Question 1

Esophagogastric varices are the result of

Accepted Answer

A)  portal hypertension resulting in diversion of blood from a high-pressure area to a low-pressure area. 
B)  superficial mucosal erosions as a result of increased stress levels. 
C)  proulcer forces breaking down the mucosal resistance. 
D)  inflammation and ulceration secondary to nonsteroidal anti-inflammatory drug use. 
A)  portal hypertension resulting in diversion of blood from a high-pressure area to a low-pressure area. 
B)  superficial mucosal erosions as a result of increased stress levels. 
C)  proulcer forces breaking down the mucosal resistance. 
D)  inflammation and ulceration secondary to nonsteroidal anti-inflammatory drug use. A

Question 2

Which of the following is a potential cause for acute liver failure?

Accepted Answer

A)  Ischemia 
B)  Hepatitis A, B, C, D, E, non-A, non-B, non-C 
C)  Acetaminophen toxicity 
D)  Wilson disease 
E)  Reye syndrome
F) Diabetes 
A)  Ischemia 
B)  Hepatitis A, B, C, D, E, non-A, non-B, non-C 
C)  Acetaminophen toxicity 
D)  Wilson disease 
E)  Reye syndrome
F) Diabetes A, B, C, D, E

Question 3

Which of the following are clinical manifestations of pancreatitis?

Accepted Answer

A)  Epigastric and abdominal pain 
B)  Nausea and vomiting 
C)  Diaphoresis 
D)  Jaundice 
E)  Hyperactive bowel sounds
F) Fever 
A)  Epigastric and abdominal pain 
B)  Nausea and vomiting 
C)  Diaphoresis 
D)  Jaundice 
E)  Hyperactive bowel sounds
F) Fever A, B, D, F

Question 4

Which of the following nursing interventions after GI surgery would have the highest priority of care?

Accepted Answer

A)  Oxygenation 
B)  Pain management 
C)  Circulation 
D)  Preventing infection 
A)  Oxygenation 
B)  Pain management 
C)  Circulation 
D)  Preventing infection

Question 5

Esophagectomy is usually performed for

Accepted Answer

A)  cancer of the proximal esophagus and gastroesophageal junction. 
B)  cancer of the distal esophagus and gastroesophageal junction. 
C)  cancer of the pancreatic head. 
D)  varices of the distal esophagus and gastroesophageal junction. 
A)  cancer of the proximal esophagus and gastroesophageal junction. 
B)  cancer of the distal esophagus and gastroesophageal junction. 
C)  cancer of the pancreatic head. 
D)  varices of the distal esophagus and gastroesophageal junction.

Question 6

Which of the following disorders is the leading cause of upper GI hemorrhage?

Accepted Answer

A)  Stress ulcers 
B)  Peptic ulcers 
C)  Nonspecific erosive gastritis 
D)  Esophageal varices 
A)  Stress ulcers 
B)  Peptic ulcers 
C)  Nonspecific erosive gastritis 
D)  Esophageal varices

Question 7

A patient with a 10-year history of alcoholism was admitted to the critical care unit with the diagnosis of acute pancreatitis.The physiologic alteration that occurs in acute pancreatitis is

Accepted Answer

A)  uncontrolled hypoglycemia caused by an increased release of insulin. 
B)  loss of storage capacity for senescent red blood cells. 
C)  premature activation of inactive digestive enzymes, resulting in autodigestion. 
D)  release of glycogen into the serum, resulting in hyperglycemia. 
A)  uncontrolled hypoglycemia caused by an increased release of insulin. 
B)  loss of storage capacity for senescent red blood cells. 
C)  premature activation of inactive digestive enzymes, resulting in autodigestion. 
D)  release of glycogen into the serum, resulting in hyperglycemia.

Question 8

A patient with a 10-year history of alcoholism was admitted to the critical care unit with the diagnosis of acute pancreatitis.The patient is complaining of a pain in left upper quadrant.Using a 1- to 10-point pain scale, the patient states the current level is at an 8.To properly manage the patient's pain, the priority of nursing interventions is to

Accepted Answer

A)  administer antiemetics around the clock. 
B)  administer analgesics around the clock. 
C)  educate the patient and family on lifestyle changes. 
D)  teach relaxation techniques. 
A)  administer antiemetics around the clock. 
B)  administer analgesics around the clock. 
C)  educate the patient and family on lifestyle changes. 
D)  teach relaxation techniques.

Question 9

Which classification of medication is used to reduce volume and concentration of gastric secretions?

Accepted Answer

A)  Antacids 
B)  Histamine2 (H2) antagonists 
C)  Gastric mucosal agents 
D)  Gastric proton pump inhibitors 
A)  Antacids 
B)  Histamine2 (H2) antagonists 
C)  Gastric mucosal agents 
D)  Gastric proton pump inhibitors

Question 10

The physician orders gastric lavage to control GI bleeding.The nurse has inserted a large-bore NG tube.What temperature and irrigating fluid would be used to obtain the best results?

Accepted Answer

A)  Warm NS or water 
B)  Iced NS or water 
C)  Room temperature NS or water 
D)  Iced NS only 
A)  Warm NS or water 
B)  Iced NS or water 
C)  Room temperature NS or water 
D)  Iced NS only

Question 11

A patient has a Salem sump to lower intermittent suction.Nursing interventions include

Accepted Answer

A)  prevention of esophageal erosion and stricture. 
B)  prevention of dry mouth. 
C)  prevention of ulceration of the nares. 
D)  irrigating the tube every 4 hours or as ordered by the health care provider. 
A)  prevention of esophageal erosion and stricture. 
B)  prevention of dry mouth. 
C)  prevention of ulceration of the nares. 
D)  irrigating the tube every 4 hours or as ordered by the health care provider.

Question 12

Which of the following interventions would you expect in the management of hepatic failure?

Accepted Answer

A)  Benzodiazepines for agitation 
B)  Pulse oximetry and serial arterial blood gas measurements 
C)  Insulin drip for hyperglycemia and hyperkalemia 
D)  Monitor electrolyte blood levels 
E)  Assess for signs of cerebral edema 
A)  Benzodiazepines for agitation 
B)  Pulse oximetry and serial arterial blood gas measurements 
C)  Insulin drip for hyperglycemia and hyperkalemia 
D)  Monitor electrolyte blood levels 
E)  Assess for signs of cerebral edema

Question 13

Signs and symptoms of an anastomotic leak include

Accepted Answer

A)  pneumonia. 
B)  subcutaneous emphysema. 
C)  bleeding. 
D)  atelectasis. 
A)  pneumonia. 
B)  subcutaneous emphysema. 
C)  bleeding. 
D)  atelectasis.

Question 14

A patient is admitted with the diagnosis of acute pancreatitis.The nurse expects which of the following laboratory test results to be elevated?

Accepted Answer

A)  Calcium 
B)  Serum amylase 
C)  Serum glucose 
D)  Potassium 
E)  WBC
F) Serum triglycerides 
A)  Calcium 
B)  Serum amylase 
C)  Serum glucose 
D)  Potassium 
E)  WBC
F) Serum triglycerides

Question 15

Verification of feeding tube placement includes

Accepted Answer

A)  auscultation for position. 
B)  aspiration of stomach contents. 
C)  x-ray study for confirmation. 
D)  gastric pH measurement. 
A)  auscultation for position. 
B)  aspiration of stomach contents. 
C)  x-ray study for confirmation. 
D)  gastric pH measurement.

Question 16

The patient at risk for GI hemorrhage should be monitored for which of the following signs and symptoms?

Accepted Answer

A)  Metabolic acidosis and hypovolemia 
B)  Decreasing hemoglobin and hematocrit 
C)  Hyperkalemia and hypernatremia 
D)  Hematemesis and melena 
A)  Metabolic acidosis and hypovolemia 
B)  Decreasing hemoglobin and hematocrit 
C)  Hyperkalemia and hypernatremia 
D)  Hematemesis and melena

Question 17

A nursing priority for a patient with GI hemorrhage is

Accepted Answer

A)  positioning the patient in a high-Fowler position. 
B)  airway protection. 
C)  irrigating the nasogastric tube with iced saline. 
D)  maintaining venous access so that fluids and blood can be administered. 
A)  positioning the patient in a high-Fowler position. 
B)  airway protection. 
C)  irrigating the nasogastric tube with iced saline. 
D)  maintaining venous access so that fluids and blood can be administered.

Question 18

A patient with a 10-year history of alcoholism was admitted to the critical care unit with the diagnosis of acute pancreatitis.Based on the diagnosis, the patient

Accepted Answer

A)  is at risk for hypovolemic shock from plasma volume depletion. 
B)  requires observation for hypoglycemia and hypercalcemia. 
C)  should be started on enteral feedings after the nasogastric tube is placed. 
D)  is placed on a fluid restriction to avoid the fluid sequestration. 
A)  is at risk for hypovolemic shock from plasma volume depletion. 
B)  requires observation for hypoglycemia and hypercalcemia. 
C)  should be started on enteral feedings after the nasogastric tube is placed. 
D)  is placed on a fluid restriction to avoid the fluid sequestration.

Question 19

Which of the following medications is/are given to help control ammonia levels in a patient with acute liver failure (ALF)?

Accepted Answer

A)  Insulin 
B)  Vitamin K 
C)  Lactulose 
D)  Benzodiazepines 
A)  Insulin 
B)  Vitamin K 
C)  Lactulose 
D)  Benzodiazepines

Question 20

Roux-en-Y gastric bypass is

Accepted Answer

A)  a restrictive type of bariatric surgery. 
B)  a malabsorptive type of bariatric surgery. 
C)  a combination of restrictive and malabsorption types of bariatric surgery. 
D)  standard operation for pancreatic cancer. 
A)  a restrictive type of bariatric surgery. 
B)  a malabsorptive type of bariatric surgery. 
C)  a combination of restrictive and malabsorption types of bariatric surgery. 
D)  standard operation for pancreatic cancer.

Exam 22: Gastrointestinal Disorders and Therapeutic Management

Esophagogastric varices are the result of

Which of the following is a potential cause for acute liver failure?

Which of the following are clinical manifestations of pancreatitis?

Which of the following nursing interventions after GI surgery would have the highest priority of care?

Esophagectomy is usually performed for

Which of the following disorders is the leading cause of upper GI hemorrhage?

A patient with a 10-year history of alcoholism was admitted to the critical care unit with the diagnosis of acute pancreatitis.The physiologic alteration that occurs in acute pancreatitis is

Which classification of medication is used to reduce volume and concentration of gastric secretions?

The physician orders gastric lavage to control GI bleeding.The nurse has inserted a large-bore NG tube.What temperature and irrigating fluid would be used to obtain the best results?

A patient has a Salem sump to lower intermittent suction.Nursing interventions include

Which of the following interventions would you expect in the management of hepatic failure?

Signs and symptoms of an anastomotic leak include

A patient is admitted with the diagnosis of acute pancreatitis.The nurse expects which of the following laboratory test results to be elevated?

Verification of feeding tube placement includes

The patient at risk for GI hemorrhage should be monitored for which of the following signs and symptoms?

A nursing priority for a patient with GI hemorrhage is

A patient with a 10-year history of alcoholism was admitted to the critical care unit with the diagnosis of acute pancreatitis.Based on the diagnosis, the patient

Which of the following medications is/are given to help control ammonia levels in a patient with acute liver failure (ALF)?

Roux-en-Y gastric bypass is

Caring for the Critically Ill Patient

Ethical and Legal Issues

Patient and Family Education

Psychosocial and Spiritual Alterations and Management

Sleep Alterations

Nutritional Alterations

Gerontological Alterations

Pain and Pain Management

Sedation, Agitation and Delirium Management

End of Life Care

Cardiovascular Clinical Assessment and Diagnostic Procedures

Cardiovascular Disorders

Cardiovascular Therapeutic Management

Pulmonary Clinical Assessment and Diagnostic Procedures

Pulmonary Disorders

Pulmonary Therapeutic Management

Neurologic Clinical Assessment and Diagnostic Procedures

Neurologic Disorders and Therapeutic Management

Kidney Clinical Assessment and Diagnostic Procedures

Kidney Disorders and Therapeutic Management

Gastrointestinal Clinical Assessment and Diagnostic Procedures

Endocrine Clinical Assessment and Diagnostic Procedures

Endocrine Disorders and Therapeutic Management

Trauma

Shock, Sepsis, and Multiple Organ Dysfunction Syndrome

Hematologic Disorders and Oncologic Emergencies

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