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AGACNP AACN Board Exam Questions with Verified Answers | 100% Correct | Latest 2025/2026.

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What is Zollinger-Ellison syndrome? rare condition characterized by gastrin-producing tumors in the duodenum and/or pancreas that lead to oversecretion of gastrin, which lead to gastric and duodenal ulcers that result in gastric bleeding. treatment is same as PUD +/- tumor resection PUD s/s gnawing epigastric pain relief of pain with eating (duodenal) if pain worsens with eating then (epigastric) duodenal ulcer age 30-55 pain relief with EATING Peptic Ulcer disease causes and incidence h. pylori men 3:1 smokers NSAIDs, ASA, glucocorticoids alcohol and dietary factors don't seem to contribute zollinger ellison syndrome which is a gastric secreting tumor gastric ulcer ages 55-65 pain worse with EATING physical findings of PUD often unremarkable but might have epigastric tenderness GI bleeding 20% of causes- melena, hematemesis or coffee ground emesis perforation s/s board like abdomen quiet bowel sounds RIGIDITY - peritonitis - hole in lumina of GI tract- requires immediate surgery (washout with abx) other acute abdomen causes crohn's disease ruptured diverticulum ruptured appendix labs/diagnostics for ulcer can show anemia endoscopy after 8-12 weeks of treatment h. pylori testing PPI vs H2RA PPI indicated for acute ulceration Medical management - H2 receptor antagonist - start with dyspepsia "tidine" cimetidine (tagamet) - 800mg/HS Famotidine (pepcid) - 40mg/HS nizatidine (axid) - 300mg/HS AGACNP AACN Board Exam Questions with Verified Answers | 100% Correct | Latest 2025/2026.

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AGACNP AACN Board Exam Questions i,- i,- i,- i,- i,-




with Verified Answers | 100% Correct | i,- i,- i,- i,- i,- i,- i,-




Latest 2025/2026. i,-




What is Zollinger-Ellison syndrome?
i,- i,- rare condition i,- i,-i,- i,- i,- i,-



characterized by gastrin-producing tumors in the duodenum i,- i,- i,- i,- i,- i,- i,-



and/or pancreas that lead to oversecretion of gastrin, which lead
i,- i,- i,- i,- i,- i,- i,- i,- i,- i,-



to gastric and duodenal ulcers that result in gastric bleeding.
i,- i,- i,- i,- i,- i,- i,- i,- i,- i,-



treatment is same as PUD +/- tumor resection i,- i,- i,- i,- i,- i,- i,-




PUD s/s i,- i,-i,- i,- gnawing epigastric pain i,- i,-




relief of pain with eating (duodenal)
i,- i,- i,- i,- i,-




if pain worsens with eating then (epigastric)
i,- i,- i,- i,- i,- i,-




duodenal ulcer i,- i,-i,- i,- age 30-55 i,-




pain relief with EATING
i,- i,- i,-




Peptic Ulcer disease causes and incidence
i,- i,- i,- i,- i,- i,-i,- i,- h. pylori
i,-




men 3:1 i,-




smokers
NSAIDs, ASA, glucocorticoids i,- i,-

,alcohol and dietary factors don't seem to contribute
i,- i,- i,- i,- i,- i,- i,-




zollinger ellison syndrome which is a gastric secreting tumor
i,- i,- i,- i,- i,- i,- i,- i,-




gastric ulcer i,- i,-i,- i,- ages 55-65 i,-




pain worse with EATING
i,- i,- i,-




physical findings of PUD i,- i,- i,- i,-i,- i,- often unremarkable but might have
i,- i,- i,- i,- i,-



epigastric tenderness i,-




GI bleeding 20% of causes- melena, hematemesis or coffee
i,- i,- i,- i,- i,- i,- i,- i,- i,-



ground emesis i,-




perforation s/s i,- i,-i,- i,- board like abdomen i,- i,-




quiet bowel sounds
i,- i,-




RIGIDITY - peritonitis - hole in lumina of GI tract- requires
i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,-



immediate surgery (washout with abx) i,- i,- i,- i,-




other acute abdomen causes
i,- i,- i,- i,-i,- i,- crohn's disease i,-




ruptured diverticulum i,-




ruptured appendix i,-

,labs/diagnostics for ulcer i,- i,- i,-i,- i,- can show anemia
i,- i,-




endoscopy after 8-12 weeks of treatment i,- i,- i,- i,- i,-




h. pylori testing
i,- i,-




PPI vs H2RA
i,- i,- i,-i,- i,- PPI indicated for acute ulceration
i,- i,- i,- i,-




Medical management - H2 receptor antagonist - start with
i,- i,- i,- i,- i,- i,- i,- i,- i,-



dyspepsia
"tidine" i,-i,- i,- cimetidine (tagamet) - 800mg/HS i,- i,- i,-




Famotidine (pepcid) - 40mg/HS i,- i,- i,-




nizatidine (axid) - 300mg/HS i,- i,- i,-




start at HS, then BID, then add PPI
i,- i,- i,- i,- i,- i,- i,-




medical management - PPI - start if pepcid ulcer disease
i,- i,- i,- i,- i,- i,- i,- i,- i,- i,-



suspected
"prazole" i,-i,- i,- lansoprazole (pravacid) - 15mg/day i,- i,- i,-




pantoprazole (protonix) - 20mg/day i,- i,- i,-




omeprazole (prilosec) - 40mg/day i,- i,- i,-




esomeprazole (nexium) - 20mg/day i,- i,- i,-

, rebound GERD i,-




BLACK BOX WARNING - hip fracture with long-term use
i,- i,- i,- i,- i,- i,- i,- i,-




mucosal protective agents i,- i,- i,-i,- i,- sucralfate (carafate) 1 gm QID i,- i,- i,- i,-




i,- - decreases nosocomial PNA
i,- i,- i,-




i,- - avoid antacids and H2 blockers
i,- i,- i,- i,- i,-




bismuth subsalicylate (pepto-bismol) i,- i,-




i,- - helps against h. pylori
i,- i,- i,- i,-




i,- - prostaglandin production/gastric bicarb
i,- i,- i,-




antacids


H. pylori eradication therapy
i,- i,- i,- i,-i,- i,- EBP - combination i,- i,- i,-




2 antibiotics + PPI with or without bismuth for 10 - 14 days
i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,-




the abx in H.Pylori tx
i,- i,- i,- i,- i,-i,- i,- clarithromycin and amoxicillin i,- i,-




what to ask for eradication therapy?
i,- i,- i,- i,- i,- i,-i,- i,- PCN allergy i,-




macrolide antibiotic use i,- i,-

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