NR 511 MIDTERM EXAM 2026|350 VERIFIED
Qs&As|A+GRADE ASSURED|CHAMBERLAIN
What are common causes of N/V associated with gastritis? - ANSWER:->>>-Alcohol,
NSAIDs, ASA, ABX, and illicit substances
What is the most common cause of nausea and vomiting? - ANSWER:->>>-Acute
Gastroenteritis (AGE)
What are some manifestations of AGE? - ANSWER:->>>-Nausea, vomiting, and diarrhea,
fever, abdominal pain. May also include fatigue, malaise, anorexia, tenesmus and borborygmus.
How is the severity of AGE gauged? - ANSWER:->>>-Dehydration secondary to profuse
watery diarrhea, fever greater than 101ºF (38.3ºC), vomiting, or dysentery.
What are important parts of a patient's history when AGE is suspected? - ANSWER:->>>-
Travel, dining locations, ABX history..
What happens to the pH of the stomach when antacids are taken and how does this affect bacteria?
- ANSWER:->>>-High pH can make it easier for bacteria to survive and cause and infection.
How does motility of the GI tract affect bacteria colonization? - ANSWER:->>>-Small bowel
stasis as a result of obstruction, diverticulitis, or blind loop syndrome frequently develop an
overgrowth of bacteria within the stagnant segment.
As pseudocysts grow they may rupture releasing enzymes into the abdominal cavity causing massive
inflammation. They can become infected, often by E. coli, which turns the pseudocyst into an
abscess.
How is a pancreatic pseudocyst distinguished from a pancreatic abscess since they present similarly
in symptoms and imaging? - ANSWER:->>>-1. High fever and WBC count since it is an
infection
What secondary complication results from damaged blood vessels as a result of acute pancreatitis? -
ANSWER:->>>-Hemorrhage --> hypovolemic shock
,How does acute pancreatitis affect the body's ability to clot? - ANSWER:->>>-It affects the
systemic activation of coagulation factors which may result in disseminated intravascular coagulation
(DIC).
How does acute pancreatitis affect the body's respiratory system? - ANSWER:->>>-May lead
to acute respiratory distress syndrome (ARDS) where massive pancreatic inflammation leads to
leaky blood vessels throughout the body making it harder to breath. #1 killer in patients with acute
pancreatitis.
What are some general symptoms of acute pancreatitis? What about distinctive signs? -
ANSWER:->>>-
1. N/V, epigastric pain radiating to the back
2. Hypocalcemia as a result of fat necrosis
3. Bruising around the umbilicus (Cullen's sign)
4. Bruising along the flanks (Grey Turner's sign)
3 & 4 happen as a result of necrosis induced hemorrhaging spreads to the soft tissues of those body
areas
What are the diagnostic features of acute pancreatitis? - ANSWER:->>>-1. Pain in epigastric
region which may radiate to the back
2. Labs: Amylase and lipase, the latter being more specific to the pancreas.
3. CT scan: inflammation, necrosis, pseudocyst
4. Ultrasound: not definitive, but can locate gallstones if they are suspected.
How is acute pancreatitis treated? - ANSWER:->>>-It can't be cured, per se. Treatment
consists of pain management, hydration, electrolyte management, bowel rest.
Treat complications with oxygen (ischemia of tissue) and antibiotics for infection such as in an
abscess.
What is the most common reason for cholecystitis? - ANSWER:->>>-When a gallstone
becomes lodged in the cystic duct.
,The small intestine secretes into the blood when food is present in order to
instruct the to secrete to help digest food. - ANSWER:->>>-1.
cholecystokinin
2. gallbladder
3. bile
Pain resulting from acute cholecystitis usually starts in the region and shifts to the
as the gallbladder becomes . - ANSWER:->>>-1. midepigastric
2. right upper quadrant
3. infection
What is the main subjective s/s of acute cholecystitis? - ANSWER:->>>-Nausea & vomiting
which can last a long time.
How does the gall bladder become inflamed? - ANSWER:->>>-Since there a is a stone stuck in
the cystic duct, the bile cannot escape the gallbladder. The bile becomes an irritant to the gallbladder
mucosa which in turn secretes mucus and enzymes. These enzymes cause the walls of the gallbladder
to
become inflamed and pressure to rise.
Where does pain caused from cholecystitis radiate? - ANSWER:->>>-Right scapula, shoulders
Bacteria eventually make their way through the gall bladder wall and into the
causing . This results in tenderness. - ANSWER:->>>-1.
peritoneum
2. peritonitis
3. rebound
sign can help with the diagnosis of cholecystitis and is performed by applying
pressure at the subcostal region of the right upper quadrant on inspiration. - ANSWER:->>>-
Murphy's
What would blood work show in a patient with cholecystitis? What is the condition called? -
ANSWER:->>>-1. Elevated neutrophils
2. Neutrophilic leukocytosis
, What is the most common resolution of cholecystitis? - ANSWER:->>>-The gallstone leaves
the cystic duct falling back into the gallbladder.
How is blood flow to the gallbladder affected in cholecystitis? What is the result? - ANSWER:-
>>>-If the stone remains lodged in place, pressure continues to increase in the gallbladder until it
expands and pushes on the vessels that supply its blood. This causes ischemia to the organ which
leads to gangrenous cell death. Rupture is possible.
What complications might arise upon gallbladder rupture? - ANSWER:->>>-Bacteria from the
gallbladder can be expelled and infect the circulatory system leading to sepsis. This is grounds for
cholecystectomy.
What complications arise if a gallstone becomes lodged in the common bile duct? - ANSWER:-
>>>-Bile backs up into the gallbladder and the liver. The pressure builds and causes bile to force
its way
through the cells that form the bile duct walls and allow it to enter the blood stream --> conjugated
bilirubin --> jaundice.
What markers in the blood can be used to assist in the diagnosis of cholecystitis? - ANSWER:-
>>>-ALT or alkaline phosphatase. This enzyme is found in high amounts in the cells of the bile
ducts of the liver. The increased pressure of the bile in the ducts can cause the cells to rupture,
releasing their ALP into the blood.
What non-invasive diagnostic test can be used for cholecystitis? What are some of its findings? -
ANSWER:->>>-1. Ultrasound
2. Gallbladder wall thickness, sludge, and distention of gallbladder of bile duct.
*This test can also elicit the Sonographic Murphy's Sign.
What is a more sensitive diagnostic tools can be used for cholecystitis? - ANSWER:->>>-1.
Cholescintigraphy (HIDA scan) - radio-labeled marker. When duct is blocked, the gallbladder can't be
seen.
2. Endoscopic Retrograde Cholangiopancreatography (ERCP) - Dye is used and then viewed with a
fluoroscope.
3. Magnetic Resonance Cholangiopancreatography (MRCP)
What are three main treatment components of cholecystitis? Surgery? - ANSWER:->>>-1.
Intravenous fluids
Qs&As|A+GRADE ASSURED|CHAMBERLAIN
What are common causes of N/V associated with gastritis? - ANSWER:->>>-Alcohol,
NSAIDs, ASA, ABX, and illicit substances
What is the most common cause of nausea and vomiting? - ANSWER:->>>-Acute
Gastroenteritis (AGE)
What are some manifestations of AGE? - ANSWER:->>>-Nausea, vomiting, and diarrhea,
fever, abdominal pain. May also include fatigue, malaise, anorexia, tenesmus and borborygmus.
How is the severity of AGE gauged? - ANSWER:->>>-Dehydration secondary to profuse
watery diarrhea, fever greater than 101ºF (38.3ºC), vomiting, or dysentery.
What are important parts of a patient's history when AGE is suspected? - ANSWER:->>>-
Travel, dining locations, ABX history..
What happens to the pH of the stomach when antacids are taken and how does this affect bacteria?
- ANSWER:->>>-High pH can make it easier for bacteria to survive and cause and infection.
How does motility of the GI tract affect bacteria colonization? - ANSWER:->>>-Small bowel
stasis as a result of obstruction, diverticulitis, or blind loop syndrome frequently develop an
overgrowth of bacteria within the stagnant segment.
As pseudocysts grow they may rupture releasing enzymes into the abdominal cavity causing massive
inflammation. They can become infected, often by E. coli, which turns the pseudocyst into an
abscess.
How is a pancreatic pseudocyst distinguished from a pancreatic abscess since they present similarly
in symptoms and imaging? - ANSWER:->>>-1. High fever and WBC count since it is an
infection
What secondary complication results from damaged blood vessels as a result of acute pancreatitis? -
ANSWER:->>>-Hemorrhage --> hypovolemic shock
,How does acute pancreatitis affect the body's ability to clot? - ANSWER:->>>-It affects the
systemic activation of coagulation factors which may result in disseminated intravascular coagulation
(DIC).
How does acute pancreatitis affect the body's respiratory system? - ANSWER:->>>-May lead
to acute respiratory distress syndrome (ARDS) where massive pancreatic inflammation leads to
leaky blood vessels throughout the body making it harder to breath. #1 killer in patients with acute
pancreatitis.
What are some general symptoms of acute pancreatitis? What about distinctive signs? -
ANSWER:->>>-
1. N/V, epigastric pain radiating to the back
2. Hypocalcemia as a result of fat necrosis
3. Bruising around the umbilicus (Cullen's sign)
4. Bruising along the flanks (Grey Turner's sign)
3 & 4 happen as a result of necrosis induced hemorrhaging spreads to the soft tissues of those body
areas
What are the diagnostic features of acute pancreatitis? - ANSWER:->>>-1. Pain in epigastric
region which may radiate to the back
2. Labs: Amylase and lipase, the latter being more specific to the pancreas.
3. CT scan: inflammation, necrosis, pseudocyst
4. Ultrasound: not definitive, but can locate gallstones if they are suspected.
How is acute pancreatitis treated? - ANSWER:->>>-It can't be cured, per se. Treatment
consists of pain management, hydration, electrolyte management, bowel rest.
Treat complications with oxygen (ischemia of tissue) and antibiotics for infection such as in an
abscess.
What is the most common reason for cholecystitis? - ANSWER:->>>-When a gallstone
becomes lodged in the cystic duct.
,The small intestine secretes into the blood when food is present in order to
instruct the to secrete to help digest food. - ANSWER:->>>-1.
cholecystokinin
2. gallbladder
3. bile
Pain resulting from acute cholecystitis usually starts in the region and shifts to the
as the gallbladder becomes . - ANSWER:->>>-1. midepigastric
2. right upper quadrant
3. infection
What is the main subjective s/s of acute cholecystitis? - ANSWER:->>>-Nausea & vomiting
which can last a long time.
How does the gall bladder become inflamed? - ANSWER:->>>-Since there a is a stone stuck in
the cystic duct, the bile cannot escape the gallbladder. The bile becomes an irritant to the gallbladder
mucosa which in turn secretes mucus and enzymes. These enzymes cause the walls of the gallbladder
to
become inflamed and pressure to rise.
Where does pain caused from cholecystitis radiate? - ANSWER:->>>-Right scapula, shoulders
Bacteria eventually make their way through the gall bladder wall and into the
causing . This results in tenderness. - ANSWER:->>>-1.
peritoneum
2. peritonitis
3. rebound
sign can help with the diagnosis of cholecystitis and is performed by applying
pressure at the subcostal region of the right upper quadrant on inspiration. - ANSWER:->>>-
Murphy's
What would blood work show in a patient with cholecystitis? What is the condition called? -
ANSWER:->>>-1. Elevated neutrophils
2. Neutrophilic leukocytosis
, What is the most common resolution of cholecystitis? - ANSWER:->>>-The gallstone leaves
the cystic duct falling back into the gallbladder.
How is blood flow to the gallbladder affected in cholecystitis? What is the result? - ANSWER:-
>>>-If the stone remains lodged in place, pressure continues to increase in the gallbladder until it
expands and pushes on the vessels that supply its blood. This causes ischemia to the organ which
leads to gangrenous cell death. Rupture is possible.
What complications might arise upon gallbladder rupture? - ANSWER:->>>-Bacteria from the
gallbladder can be expelled and infect the circulatory system leading to sepsis. This is grounds for
cholecystectomy.
What complications arise if a gallstone becomes lodged in the common bile duct? - ANSWER:-
>>>-Bile backs up into the gallbladder and the liver. The pressure builds and causes bile to force
its way
through the cells that form the bile duct walls and allow it to enter the blood stream --> conjugated
bilirubin --> jaundice.
What markers in the blood can be used to assist in the diagnosis of cholecystitis? - ANSWER:-
>>>-ALT or alkaline phosphatase. This enzyme is found in high amounts in the cells of the bile
ducts of the liver. The increased pressure of the bile in the ducts can cause the cells to rupture,
releasing their ALP into the blood.
What non-invasive diagnostic test can be used for cholecystitis? What are some of its findings? -
ANSWER:->>>-1. Ultrasound
2. Gallbladder wall thickness, sludge, and distention of gallbladder of bile duct.
*This test can also elicit the Sonographic Murphy's Sign.
What is a more sensitive diagnostic tools can be used for cholecystitis? - ANSWER:->>>-1.
Cholescintigraphy (HIDA scan) - radio-labeled marker. When duct is blocked, the gallbladder can't be
seen.
2. Endoscopic Retrograde Cholangiopancreatography (ERCP) - Dye is used and then viewed with a
fluoroscope.
3. Magnetic Resonance Cholangiopancreatography (MRCP)
What are three main treatment components of cholecystitis? Surgery? - ANSWER:->>>-1.
Intravenous fluids
