NR 572 ADVANCED ACUTE CARE
MANAGEMENT FINAL EXAM 2026
COMPREHENSIVE STUDY GUIDE SOLVED
QUESTION SET
◉ Irritable bowel syndrome Answer: disorder of the bowel function not
from anatomic abnormality--constipation, diarrhea, bloating, urgency
w/diarrhea
+s/s--result from disordered sensations or abnormal function of the small
and large bowel
NOT associated with serious medical conditions, IBD, CA
◉ Inflammatory bowel disorder Answer: chronic immunologic disease
that manifests in intestinal inflammation
Ulcerative colitis
crohn's disease
◉ Two common inflammatory bowel diseases Answer: Ulcerative
colitis-mucosal surface of the colon is inflamed and ultimately results in
frability, erosions, and bleeding--most common in recto-sigmoid colon.
Can involve entire colon, pain in RLQ
Crohns disease-inflammation extends deeper into the intestional wall
and can involve all or any layer of the bowel wall and any portion of the
GI tract from the mouth to the anus--skipped lesions, pain in LLQ
,◉ Diverticulitis Answer: Symptoms: LLQ pain/tenderness, fever, N/V/D
Need imagining especially if perforation or peritonitis is suspected--free
air=perforation; patient may have ileus, small or large bowel obstruction
Can use plain x-ray
CT or Barium enema are preferred
CT with contrast is more sensitive and accurate
◉ Identify the significance of Barrett's esophagus Answer: After
repeated exposure to gastric contents, inflammation of the esophageal
mucosa becomes chronic
Blood flow increases, erosion occurs
As erosion heals, normal squamous epithelium replaced with metaplastic
columnar epithelium containing goblet and columnar cells.
More resistant to acid and supports esophageal healing
Premalignant tissue
40-fold frisk for developing esophageal adenocarcinma
Fibrosis and scarring during healing of erosions; leads to strictures
◉ Diagnosis of GERD Answer: made on history alone: sensitivity of
80%
if symptoms are unclear/patient does not respond to 4 weeks of empiric
tx
made by ambulatory esophageal pH monitoring
,pH <4 above the lower esophageal sphincter correlates with symptoms =
GERD
EDG with biopsy-Barrett's esohagus
Normal results in 50% of symptomatic patients
◉ Risks of GERD Answer: Obesity
Increase after age 50
Equal across gender, ethnic, and cultural groups
◉ Treatments of GERD Answer: Small frequent meals-main meal in
midday
Avoid trigger foods
No bedtime snacks: no eating <4 hours prior to bed
Eliminate caffeine, stop smoking, avoid tight fitting clothing, sleep with
head of the bed elevated.
◉ Medications for GERD Answer: antacids or OTC H2 (Tagamet,
zantac, axid)
Rx-strength H2 (ranitidine 150mg BID, famotidine 20mg BID) or PPI
(pantoprazole 40mg daily, omeprazole 20mg daily)
PPI (Omeprazole 40mg daily)
Surgery (fundoplication)
, ◉ Differential diagnosis of acute abd pain Answer: Acute appendicitis
Acute pancreatitis
Acute cholecystitis
◉ Acute appendicitis Answer: Inflammation of the vermiform appendix;
due to obstruction or infection
Most common surgical emergency of the abdomen
Hollow tube - most common cause is obstruction of appendix
Fecaltih - hard lump of fecal matter
Undigested seeds
Pinworm infections
Lymphoid follicle growth/lymphoid hyperplasia Symptoms
4. Symptoms
Nausea/vomiting
RLQ pain
Guarding
◉ Acute pancreatitis Answer: Sudden inflammation and hemorrhaging
of the pancreas due to destruction by its own digestive enzymes
1. Autodigestion
Most of the time mild, but can be severe
Pancreas
MANAGEMENT FINAL EXAM 2026
COMPREHENSIVE STUDY GUIDE SOLVED
QUESTION SET
◉ Irritable bowel syndrome Answer: disorder of the bowel function not
from anatomic abnormality--constipation, diarrhea, bloating, urgency
w/diarrhea
+s/s--result from disordered sensations or abnormal function of the small
and large bowel
NOT associated with serious medical conditions, IBD, CA
◉ Inflammatory bowel disorder Answer: chronic immunologic disease
that manifests in intestinal inflammation
Ulcerative colitis
crohn's disease
◉ Two common inflammatory bowel diseases Answer: Ulcerative
colitis-mucosal surface of the colon is inflamed and ultimately results in
frability, erosions, and bleeding--most common in recto-sigmoid colon.
Can involve entire colon, pain in RLQ
Crohns disease-inflammation extends deeper into the intestional wall
and can involve all or any layer of the bowel wall and any portion of the
GI tract from the mouth to the anus--skipped lesions, pain in LLQ
,◉ Diverticulitis Answer: Symptoms: LLQ pain/tenderness, fever, N/V/D
Need imagining especially if perforation or peritonitis is suspected--free
air=perforation; patient may have ileus, small or large bowel obstruction
Can use plain x-ray
CT or Barium enema are preferred
CT with contrast is more sensitive and accurate
◉ Identify the significance of Barrett's esophagus Answer: After
repeated exposure to gastric contents, inflammation of the esophageal
mucosa becomes chronic
Blood flow increases, erosion occurs
As erosion heals, normal squamous epithelium replaced with metaplastic
columnar epithelium containing goblet and columnar cells.
More resistant to acid and supports esophageal healing
Premalignant tissue
40-fold frisk for developing esophageal adenocarcinma
Fibrosis and scarring during healing of erosions; leads to strictures
◉ Diagnosis of GERD Answer: made on history alone: sensitivity of
80%
if symptoms are unclear/patient does not respond to 4 weeks of empiric
tx
made by ambulatory esophageal pH monitoring
,pH <4 above the lower esophageal sphincter correlates with symptoms =
GERD
EDG with biopsy-Barrett's esohagus
Normal results in 50% of symptomatic patients
◉ Risks of GERD Answer: Obesity
Increase after age 50
Equal across gender, ethnic, and cultural groups
◉ Treatments of GERD Answer: Small frequent meals-main meal in
midday
Avoid trigger foods
No bedtime snacks: no eating <4 hours prior to bed
Eliminate caffeine, stop smoking, avoid tight fitting clothing, sleep with
head of the bed elevated.
◉ Medications for GERD Answer: antacids or OTC H2 (Tagamet,
zantac, axid)
Rx-strength H2 (ranitidine 150mg BID, famotidine 20mg BID) or PPI
(pantoprazole 40mg daily, omeprazole 20mg daily)
PPI (Omeprazole 40mg daily)
Surgery (fundoplication)
, ◉ Differential diagnosis of acute abd pain Answer: Acute appendicitis
Acute pancreatitis
Acute cholecystitis
◉ Acute appendicitis Answer: Inflammation of the vermiform appendix;
due to obstruction or infection
Most common surgical emergency of the abdomen
Hollow tube - most common cause is obstruction of appendix
Fecaltih - hard lump of fecal matter
Undigested seeds
Pinworm infections
Lymphoid follicle growth/lymphoid hyperplasia Symptoms
4. Symptoms
Nausea/vomiting
RLQ pain
Guarding
◉ Acute pancreatitis Answer: Sudden inflammation and hemorrhaging
of the pancreas due to destruction by its own digestive enzymes
1. Autodigestion
Most of the time mild, but can be severe
Pancreas
