. you need to limit calories. Would you like some sugar-free gelatin?

Answer 28

c