NR603 CEA Prep: GI Exam with All Correct & 100%
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Which of the following gastrointestinal changes is associated with normal aging? ✔Correct
Answer-Decreased production of gastric acid
A 63-year-old male presents with a suspected lower GI bleed. He reports passing frank small
amounts of blood several times today. He denies use of NSAID's or blood thinners. What questions
would be important to ask to further differentiate your diagnosis? ✔Correct Answer-All options are
appropriate
Rationale: All the above, these questions would help determine if this bleed was associated with a
potential diverticular bleed (typically painless), painful bowel movement associated with IBD
(UC/Crohn's), and changes in bowel habit/colonoscopy risk for malignancy.
Anorexia nervosa occurs most commonly in which of the following? ✔Correct Answer-High-level
athletes
A 29-year-old male presents with severe abdominal pain, he has a history of alcohol abuse, and
recurrent pancreatitis. Patient's Lipase is elevated, and he has nausea and vomiting as well.
Abdominal CT shows inflammatory changes around the pancreas. What is the most important
intervention to consider in the acute phase? ✔Correct Answer-Admit to the hospital for fluid
resuscitation to avoid hypovolemic state, and reduce risk of developing further complications
An adult female returns to the clinic with severe profuse watery diarrhea, abdominal pain, and
cramping after treatment with Cipro x 10 days. WBC is 12.5, stool culture is positive for c diff. The NP
would recommend: ✔Correct Answer-Metronidazole 500 tid for 10-14 d
Rationale: Treatment of C Diff should include metronidazole (Flagyl) or PO vancomycin.
An adult presents with increasing abdominal girth. The nurse practitioner suspects ascites. Which
finding on physical exam would confirm the suspicion of ascites? ✔Correct Answer-Dullness shifts
to the more dependent side
Rationale: In the fluid wave test for ascites, dullness shifts to the more dependent side. The impulse
of the wave should be easily palpable.
A 45-year-old woman presents with chronic diarrhea, weight loss, and abdominal pain. Endoscopy
reveals villous atrophy of the small intestine. What is the most appropriate initial management?
✔Correct Answer-Gluten-free diet
Rationale: Villous atrophy in the small intestine supports a diagnosis of celiac disease which can be
managed by avoidance of gluten.
A 49-year-old male presents to your service with symptoms of fever 102.3, jaundice, and abdominal
pain. Imagining reveals a biliary obstruction. Which diagnosis is most likely for this patient?
✔Correct Answer-Cholangitis
, Rationale: The most common cause of this is a biliary stone causing obstruction and allowing for
ascending of bacteria and infection
An adult female presents with a 1-week history of left lower quadrant abdominal pain. T=101.2
degrees F. (38.4 degrees C) and an elevated WBC count. This is the patient's first episode of severe
abdominal pain. The nurse practitioner suspects diverticulitis. Which of the following diagnostic tests
would confirm the diagnosis? ✔Correct Answer-CT scan of the abdomen
The most common side effect of the oral ribavirin used in the treatment of hepatitis C is: ✔Correct
Answer-Depression
Rationale: It is important to note that ribavirin will not treat hepatitis C unless it is taken with
another medication called pegylated-interferon α (PEG-IFNα).
A 59-year-old male presents with symptoms of abdominal pain, jaundice, and weight loss which he
has not been trying to lose weight. What would be a malignancy associated with these symptoms?
✔Correct Answer-Pancreatic cancer
Rationale: Pancreatic cancer, the most typically presentation includes abdominal pain, jaundice, and
weight loss. Although weight loss and abdominal pain may be present with adenocarcinoma it is
unlikely to present with jaundice, and you're unlikely to have abdominal pain or jaundice with any
esophageal malignancy.
An adult female with rheumatoid arthritis presents to the office for a follow up. She is currently
taking methotrexate and over the counter Ibuprofen. Today she complains of severe stomach pain
and intense abdominal cramping. After the nurse practitioner makes appropriate adjustments to the
patient's medication regimen, the patient still complains of abdominal discomfort and reports dark
stools. The practitioner suspects: ✔Correct Answer-Gastric ulceration
Rationale: The overuse of NSAIDs such as ibuprofen (Advil) have caused the prostaglandin inhibition-
related thinning of the mucosal lining of the stomach, thereby predisposing the patient to gastric
ulceration and GI bleeding.
Where can Crohn's disease be located within the GI tract and how does it present (continuous or
patchy)? ✔Correct Answer-Patchy inflammation throughout the small bowel and colon
Rationale: Crohn's disease unlike UC is a patchy inflammation that can be found throughout the small
bowel and colon.
A 42-year-old female presents with large watery frequent stools. She also reports abdominal pain
and cramping, bloating and gas. The likely anatomical source of her diarrhea is where? ✔Correct
Answer-Small intestine
Rationale: These are all signs typically seen with small intestine diarrhea. Diarrhea of large intestinal
origin often presents with frequent, regular, small volume, and often painful bowel movements
A patient states that his girlfriend was recently diagnosed with hepatitis, and he tests positive for
hepatitis C. He expresses fear of the diagnosis because his father died after a liver transplantation.
Which existing information in the patient's history is the most significant factor in the progression of
liver failure? ✔Correct Answer-Chronic alcohol intake
Verified Answers |Actual Complete Exam| Guaranteed
to Pass
Which of the following gastrointestinal changes is associated with normal aging? ✔Correct
Answer-Decreased production of gastric acid
A 63-year-old male presents with a suspected lower GI bleed. He reports passing frank small
amounts of blood several times today. He denies use of NSAID's or blood thinners. What questions
would be important to ask to further differentiate your diagnosis? ✔Correct Answer-All options are
appropriate
Rationale: All the above, these questions would help determine if this bleed was associated with a
potential diverticular bleed (typically painless), painful bowel movement associated with IBD
(UC/Crohn's), and changes in bowel habit/colonoscopy risk for malignancy.
Anorexia nervosa occurs most commonly in which of the following? ✔Correct Answer-High-level
athletes
A 29-year-old male presents with severe abdominal pain, he has a history of alcohol abuse, and
recurrent pancreatitis. Patient's Lipase is elevated, and he has nausea and vomiting as well.
Abdominal CT shows inflammatory changes around the pancreas. What is the most important
intervention to consider in the acute phase? ✔Correct Answer-Admit to the hospital for fluid
resuscitation to avoid hypovolemic state, and reduce risk of developing further complications
An adult female returns to the clinic with severe profuse watery diarrhea, abdominal pain, and
cramping after treatment with Cipro x 10 days. WBC is 12.5, stool culture is positive for c diff. The NP
would recommend: ✔Correct Answer-Metronidazole 500 tid for 10-14 d
Rationale: Treatment of C Diff should include metronidazole (Flagyl) or PO vancomycin.
An adult presents with increasing abdominal girth. The nurse practitioner suspects ascites. Which
finding on physical exam would confirm the suspicion of ascites? ✔Correct Answer-Dullness shifts
to the more dependent side
Rationale: In the fluid wave test for ascites, dullness shifts to the more dependent side. The impulse
of the wave should be easily palpable.
A 45-year-old woman presents with chronic diarrhea, weight loss, and abdominal pain. Endoscopy
reveals villous atrophy of the small intestine. What is the most appropriate initial management?
✔Correct Answer-Gluten-free diet
Rationale: Villous atrophy in the small intestine supports a diagnosis of celiac disease which can be
managed by avoidance of gluten.
A 49-year-old male presents to your service with symptoms of fever 102.3, jaundice, and abdominal
pain. Imagining reveals a biliary obstruction. Which diagnosis is most likely for this patient?
✔Correct Answer-Cholangitis
, Rationale: The most common cause of this is a biliary stone causing obstruction and allowing for
ascending of bacteria and infection
An adult female presents with a 1-week history of left lower quadrant abdominal pain. T=101.2
degrees F. (38.4 degrees C) and an elevated WBC count. This is the patient's first episode of severe
abdominal pain. The nurse practitioner suspects diverticulitis. Which of the following diagnostic tests
would confirm the diagnosis? ✔Correct Answer-CT scan of the abdomen
The most common side effect of the oral ribavirin used in the treatment of hepatitis C is: ✔Correct
Answer-Depression
Rationale: It is important to note that ribavirin will not treat hepatitis C unless it is taken with
another medication called pegylated-interferon α (PEG-IFNα).
A 59-year-old male presents with symptoms of abdominal pain, jaundice, and weight loss which he
has not been trying to lose weight. What would be a malignancy associated with these symptoms?
✔Correct Answer-Pancreatic cancer
Rationale: Pancreatic cancer, the most typically presentation includes abdominal pain, jaundice, and
weight loss. Although weight loss and abdominal pain may be present with adenocarcinoma it is
unlikely to present with jaundice, and you're unlikely to have abdominal pain or jaundice with any
esophageal malignancy.
An adult female with rheumatoid arthritis presents to the office for a follow up. She is currently
taking methotrexate and over the counter Ibuprofen. Today she complains of severe stomach pain
and intense abdominal cramping. After the nurse practitioner makes appropriate adjustments to the
patient's medication regimen, the patient still complains of abdominal discomfort and reports dark
stools. The practitioner suspects: ✔Correct Answer-Gastric ulceration
Rationale: The overuse of NSAIDs such as ibuprofen (Advil) have caused the prostaglandin inhibition-
related thinning of the mucosal lining of the stomach, thereby predisposing the patient to gastric
ulceration and GI bleeding.
Where can Crohn's disease be located within the GI tract and how does it present (continuous or
patchy)? ✔Correct Answer-Patchy inflammation throughout the small bowel and colon
Rationale: Crohn's disease unlike UC is a patchy inflammation that can be found throughout the small
bowel and colon.
A 42-year-old female presents with large watery frequent stools. She also reports abdominal pain
and cramping, bloating and gas. The likely anatomical source of her diarrhea is where? ✔Correct
Answer-Small intestine
Rationale: These are all signs typically seen with small intestine diarrhea. Diarrhea of large intestinal
origin often presents with frequent, regular, small volume, and often painful bowel movements
A patient states that his girlfriend was recently diagnosed with hepatitis, and he tests positive for
hepatitis C. He expresses fear of the diagnosis because his father died after a liver transplantation.
Which existing information in the patient's history is the most significant factor in the progression of
liver failure? ✔Correct Answer-Chronic alcohol intake
