NURS 8114 Module 1: GI System – 2025
Advanced Practice Study Guide REAL
EXAM!!!
Route of Food or Drink from the Mouth ANSWER ✔---Esophagus > stomach (hydrochloric acid
intrinsic factor) > duodenum (bile, amylase, lipase) > jejunum > ileum > colon > cecum > rectum > anus
Organs of the RUA of the abdomen ANSWER ✔---Liver, gallbladder, ascending colon, kidney (R),
pancreas (small portion); R kidney is lower than the left because of displacement by the liver
Organs of the LUA of the abdomen ANSWER ✔---Stomach, pancreas, descending colon, kidney (L)
Organs in the RLQ of the abdomen ANSWER ✔---Appendix, ileum, cecum, ovary (R)
Organs in the LLQ of the abdomen ANSWER ✔---Sigmoid colon, ovary (L)
Organs in the suprapubic area ANSWER ✔---Bladder, uterus, rectum
,Psoas/Iliopsoas (supine) ANSWER ✔---Flex the hip 90 degrees; ask the patient to push against
resistance (examiner's hand) and to straighten the leg (+), finding if RLQ abd pain occur during
manuever.
Obturator Sign (supine) ANSWER ✔---Rotate (R) hip thru ROM. (+) sign is the pain w/ mvmt or
flexion of hip. (+) if inward rotation of hip causes RLQ abd pain
Rovsing's sign (supine) ANSWER ✔---(+) if deep palpation of the LLQ of abd results in referred pain
to the RLQ (sign of peritonitis)
McBurney's Point ANSWER ✔---area between the superior iliac crest & umbilicus in the RLQ (+) sign
of possible acute appendicitis
Markle Test (Heel Jar) ANSWER ✔---Instruct patient to raise heels and then drop them suddenly. Alt
pt can jump in place. (+) if pain is elicited or if pt refuses to perform b/c of pain
Involuntary Guarding ANSWER ✔---with abd palpation, the abd muscle reflexively become tense or
board like (suspect acute or surgical abdomen). Refer. to the ED
Rebound tenderness ANSWER ✔---c/o worsening abd pain when the hand is released after
palpation of abd. compared to the pain felt during deep palpation (suspect acute or surgical abdomen, if
(+) refer to ED
Murphy's Manuever ANSWER ✔---Press deeply on the RUQ under the costal border (or medial to
the midclavicular line) during inspiration. (+) finding if mid inspiratory arrest (Murphy's sign). (+) finding
with acute cholecystitis. Remember, the absence of this sign does not rule out cholecystitis
Carnett's Test ANSWER ✔---abdominal maneuver that is used to determine if abd. pain is from
inside the abdomen or if it is located on the abdominal wall. Pt is supine, arms crossed over their chest.
Instruct patient to lift up shoulders from the table so that the abd. muscles (rectus abdominus) tighten
(pain increases = source of pain is the abd. wall; pain decreases = pain is inside the abdomen
, Involuntary Weight Loss ANSWER ✔---clinically significant when it exceeds 5% or more of usual body
weight over a 6 to 12 month period
Most common causes of involuntary weight loss ANSWER ✔---cancer
GI disorders
dementia or depression
When involuntary weight loss is identified, you should ANSWER ✔---Take a good hx
medications
PE
labs (CBC, liver panel, kidney panel, serologic tests (HIV), TSH, UA, FOBT
Radiology - CXR, upper GI series
Don't miss diagnosis of unintentional weight loss? ANSWER ✔---MALIGNANCY
Unintentional weight loss treatment ANSWER ✔---Appetite stimulants: corticosteroids,
progestational agents megestrol (megace); dronabinol (marinol); serotonin antagonists (ondansetron)
Anabolic agents: growth hormone, testosterone derivatives
Anticatabolic agents: omega-3 fatty acids, pentoxifylline (Trental), hydrazine sulfate (Sehydrin),
thalidomide (Thalomid)
When to refer ANSWER ✔---weight loss caused by malabsorption
persistent nutritional deficiencies despite adequate supplementation
weight loss as a result of anorexia or bulimia
When to admit ANSWER ✔---severe protein-energy malnutrition, including the syndromes of
kwashiorkor and marasmus
vitamin deficiency syndromes
cachexia with anticipated progressive weight loss secondary to unmanageable psychiatric disease
Advanced Practice Study Guide REAL
EXAM!!!
Route of Food or Drink from the Mouth ANSWER ✔---Esophagus > stomach (hydrochloric acid
intrinsic factor) > duodenum (bile, amylase, lipase) > jejunum > ileum > colon > cecum > rectum > anus
Organs of the RUA of the abdomen ANSWER ✔---Liver, gallbladder, ascending colon, kidney (R),
pancreas (small portion); R kidney is lower than the left because of displacement by the liver
Organs of the LUA of the abdomen ANSWER ✔---Stomach, pancreas, descending colon, kidney (L)
Organs in the RLQ of the abdomen ANSWER ✔---Appendix, ileum, cecum, ovary (R)
Organs in the LLQ of the abdomen ANSWER ✔---Sigmoid colon, ovary (L)
Organs in the suprapubic area ANSWER ✔---Bladder, uterus, rectum
,Psoas/Iliopsoas (supine) ANSWER ✔---Flex the hip 90 degrees; ask the patient to push against
resistance (examiner's hand) and to straighten the leg (+), finding if RLQ abd pain occur during
manuever.
Obturator Sign (supine) ANSWER ✔---Rotate (R) hip thru ROM. (+) sign is the pain w/ mvmt or
flexion of hip. (+) if inward rotation of hip causes RLQ abd pain
Rovsing's sign (supine) ANSWER ✔---(+) if deep palpation of the LLQ of abd results in referred pain
to the RLQ (sign of peritonitis)
McBurney's Point ANSWER ✔---area between the superior iliac crest & umbilicus in the RLQ (+) sign
of possible acute appendicitis
Markle Test (Heel Jar) ANSWER ✔---Instruct patient to raise heels and then drop them suddenly. Alt
pt can jump in place. (+) if pain is elicited or if pt refuses to perform b/c of pain
Involuntary Guarding ANSWER ✔---with abd palpation, the abd muscle reflexively become tense or
board like (suspect acute or surgical abdomen). Refer. to the ED
Rebound tenderness ANSWER ✔---c/o worsening abd pain when the hand is released after
palpation of abd. compared to the pain felt during deep palpation (suspect acute or surgical abdomen, if
(+) refer to ED
Murphy's Manuever ANSWER ✔---Press deeply on the RUQ under the costal border (or medial to
the midclavicular line) during inspiration. (+) finding if mid inspiratory arrest (Murphy's sign). (+) finding
with acute cholecystitis. Remember, the absence of this sign does not rule out cholecystitis
Carnett's Test ANSWER ✔---abdominal maneuver that is used to determine if abd. pain is from
inside the abdomen or if it is located on the abdominal wall. Pt is supine, arms crossed over their chest.
Instruct patient to lift up shoulders from the table so that the abd. muscles (rectus abdominus) tighten
(pain increases = source of pain is the abd. wall; pain decreases = pain is inside the abdomen
, Involuntary Weight Loss ANSWER ✔---clinically significant when it exceeds 5% or more of usual body
weight over a 6 to 12 month period
Most common causes of involuntary weight loss ANSWER ✔---cancer
GI disorders
dementia or depression
When involuntary weight loss is identified, you should ANSWER ✔---Take a good hx
medications
PE
labs (CBC, liver panel, kidney panel, serologic tests (HIV), TSH, UA, FOBT
Radiology - CXR, upper GI series
Don't miss diagnosis of unintentional weight loss? ANSWER ✔---MALIGNANCY
Unintentional weight loss treatment ANSWER ✔---Appetite stimulants: corticosteroids,
progestational agents megestrol (megace); dronabinol (marinol); serotonin antagonists (ondansetron)
Anabolic agents: growth hormone, testosterone derivatives
Anticatabolic agents: omega-3 fatty acids, pentoxifylline (Trental), hydrazine sulfate (Sehydrin),
thalidomide (Thalomid)
When to refer ANSWER ✔---weight loss caused by malabsorption
persistent nutritional deficiencies despite adequate supplementation
weight loss as a result of anorexia or bulimia
When to admit ANSWER ✔---severe protein-energy malnutrition, including the syndromes of
kwashiorkor and marasmus
vitamin deficiency syndromes
cachexia with anticipated progressive weight loss secondary to unmanageable psychiatric disease
